In recent decades low-income countries experienced an increasing trend in dental caries among children, particularly recorded in 12-year olds, which is the principal WHO indicator age group for children. This increases the risks of negative affects on children's life. Some data exist on the oral health status of children in low-income countries of Southeast Asia. However, information on how oral health is associated with socio-behavioural factors is almost not available. The aims of this study were to: assess the level of oral health of Lao 12-year-olds in urban and semi-urban settings; study the impact of poor oral health on quality of life; analyse the association between oral health and socio-behavioural factors; investigate the relation between obesity and oral health.
A cross sectional study of 12-year old schoolchildren chosen by multistage random sampling in Vientiane, Lao P.D.R (hereafter Laos). The final study population comprised 621 children. The study consisted of: clinical registration of caries and periodontal status, and scores for dental trauma according to WHO; structured questionnaire; measurement of anthropometric data. Frequency distributions for bi-variate analysis and logistic regression for multivariate analysis were used for assessment of statistical association between variables.
Mean DMFT was 1.8 (SEM = 0.09) while caries prevalence was 56% (CI95 = 52-60). Prevalence of gingival bleeding was 99% (CI95 = 98-100) with 47% (CI95 = 45-49) of present teeth affected. Trauma was observed in 7% (CI95 = 5-9) of the children. High decay was seen in children with dental visits and frequent consumption of sweet drinks. Missed school classes, tooth ache and several impairments of daily life activities were associated with a high dD-component. No associations were found between Body Mass Index (BMI) and oral health or common risk factors. The multivariate analyses revealed high risk for caries for children with low or moderate attitude towards health, a history of dental visits and a preference for drinking sugary drinks during school hours. Low risk was found for children with good or average perception of own oral health. High risk for gingival bleeding was seen in semi-urban children and boys.
Although the caries level is low it causes considerable negative impact on daily life. School based health promotion should be implemented focussing on skills based learning and attitudes towards health.
Social and emotional well-being is an important component of overall health. In the Indigenous Australian context, risk indicators of poor social and emotional well-being include social determinants such as poor education, employment, income and housing as well as substance use, racial discrimination and cultural knowledge. This study sought to investigate associations between oral health-related factors and social and emotional well-being in a birth cohort of young Aboriginal adults residing in the northern region of Australia's Northern Territory.
Data were collected on five validated domains of social and emotional well-being: anxiety, resilience, depression, suicide and overall mental health. Independent variables included socio-demographics, dental health behaviour, dental disease experience, oral health-related quality of life, substance use, racial discrimination and cultural knowledge.
After adjusting for other covariates, poor oral health-related items were associated with each of the social and emotional well-being domains. Specifically, anxiety was associated with being female, having one or more decayed teeth and racial discrimination. Resilience was associated with being male, having a job, owning a toothbrush, having one or more filled teeth and knowing a lot about Indigenous culture; while being female, having experienced dental pain in the past year, use of alcohol, use of marijuana and racial discrimination were associated with depression. Suicide was associated with being female, having experience of untreated dental decay and racial discrimination; while being female, having experience of dental disease in one or more teeth, being dissatisfied about dental appearance and racial discrimination were associated with poor mental health.
The results suggest there may be value in including oral health-related initiatives when exploring the role of physical conditions on Indigenous social and emotional well-being.
Dental caries, dental pain and reported oral problems influence people's oral quality of life and thus their perceived need for dental care. So far there is scant information as to the psychosocial impacts of dental diseases and the perceived treatment need in child populations of sub-Saharan Africa.
Focusing on primary school students in Kilwa, Tanzania, a district deprived of dental services and with low fluoride concentration in drinking water, this study aimed to assess the prevalence of dental pain and oral impacts on daily performances (OIDP), and to describe the distribution of OIDP by socio-demographics, dental caries, dental pain and reported oral problems. The relationship of perceived need estimates with OIDP was also investigated.
A cross-sectional study was conducted in 2008. A total of 1745 students (mean age 13.8 yr, sd = 1.67) completed an extensive personal interview and under-went clinical examination. The impacts on daily performances were assessed using a Kiswahili version of the Child-OIDP instrument and caries experience was recorded using WHO (1997) criteria.
