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PubMed1988

Changing patterns of oral health and implications for oral health manpower. Responsibility to the public.

This paper examines organized dentistry's responsibility for informing the public about changing patterns of oral disease. The public is divided into two groups: governments and other organizations that are responsible for allocating funds for dental treatment, education and research, and the general population that is eligible to use dental services. Some governments in industrialized countries apparently believe that with the decline in caries, monies for dentistry can be reduced without affecting the oral health of the population. This assumption can be challenged, since oral disease levels in lower socioeconomic class groups and the elderly continue to be very high. Further, the goals of the dental care system should be raised to eliminate edentulousness. Dentistry needs to make the public aware that adequate care for the poor and elderly and eliminating edentulousness will require increased support for dentistry. At the patient level, regular users of care who are healthy should be informed that more frequent visits and complex services may have little effect on oral health. In contrast, infrequent users of dental care should be made aware that dentistry has the technology to prevent disease and the loss of teeth. One phase in the history of dentistry is coming to an end but another is beginning. In the new era the dental profession can make even greater contributions to the quality of life of individuals and society.

Delivery of Health Care↗
PubMed2001

Adolescents' sense of coherence, oral health status, and oral health-related behaviours.

OBJECTIVE: To investigate the relationship between sense of coherence (SOC) and oral health. It was hypothesised that subjects with better oral health status and better oral health-related behaviours have higher levels of SOC. METHODS: A cross-sectional study was conducted in Goiânia-GO, Middle-West Brazil, on a sample of 664 15-year-olds randomly selected from schools. Data were collected through questionnaires, the short version of Antonovsky's SOC Scale (13-item) and clinical dental examinations. Multiple logistic regression and polytomous ordered regression were used in the data analysis. Two sets of outcome variables were selected for the analyses: oral health status (dental caries, oral cleanliness, and periodontal disease), and oral health-related behaviours (frequency of sugar intake, toothbrushing frequency, and pattern of dental attendance). RESULTS: Adolescents' SOC was associated with their caries experience in anterior teeth (OR=0.81 for 10 units increase in SOC scale; 95% CI=0.66-0.98), but the relationship did not remain significant after controlling for other factors. Adolescents with higher SOC were less likely to visit the dentist mainly when in trouble, compared with those with lower SOC (OR=0.83, 95% CI=0.71-0.98), or equivalently more likely to visit for mainly check-ups. Other measures of oral health status and behaviours were not significantly associated with SOC. CONCLUSION: SOC was identified as a psychosocial determinant of adolescents' oral health-related behaviour, particularly affecting their pattern of dental attendance.

Adolescent↗
PubMed2004

Social inequalities in oral health and in use of oral health care services among adolescents in Uganda.

OBJECTIVE: The aim of this study was to describe clinical and self-perceived indicators of oral health status and the use of oral health care services by social and demographic characteristics. METHODS: In 2001, a cross-sectional random sample survey was conducted in urban and rural settings in Uganda (Kampala and Lira, respectively), and 1146 secondary school students with a mean age of 15.8 years completed questionnaires in school. Dental caries was recorded by one examiner on a random subsample of 372 students. RESULTS: Logistic regression analyses revealed that being an urban resident was associated with higher odds for having dental caries (dmft > 0), seeking care because of toothache (delayed treatment demand) and being dissatisfied with one's own oral health status [adjusted odds ratio (OR) = 1.5-2.1]. Being an urban resident was associated with lower odds for oral health care attendance generally and for having missing teeth in particular (adjusted OR = 0.6-0.4). Students who had parents with a higher education and those with weak social ties were, respectively, less and more likely to be dissatisfied with their oral health status. As compared to caries-free participants, the odds for being dissatisfied with oral health and delayed treatment demand increased significantly with an increasing dmft score (adjusted OR = 2.1-3.2). CONCLUSION: Urban students were most likely to have a dmft > 0 and to rate their oral health status negatively. Having received dental care and the prevalence of missing teeth, and delayed treatment demand were, respectively, most and least prevalent among rural students. Dental caries at different diagnostic cut-off points and weak social ties affected self-reported oral health negatively, independently of social and demographic characteristics.

Adolescent↗
PubMed2001

Socio-economic differences in patterns of health and oral health behaviour in 25 year old Norwegians.