A total of 36.2% (41.3% urban and 31.4% rural, p < 0.001) reported at least one OIDP. The prevalence of dental caries was 17.4%, dental pain 36.4%, oral problems 54.1% and perceived need for dental treatment 46.8% in urban students. Corresponding estimates in rural students were 20.8%, 24.4%, 43.3% and 43.8%. Adjusted OR for reporting oral impacts if having dental pain ranged from 2.5 (95% CI 1.8–3.6) (problem smiling) to 4.7 (95% CI 3.4–6.5) (problem sleeping),- if having oral problems, from 1.9 (95% CI 1.3–2.6) (problem sleeping) to 3.8 (95% CI 2.7–5.2) (problem eating) and if having dental caries from 1.5 (95% CI 1.1–2.0) (problem eating) to 2.2 (95% CI 1.5–2.9) (problem sleeping). Students who perceived need for dental care were less likely to be females (OR = 0.8, 95% CI 0.6–0.9) and more likely to have impacts on eating (OR = 1.9, 95% CI 1.4–2.7) and tooth cleaning (OR = 1.6, 95% CI 1.6–2.5).
Substantial proportions of students suffered from untreated dental caries, oral impacts on daily performances and perceived need for dental care. Dental pain and reported oral problems varied systematically with OIDP across the eight impacts considered. Eating and tooth cleaning problems discriminated between subjects who perceived need for dental treatment and those who did not.
Explanations for the social gradient in health status are informed by the rare exceptions. This cross-sectional observational study examined one such exception, the “Latino paradox” by investigating the presence of a Latino advantage in oral health-related quality of life and the effect of nativity status on this relationship. A nationally representative sample of adults (n = 4208) completed the National Health and Nutrition Examination Survey (NHANES) 2003–2004. The impact of oral disorders on oral health-related quality of life was evaluated using the NHANES Oral Health Impact Profile. Exposures of interest were race, ethnicity and nativity status. Covariates included sociodemographic characteristics, smoking status, self-rated health, access to dental care and number of teeth. Unconditional logistic regression models estimated odds of impaired oral health-related quality of life for racial/ethnic and nativity groups compared to the Non-Latino white population. Overall prevalence of impaired oral health-related quality of life was 15.1%. A protective effect of Latino ethnicity was modified by nativity status, such that Latino immigrants experienced substantially better outcomes than non-Latino whites. However the effect was limited to first-generation Latinos. U.S. born Latinos did not share the oral health-related quality of life advantage of their foreign-born counterparts. This advantage was not attributable to the healthy migrant phenomenon since immigrants of non-Latino origin did not differ from Non-Latino whites. The excess risk among Non-Hispanic Blacks was rendered non-significant after adjustment for socioeconomic position. A protective effect conferred by Latino nativity is unexpected given relatively disadvantaged socioeconomic position of this group, their language barrier and restrictions to needed dental care. As the Latino advantage in oral health-related quality of life is not explained by healthy immigrant selection, cultural explanations seem more likely than explanations based on characteristics of individuals.
USA; Acculturation; Hispanic; Disparities; Epidemiology; Social Class; Oral Health; nativity; Latino paradox; ethnicity
In western Sweden, the aim was to study the associations between oral health variables and total and central adiposity, respectively, and to investigate the influence of socio-economic factors (SES), lifestyle, dental anxiety and co-morbidity.
The subjects constituted a randomised sample from the 1992 data collection in the Prospective Population Study of Women in Gothenburg, Sweden (n = 999, 38- > =78 yrs). The study comprised a clinical and radiographic examination, together with a self-administered questionnaire. Obesity was defined as body mass index (BMI) > =30 kg/m2, waist-hip ratio (WHR) > =0.80, and waist circumference >0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders.
The mean BMI value was 25.96 kg/m2, the mean WHR 0.83, and the mean waist circumference 0.83 m. The number of teeth, the number of restored teeth, xerostomia, dental visiting habits and self-perceived health were associated with both total and central adiposity, independent of age and SES. For instance, there were statistically significant associations between a small number of teeth (<20) and obesity: BMI (OR 1.95; 95% CI 1.40-2.73), WHR (1.67; 1.28-2.19) and waist circumference (1.94; 1.47-2.55), respectively. The number of carious lesions and masticatory function showed no associations with obesity. The obesity measure was of significance, particularly with regard to behaviour, such as irregular dental visits, with a greater risk associated with BMI (1.83; 1.23-2.71) and waist circumference (1.96; 1.39-2.75), but not with WHR (1.29; 0.90-1.85).
Associations were found between oral health and obesity. The choice of obesity measure in oral health studies should be carefully considered.
Body mass index; Waist-to-hip ratio; Waist circumference; Number of teeth; Health behaviour
The aims of the study were to assess the impact of both positive (PA) and negative affect (NA) on self-reported oral health-related quality of life and to determine the effect of including affectivity on the relationship between oral health-related quality of life and a set of explanatory variables consisting of oral health status, socio-economic status and dental visiting pattern.
A random sample of 45–54 year-olds from metropolitan Adelaide, South Australia was surveyed by mailed self-complete questionnaire during 2004–05 with up to four follow-up mailings of the questionnaire to non-respondents (n = 986 responded, response rate = 44.4%). Oral health-related quality of life was measured using OHIP-14 and affectivity using the Bradburn scale. Using OHIP-14 and subscales as the dependent variables, regression models were constructed first using oral health status, socio-economic characteristics and dental visit pattern and then adding PA and NA as independent variables, with nested models tested for change in R-squared values.
PA and NA exhibited a negative correlation of -0.49 (P < 0.01). NA accounted for a larger percentage of variance in OHIP-14 scores (3.0% to 7.3%) than PA (1.4% to 4.6%). In models that included both PA and NA, PA accounted for 0.2% to 1.1% of variance in OHIP-14 scores compared to 1.8% to 3.9% for NA.
PA and NA both accounted for additional variance in quality of life scores, but did not substantially diminish the effect of established explanatory variables such as oral health status, socio-economic status and dental visit patterns.
Chronic, untreated oral disease adversely affects one's systemic health, quality of life, and economic productivity. This study evaluated the effect of rehabilitative dental treatment on the oral-health-related quality of life and employment of welfare recipients. Three hundred and seventy-seven participants in a novel welfare dental program received oral examinations, questionnaires, and rehabilitative dental treatment. Seventy-nine percent of participants exhibited improvement in their oral-health-related quality-of-life scores following dental treatment. Improved OHIP-14 change scores were associated with being Caucasian or African-American, initial poor general health, severity of treatment urgency, worse baseline oral-health-related quality-of-life scores, subsequent patient satisfaction with the Dental Program, and resolution of their chief complaint (all p < 0.04). Those who completed their dental treatment were twice as likely to achieve a favorable/neutral employment outcome (OR = 2.01, 95%CI = 1.12, 3.62). Thus, oral health improved the quality of life and employment outcome for this welfare population.
oral-health-related quality of life; dental program; dental treatment; welfare; employment
Promoting oral health of adolescents is important for improvement of oral health globally. This study used baseline-data from LASH-project targeting secondary students to; 1) assess frequency of poor oral hygiene status and oral impacts on daily performances, OIDP, by socio-demographic and behavioural characteristics, 2) examine whether socio-economic and behavioural correlates of oral hygiene status and OIDP differed by gender and 3) examine whether socio-demographic disparity in oral health was explained by oral health-related behaviours.
Cross-sectional study was conducted in 2009 using one-stage cluster sampling design. Total of 2412 students (mean age 15.2 yr) completed self-administered questionnaires, whereas 1077 (mean age 14.9 yr) underwent dental-examination. Bivariate analyses were conducted using cross-tabulations and chi-square statistics. Multiple variable analyses were conducted using stepwise standardized logistic regression (SLR) with odds ratios and 95% Confidence intervals (CI).
44.8% presented with fair to poor OHIS and 48.2% reported any OIDP. Older students, those from low socio-economic status families, had parents who couldn't afford dental care and had low educational-level reported oral impacts, poor oral hygiene, irregular toothbrushing, less dental attendance and fewer intakes of sugar-sweetened drinks more frequently than their counterparts. Stepwise logistic regression revealed that reporting any OIDP was independently associated with; older age-groups, parents do not afford dental care, smoking experience, no dental visits and fewer intakes of sugar-sweetened soft drinks. Behavioural factors accounted partly for association between low family SES and OIDP. Low family SES, no dental attendance and smoking experience were most important in males. Low family SES and fewer intakes of sugar-sweetened soft drinks were the most important correlates in females.
Socio-behavioural factors associated with higher odds ratios for poor OHIS were; older age, belonging to the poorest household category and having parents who did not afford dental care across both genders.
Disparities in oral hygiene status and OIDP existed in relation to age, affording dental care, smoking and intake of sugar sweetened soft drinks. Gender differences should be considered in intervention studies, and modifiable behaviours have some relevance in reducing social disparity in oral health.