The purpose of this study was to test the hypothesis of multidimensionality of oral and general health behaviour. To evaluate the proposed behavioural dimensions, relationships with individual beliefs and socio-economic factors were explored. A simple random sample of 1190 residents born in 1972 was drawn from the populations of three counties in western Norway in February 1997. A questionnaire was mailed to the eligible sample. After one reminder, 735 subjects (58% women) replied. Principal component analysis (PCA) provided two factors, which accounted for 32.5% of the variance among the behavioural variables. One-way analysis of variance revealed significant, inverse relationships between two sum scores of health enhancing and health detrimental behaviour derived from the factors; socioeconomic variables and perceived vulnerability. Controlling for gender, multiple logistic regression analyses revealed significant relationships between health enhancing behaviour and occupational status (non-manual versus student, OR=0.6, 95% CI 0.4-0.8) and perceived vulnerability (OR=2.2, 95% CI 1.5-3.0). Occupational status (manual versus student OR=1.8 95% CI 1.2-2.6 and non-manual versus student OR=1.4 95% CI 1.0-2.1) turned out to be the strongest predictor of health detrimental behaviour. The present results indicate that oral and general health behaviour reflects two distinct behavioural domains. This appears to imply that oral and general health behaviour should be approached jointly in health promotion lifestyle programmes and that the lower socio-economic status groups should be targeted.

Adult↗
PubMed2006

A sociodental approach to assessing children's oral health needs: integrating an oral health-related quality of life (OHRQoL) measure into oral health service planning.

OBJECTIVE: We adopted a sociodental approach to assess the real dental needs of Thai primary school children, and integrated an oral health-related quality of life measure (OHRQoL) into oral health service planning. We then compared the results of this sociodental assessment with standard estimates of a child's oral health needs. METHODS: We developed a new model of sociodental needs assessment and used it to assess the level of impact that various oral health conditions have on the everyday lives of school children. We then carried out a cross-sectional study of all grade-6 children (11-12 years old) in Suphan-buri Province, Thailand. We examined the sample (n = 1034) to assess the children's oral health and then we interviewed each child individually to assess what impact any dental conditions he or she may have on their quality of life. This assessment was done using an OHRQoL indicator, the Child Oral Impacts on Daily Performances index (child-OIDP). We integrated the results obtained using this indicator with those estimates obtained using more traditional, standard clinical methods, in order to generate a clearer picture of exactly which non-progressive dental conditions really needed treatment. These results take into account the impact those conditions have on the overall well-being of children and their ability to function normally and unimpeded. We were then able to prioritize their dental needs according to the severity of disruption caused in their daily lives. FINDINGS: Using standard or "normative" estimates of dental health care needs, the children's need was 98.8%. This level of need decreased signifi cantly to 39.5% when adopting the sociodental approach (P <0.001). Overall, per 100 children with a standard or normative need for dental treatment, only 40 had a sociodental need for treatment when taking into account the impact their condition has on their everyday lives. Children thus identifi ed as requiring treatment were further categorized according to the severity of impact their condition had: 7.2% had severe, 10.3% moderate and 22.0% had minor impacts on OHRQoL. CONCLUSIONS: There was a marked difference between the standard normative and the sociodental needs assessment approach, with the latter approach showing a 60% lower assessment of dental health care needs in Thai 11-12-year-old children. Different levels of "impacts" on daily life can be used to prioritize children with needs.

Child↗
PubMed2006

Oral health beliefs in adolescence and oral health in young adulthood.

According to theory, health beliefs are related to health behaviors. We investigated whether individuals who hold favorable oral-health-related beliefs over time have better adult oral health than those who do not. Beliefs about the efficacy of water fluoridation, keeping the mouth clean, avoiding sweet foods, visiting the dentist, using dental floss, and using fluoridated toothpaste were assessed in a birth cohort at ages 15, 18, and 26 years. At each age, the majority of participants endorsed the importance of each practice. However, there was also evidence of instability across time. Individuals who held stable favorable dental beliefs from adolescence through adulthood had fewer teeth missing due to caries, less periodontal disease, better oral hygiene, better self-rated oral health, and more restorations. Dental beliefs can change between adolescence and young adulthood, and these changes are related to oral health. In particular, unfavorable dental health beliefs are related to poorer oral health.

Adolescent↗
PubMed2001

Women's health and oral health implications of the curriculum study.

This article discusses the effect of medical school and dental school curriculum surveys, which allowed interdisciplinary analysis of the status of women's issues in the health profession. With this documentation of the status of women's health and oral issues, changes in the curriculum can now occur to close the gaps in education and training exposed in the surveys. Changes in the curriculum are aimed at improving clinical practice by practitioners and lowering barriers to care experienced by women. These changes must be incorporated into not only the medical school and dental school curriculums, but also into the practices of the current health care practitioners to be effective.

Curriculum↗
PubMed2005

Bacteriotherapy and probiotics' role on oral health.