Despite its relatively recent emergence over the past few decades, oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research. OHRQoL is a multidimensional construct that includes a subjective evaluation of the individual’s oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self. It has wide-reaching applications in survey and clinical research. OHRQoL is an integral part of general health and well-being. In fact, it is recognized by the World Health Organization (WHO) as an important segment of the Global Oral Health Program (2003). This paper identifies the what, why, and how of OHRQoL and presents an oral health theoretical model. The relevance of OHRQoL for dental practitioners and patients in community-based dental practices is presented. Implications for health policy and related oral health disparities are also discussed. A supplemental Appendix contains a Medline and ProQuest literature search regarding OHRQoL research from 1990-2010 by discipline and research design (e.g., descriptive, longitudinal, clinical trial, etc.). The search identified 300 articles with a notable surge in OHRQoL research in pediatrics and orthodontics in recent years.
quality of life; health services research; patient outcomes; evidence-based dentistry/health care; community dentistry; psychosocial factors
A total of 137 patients in a Hamburg dental fears clinic, a majority of them persons with dental phobia, were administered questionnaires regarding dental fears and health-related quality of life. Subjects also underwent a dental examination. Dental fears were shown to be associated with dental health problems. Women were more fearful than men, and younger persons were more fearful than older ones. Patients of lower social economic status had somewhat more dental health problems compared with more economically privileged persons. This study also shows, with the use of the SF-36, that dental fears are negatively related to quality of life, especially as measured in areas such as psychological well-being, vitality, and social functioning.
Dental caries among young children are a global problem. Scant attention is paid towards primary teeth, leading to high prevalence of dental caries. There are only few studies done in Sri Lanka, addressing oral hygiene among preschool children. Scientific evidence is in need to persuade authorities to establish a programme promoting oral hygiene among preschool children.
A descriptive cross sectional study was conducted in Ragama Medical officer of Health area. Consecutive children between 2 – 5 years of age, attending child welfare clinics were recruited for the study. Practices related to dental hygiene and socio-economic characteristics were obtained using an interviewer administered questionnaire. Mouth was examined for evidence of dental caries. Data collection and examination were done by two doctors who were trained for this purpose. The data were analysed using SSPS version 16.
Total of 410 children were included. None had a routine visits to a dentist. Practices related to tooth brushing were satisfactory. Prevalence of dental caries gradually increased with age to reach 68.8% by 5 years. Mean total decayed-extracted-filled (deft) score for the whole sample was 1.41 and Significant caries index (SIC) was 4.09. Decayed tooth were the main contributor for the deft score and Care index was only 1.55. Girls had a significantly higher prevalence of caries than boys.
Dental care provided for Sri Lankan preschool children appears to be unsatisfactory as prevalence of dental caries among this cohort of preschool children was very high. There is an urgent need to improve dental care facilities for Sri Lankan preschool children.
Dental caries; Deft score; SIC index; Care index
Rationale: oral health is one of the fundamental steps to general health, well being and a determinant factor for the quality of life.
Objective of this cross–sectional study is to assess the oral–systemic health and the treatment needs among the institutionalized people in a homeless center, with high prevalence of co–morbidities and barriers to care.
Methods and Results: after getting the informed consent, 51 adults from a community, which is disadvantaged from a socio–economic and medical point of view, were studied: frequently with multiple general diseases treated with medicines that produce oral side effects, a high need of treatment and the lack of a dental office. The subjects were orally examined from a clinical point of view and received a questionnaire with regard to the presence of the health risk factors. General health status and drug treatments of subjects were evaluated based on medical records. Results showed that oral health status of the subjects is precarious, oral hygiene is poor and the subjects are exposed to common risk factors for oral and systemic diseases: tobacco use, alcohol consumption, diet, poor hygiene and history of cancer.
Discussion: if their needs are not met, the oral health will be persistently poor and will further deteriorate during their residency, because of increasing care dependency and subsequent lack of adequate oral health care. Despite great achievements in oral and general health of populations, problems still remain in many communities, particularly among underprivileged groups.
institutionalized people; chronic diseases; risk factors; medications; treatment needs
Interest is growing on conceptualizing dental disease aetiology under the life-course approach. The aim of this study was to assess the association of dental caries experience with the major components of life-course approach, health- and behavioral capital, among Turkish and Finnish pre-adolescents, with different family-related characteristics, as this association has not been explored yet.