Oral infections constitute some of the most common and costly forms of infections in humans. The concept of microbial ecological change as a mechanism for preventing dental disease is an important one while altered microbial ecology may lead to dental disease. New methods such as probiotic approaches (i.e. whole bacteria replacement therapy) to eliminate pathogenic members of the microbiota can be investigated. Bacteriotherapy is an alternative and promising way to combat infections by using harmless bacteria to displace pathogenic microorganisms. Probiotics are one of these new agents which are widely used for their therapeutic action. Limited research is available showing that some probiotic cultures may help dental improvement. Present paper focuses on possible oral benefits of probiotics.

Animals↗
PubMed1992

The role of the dental team in promoting dental health and general health through oral health.

The two major dental diseases are related to diet and dirt. These are common risk factors for a number of chronic diseases. A logical approach to the prevention of chronic diseases is to focus on risk factors rather than on specific diseases, a common risk factor approach using health promotion. Health promotion is the process of enabling individuals and communities to increase control over the determinants of health and thereby improve their health. The concepts incorporated in health promotion include a promotion of health through public policy, creating supportive environments, developing personal skills, strengthening community action and reorienting health services. The dental team should incorporate the following principles: integration with general health education, encouraging participation of the community, the public and staff in the planning process; making healthy choices the easier choices. By adopting a Common Risk Factor Strategy incorporated into Primary Health Care, dental teams can promote dental health and general health. The latter objective will be achieved by reducing pain and suffering related to dental diseases. A much broader remit for dental teams is outlined, one which will do justice to the abilities and training of all members of the team.

Dental Care↗
PubMed1987

Oral health and factors related to oral health in Polish schoolchildren.

The oral health and factors related to oral health were surveyed in 168 schoolchildren, aged 10-12 years, attending one school in Warsaw. The children were examined for dental caries and gingival status, dental plaque and salivary Streptococcus mutans and Lactobacillus counts. An interview on dietary habits and use of fluoridated toothpaste was also performed. The results showed a mean DMFT of 4.7 in the sample. Gingival Index 1 and Plaque Index 3 were median scores for the majority of the children. S. mutans was demonstrated in 94% of the children and high numbers were found in 15%. Lactobacillus sp. were present in all examined children, with high counts in 56% of the subjects. The interview revealed that most of the children eat five or six times per day and consume candies or cakes each day. Fluoridated toothpaste was not used regularly by any of the children. In conclusion this study shows a high prevalence of dental disease and an unfavorable combination of etiologic factors.

Child↗
PubMed1993

An investigation into the role of post-natal health clinics in oral health education.

This project investigated the oral health information that was given to parents by health visitors at post-natal clinics. This issue was examined by conducting an investigation in one health district in the United Kingdom and, within that, three socially diverse locations. A questionnaire to evaluate parental oral health knowledge and awareness, as well as the personal characteristics of each respondent was developed, tested and administered to 92 respondents. This questionnaire was analysed and compared with previous studies in the same field. Few parents reported receiving oral health information from health visitors. In general, levels of knowledge reported by this sample were better than those reported for the national sample used for the 1983 child dental health survey (Todd and Dodd, 1985). However, fewer of this sample reported receiving oral health education compared to the national sample respondents. A major gap in their knowledge related to fluoride levels in water and fluoride supplements. As found in other studies this sample was also confused about the role of diet in dental caries. Recommendations are made for further improvement in the delivery and reception of oral health education in the post-natal period.

England↗
PubMed2004

Sexual differences in oral health behaviour and factors associated with oral health behaviour in Japanese young adults.

The aim of this study is to compare the state of oral health behaviour between genders and to analyse factors associated with oral health behaviour by gender in young adults. Anonymous questionnaire data were collected from 527 adults (245 men and 282 women) aged 20-29 years who consulted dentists in Chiba City. The Chi-square test, Mann-Whitney analysis, and logistic regression analysis were used to examine the differences in oral health behaviour and determinants of oral health behaviour between young men and young women. The rate of good behaviour among women were significantly higher than those among men in each oral health behaviour item (toothbrushing frequency p < 0.001; using dental floss p = 0.042; dental check-ups p < 0.001). In women, factors associated with each oral health behaviour were as follows: toothbrushing frequency (family composition p = 0.030); using dental floss (dental health knowledge p = 0.025, employment status p = 0.031), and dental check-ups (age group p = 0.024). In men, a significant relationship was seen only between using dental floss and age group p = 0.025). This study indicated that young women had better oral health behaviour and that more factors were associated with their oral health behaviour in comparison with young men.

Adult↗