A cross-sectional study of Finnish (n=338) and Turkish (n=611) pre-adolescents was undertaken with questionnaires and oral health data.
Turkish pre-adolescents, more dentally diseased (84%) than the Finnish (33%) (P<.01), had lower means of health (body height-weight) and behavioural (self-esteem, tooth-brushing self-efficacy) capital, (P<.01). Finnish pre-adolescents were less likely to live in two-parent families (P=.001) and spent less time with their mothers (P<.05). Turkish pre-adolescents with high levels of self-esteem were more likely to spend time with their mothers and less likely to live in families with three or more children (28%) than were their counterparts with low levels of self-esteem (41%). Such associations were not evident among Finnish pre-adolescents (P>.05). Health capital, in terms of body height, and family-related characteristics in differing patterns, contributed to DMFT, in common, among Turkish and Finnish pre-adolescents. Self-esteem, behavioural capital was explanatory variable for DMFT only for the Turks.
Dental health of pre-adolescents was associated with health- and behavioural capital in different pathways under the influence of family-related characteristics. The cooperation of paediatricians and dentists is vital in assessment of general and dental health in a holistic context throughout the life-course, to enhance the well-being of pre-adolescents.
Life-course approach; Dental health; Body height-weight; Self-esteem; Pre-adolescents; Family-related characteristics
Need perceptions for dental care play a key role as to whether people in general will seek dental care. The aim was to assess the prevalence of perceived need of problem based dental care, dental check-ups and any type of dental care. Guided by the conceptual model of Wilson and Cleary, the relationship of perceived need for dental care with socio-demographic characteristics, clinically defined dental problems and self-reported oral health outcomes was investigated. Partial prosthetic treatment need was estimated using a socio-dental approach.
A cross-sectional survey was conducted in Pwani region and in Dar es Salaam in 2004/2005. Information from interviews and clinical examination became available for 511 urban and 520 rural adults (mean age 62.9 yr).
51.7% (95% CI 46.2, 57.0) urban and 62.5 % (95% CI 53.1, 70.9) rural inhabitants confirmed need for dental check-up, 42.9% (95% CI 36.9, 48.9) urban and 52.7% (95% CI 44.5, 60.6) rural subjects confirmed need for problem oriented care and 38.4% (95% CI 32.4, 44.6) urban versus 49.6% (95% CI 41.8, 57.4) rural residents reported need for any type of dental care. Binary and ordinal multiple logistic regression analyses revealed that adults who reported bad oral health and broken teeth were more likely to perceive need for dental care across the three outcome measures than their counterparts. Socio-demographic factors and clinically defined problems had less impact. Based on a normative and an integrated socio-dental approach respectively 39.5% and 4.7% were in need for partial dentures.
About half of the participants confirmed need for problem oriented care, dental check-ups and any type of dental care. Need perceptions were influenced by perceived oral health, clinically assessed oral problems and socio-demographic characteristics. Need estimates for partial denture was higher when based on clinical examination alone compared to an integrative socio-dental approach.
Traditional methods of measuring oral health mainly use clinical dental indices and have been complemented by oral health related quality of life (OHRQoL) measures. Most OHRQoL studies have been on adults and elderly populations. There are no systematic OHRQoL studies of a population-based sample of children. The objective of this study was to assess the prevalence, characteristics and severity of oral impacts in primary school children.
Cross-sectional study of all 1126 children aged 11–12 years in a municipal area of Suphanburi province, Thailand. An OHRQoL measure, Child-Oral Impacts on Daily Performances index (Child-OIDP) was used to assess oral impacts. Children were also clinically examined and completed a self-administered questionnaire about demographic information and oral behaviours.
89.8% of children had one or more oral impacts. The median impact score was 7.6 and mean score was 8.8. Nearly half (47.0%) of the children with impacts had impacts at very little or little levels of intensity. Most (84.8%) of those with impacts had 1–4 daily performances affected (out of 8 performances). Eating was the most common performance affected (72.9%). The severity of impacts was high for eating and smiling and low for study and social contact performances. The main clinical causes of impacts were sensitive tooth (27.9%), oral ulcers (25.8%), toothache (25.1%) and an exfoliating primary tooth (23.4%).
The study reveals that oral health impacts on quality of life in Thai primary school children. Oral impacts were prevalent, but not severe. The impacts mainly related to difficulty eating and smiling. Toothache, oral ulcers and natural processes contributed largely to the incidence of oral impacts.
oral impacts; quality of life; children
To determine the predictive value of dental readiness and psychological dimensions for oral health-related quality of life (OHRQoL) in Croatian soldiers.
The sample consisted of 402 consecutive soldiers aged 21 to 54 years classified into the following groups according to dental readiness: Class 1 – not requiring dental treatment (N = 54), Class 2 – unlikely to need emergency treatment within 12 months (N = 205), and Class 3 – very likely to need treatment within 12 months (N = 143). OHRQoL was assessed by the Oral Health Impact Profile and psychological dimensions by the Brief Symptom Inventory and Dental Anxiety Scale.
Multivariate analysis showed that Class 3 soldiers had higher frequency of psychological discomfort, psychological disability, and physical pain and handicap than Class 1 soldiers (P = 0.019). Multiple linear regression showed that longer military experience, higher level of dental anxiety, and dental unreadiness were significant predictors of lower OHRQoL (P < 0.050) but accounted for low variability. None of the single psychological symptomatic dimensions was a significant predictor of OHRQoL.
Although this study found a moderate association between OHRQoL and clinical, military, demographic, and psychological variables, the significant predictors could be used as a basis for further research of clinical and psychosocial factors of OHRQoL.
To determine the perceived oral health status and treatment needs of Nigerian dental therapists in training and dental technology students.
A descriptive cross-sectional study of students from Federal School of Dental Therapy and Technology Enugu, Nigeria was conducted using self-administered questionnaire to obtain information on demography, self-reported oral health status, knowledge of impact of oral health on daily life activity, dental attendance and perceived dental need.
The perception of oral health status and treatment need of the two groups of dental auxiliaries was the same. Fewer respondents (27.3%) rated their oral health as excellent, while 50.4% rated their oral health as good. Majority (95.5%) agreed that oral health is a part of general health and 94.6% agreed that oral health has a role in daily life.
Out of 81.4% that had previous dental treatment, scaling and polishing accounted for 66.1%. Presently, 48.8% think they need dental treatment ranging from scaling and polishing (33.9%), tooth restoration (10.3%), to extraction (1.2%).
This survey revealed that most of the students are aware that oral health is a component of general health and that it has an impact on an individual's daily life. More than half of the students perceived their oral health as good, but only a few knew that there is a need for a preventive approach to oral health as evident by the percentage that perceived scaling and polishing as a treatment need.
oral health; status; dental auxiliaries
According to World Oral Health report 2003, the prevalence of periodontitis is 86% in India. Dental care can sometimes be a forgotten part of a healthy life style. While its importance is often underestimated, the need for regular dental care cannot be overstated. Oral health has been neglected for long in India. The scarce literature on dental health awareness, attitude, oral health-related habits and behavior among the adult population in Rajasthan prompted us to assess the preventive oral health awareness and oral hygiene practices in patients attending outpatient department of Vyas Dental College and Hospital (VDCH), Jodhpur through this study.
Materials and Methods:
A total of 500 patients in the age group 15–50 years were selected using random sampling technique. A self-administered structured questionnaire including 16 multiple choice questions was given to them. The results were analyzed using percentage.
The result of this study shows an acute lack of oral hygiene awareness and limited knowledge of oral hygiene practices. In Jodhpur, few people use tooth brush.
Hence, there is an urgent need for comprehensive educational programs to promote good oral health and impart education about correct oral hygiene practices.
Motivation; oral hygiene practices; oral hygiene awareness
Oral health studies conducted so far in Nigeria have documented prevalence and incidence of dental disease using traditional clinical measures. However none have investigated the use of an oral health-related quality of life (OHRQoL) instrument to document oral health outcomes. The aims of this study are: to describe how oral health affects and impacts quality of life (QoL) and to explore the association between these affects and the oral health care seeking behavior of adults in Benin City, Edo State, Nigeria.
A cross-sectional survey recruited 356 adults aged 18–64 years from two large hospital outpatient departments and from members of a university community. Closed-ended oral health questionnaire with "effect and impact" item-questions from OHQoL-UK© instrument was administered by trained interviewers. Collected data included sociodemographic, dental visits, and effects and impact of oral health on QoL. Univariate and bivariable analyses were done and a chi-square test was used to test differences in proportions. Multivariable analyses using ANOVA examined the association between QoL factors and visits to a dentist.
Complete data was available for 83% of the participants. About 62% of participants perceived their oral health as affecting their QoL. Overall, 82%, 63%, and 77% of participants perceived that oral health has an effect on their eating or enjoyment of food, sleep or ability to relax, and smiling or laughing, respectively. Some 46%, 36%, and 25% of participants reported that oral health impact their daily activities, social activities, and talking to people, respectively. Dental visits within the last year was significantly associated with eating, speech, and finance (P < 0.05). The summary score for the oral health effects on QoL ranged from 33 to 80 with a median value of 61 (95% CI: 60, 62) and interquartile range of 52–70. Multivariable modeling suggested a model containing only education (F = 6.5, pr>F = 0.0111). The mean of effects sum score for those with secondary/tertiary education levels (mean = 61.8; 95% CI: 60.6, 62.9) was significantly higher than those with less than secondary level of education (mean = 57.2; 95% CI: 57.2, 60.6).
Most adults in the study reported that oral health affects their life quality, and have little/no impact on their quality of life. Dental visits within the last year were associated with eating, speech, and finance.
Children with Acquired Immune Deficiency Syndrome (AIDS) exhibit impaired dental status, which can affect their quality of life. This study assessed the oral health-related quality of life of these patients and associated factors.
The "Child Perceptions Questionnaire 11-14", rating overall and domain-specific (oral symptoms, functional limitations, emotional well being, and social well being) oral health-related quality of life (OHR-QoL) was completed by 88 children with AIDS assisted in the Child Institute, Sao Paulo, Brazil. Parents or guardians provided behavioural and socio-demographic information. The clinical status was provided by hospital records. OHR-QoL covariates were assessed by Poisson regression analysis.
The most affected OHR-QoL subscale concerned oral symptoms, whose rate was 23.9%. The direct answer for oral health and well being made up a rate of 47.7%. Brushing the teeth less than two times a day and viral load exceeding 10,000 HIV-RNA copies per millilitre of plasma were directly associated (p < 0.05) with a poorer oral health-related quality of life.
Children with more severe AIDS manifestations complained of poorer status of oral symptoms, functional limitations, emotional and social well being related to their oral health. Recognizing the factors that are associated with poorer OHR-QoL in children with AIDS may contribute to the planning of dental services for this population.
There are scarce evidences that evaluated the impact of periodontal disease on oral health-related quality of life (OHRQoL) taking marginal gingival alterations into consideration. Thus, this study aimed to verify the association between OHRQoL and gingival enlargement and gingival bleeding in subjects under fixed orthodontic treatment (FOT).
330 participants under FOT for at least 6 months were examined by a single, calibrated examiner for periodontal variables and dental aesthetic index. Socio-economic background, body mass index, time with orthodontic appliances, and use of dental floss were assessed by oral interviews. OHRQoL was evaluated using the oral health impact profile (OHIP-14) questionnaire. The assessment of associations used unadjusted and adjusted Poisson regression models.
Higher impacts on the OHIP-14 overall were observed in subjects who presented higher levels of anterior gingival enlargement (RR 2.83; 95% CI 2.60-3.09), were non-whites (RR 1.29; 95% CI 1.15-1.45), had household income lower than five national minimum wages (RR 1.85; 95% CI 1.30-2.61), presented body mass index > 25 (RR 1.14; 95% CI 1.01-1.29), and showed a dental aesthetic index > 30 (RR 1.32; 95% CI 1.20-1.46).
Anterior gingival enlargement seems to influence the OHRQoL in subjects receiving orthodontic treatment.
Quality of life; Epidemiology; Risk factors; Orthodontics; Gingivitis; Gingival hyperplasia
To assess the relationship between insurance status and type of service received among dentate adults in a developing oral health care system.
A cross-sectional survey based on phone interviews in Tehran, Iran. Four trained interviewers collected data using a structured questionnaire. Of 1,531 subjects answering the phone call, 224 were <18 years; of the remaining 1,307, 221 (17%) refused to participate, and 85 (6%) were excluded as edentate or reporting no dental visit, leaving 1,001 eligible subjects in the sample. The questionnaire covered insurance status, socio-demographics, frequency of tooth brushing, dental attendance as reasons for, and time since last dental visit, and dental service received then. Data analysis included the chi-square test and logistic regression.
Of the subjects, 71% had a dental insurance. Those with no insurance were more likely to report tooth extractions (OR=1.5) than those with an insurance coverage; for all other treatments no differences according to the insurance status appeared. Among the insured subjects, extractions were more likely for those reporting a problem-based dental visit (OR=6.0) or having a low level of education (OR=2.3).
In Iran, with its developing oral health care system, dental insurance had only a minor impact on dental services reported.
Adults’ dental care; Dental services; Dental insurance
The aim of this study was to assess homeless veterans’ perception of their oral health and the impact that oral disease and treatment have on self-assessed quality of life.
Outcomes included measures of general and oral-specific quality of life and functional status. Single-item self-report of oral health and the General Oral Health Assessment Index were assessed at baseline and after treatment.
One hundred and twelve veterans completed the baseline questionnaire, and 48 completed the follow-up. Veterans who were eligible for ongoing dental care had improved General Oral Health Assessment scores, while patients who received only emergency dental care saw a decreased score (2.46 versus −2.12). General Oral Health Assessment improvement was significantly related to fewer teeth at baseline (18 versus 23), a lower baseline General Oral Health Assessment (23.6 versus 28.1), having a denture visit (22 versus 35 percent), and improvement in self-reported oral health (25 versus 42 percent).
There was significant improvement in homeless veterans’ perceived oral health after receiving dental care.
homeless; dental; oral quality of life; self-reported oral health
Children’s oral health related quality of life (OHRQoL) evaluates the impacts of oral daily activities of children and family on quality of life. Oral health related quality of life as outcome can be used to evaluate the dental health services. This study aimed to assess the extent to which dental treatment under general anesthesia affects quality of life of children and their families.
One hundred parents of 3-10 year-old children who needed dental treatment under general anesthesia completed a parent-children perception questionnaire (P-CPQ) and family impact scale (FIS) before, and 4 weeks after dental treatment under general anesthesia. The questionnaire had statements related to oral health, functional limitation, emotional state and well being social well-being and family issues. Data were analyzed using SPSS version 11.5.
The mean scores and standard deviations of oral health quality of life of the children before and after dental treatment were 43.3 ± 7.14 and 39.24 ± 5.47 respectively. The mean scores of FIS before and after dental treatment were 8.00 ± 3.21 and 3.66 ± 2.62, respectively. The effect size of mean differences in P-CPQ and FIS scores were 1.84 ± 1.64 and 1.35 ± 4.34, respectively.
Provision of dental treatment under general anesthesia for uncooperative, young children with extensive dental problems had significant effects on quality of life of both children and their families.
Anesthesia; dental care; oral health; quality of life; social impact
Oral health impairment comprises three conceptual domains; pain, appearance and function. This study sought to: (1) estimate the prevalence of severe oral health impairment as assessed by a summary oral health impairment measure, including aspects of dental pain, dissatisfaction with dental appearance and difficulty eating, among a birth cohort of Indigenous Australian young adults (n = 442, age range 16-20 years); (2) compare prevalence according to demographic, socio-economic, behavioural, dental service utilisation and oral health outcome risk indicators; and (3) ascertain the independent contribution of those risk indicators to severe oral health impairment in this population.
Data were from the Aboriginal Birth Cohort (ABC) study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Data for this analysis pertained to Wave-3 of the study only. Severe oral health impairment was defined as reported experience of toothache, poor dental appearance and food avoidance in the last 12 months. Logistic regression models were used to evaluate effects of demographic, socio-economic, behavioural, dental service utilisation and clinical oral disease indicators on severe oral health impairment. Effects were quantified as odds ratios (OR).
The percent of participants with severe oral health impairment was 16.3 (95% CI 12.9-19.7). In the multivariate model, severe oral health impairment was associated with untreated dental decay (OR 4.0, 95% CI 1.6-9.6). In addition to that clinical indicator, greater odds of severe oral health impairment were associated with being female (OR 2.0, 95% CI 1.2-3.6), being aged 19-20 years (OR 2.1, 95% CI 1.2-3.6), soft drink consumption every day or a few days a week (OR 2.6, 95% 1.2-5.6) and non-ownership of a toothbrush (OR 1.9, 95% CI 1.1-3.4).
Severe oral health impairment was prevalent among this population. The findings suggest that public health strategies that address prevention and treatment of dental disease, self-regulation of soft drink consumption and ownership of oral self-care devices are needed if severe oral health impairment among Indigenous Australian young adults is to be reduced.