Rurality of Location of Origin among Adult Latinx Immigrants: Association with Oral Health Factors.

This study examined how Mexican and Central American immigrants' social support was associated with three selected dental outcomes among recent immigrants, prior to the 2020 COVID-19 pandemic. Using baseline wave data from the 2017-2022 VidaSana study about the health and social networks of Mexican and Central American immigrants living in Indiana, this study utilized logistic and ordinal logistic regression to predict lifetime fluoride use, lifetime dental restoration and flossing frequency, across levels of social support and differences between Mexican and Central American immigrants. Data from 547 respondents were included in the present analysis (68% women; mean age 34.4 years [SD 11.2]; Central American 42%; Mexican 58%). Results show a high level of social support was associated with increased probability of fluoride use, dental restoration and higher flossing frequency for Mexican immigrants. However, social support for Central American immigrants was associated with a decreased likelihood of fluoride use, more infrequent flossing, and had no significant association with dental restorations experience. What would be a negative association between Central American immigrants and dental restoration was accounted for by education level and never having been to a dentist. While higher social support was linked to beneficial outcomes for oral health in Mexican immigrants, the opposite was found in Central Americans. These findings highlighted the complexities of social relationships among new immigrants, and potential heterogeneity within the Hispanic population, particularly regarding social and behavioural measures as they pertain to oral health. Further research is needed to identify the underlying mechanisms producing both differences in social support and oral health outcomes.

Objectives. To determine oral health control beliefs of Istanbul adults using the Multidimensional Oral Health Locus of Control Scale (MOHLCS) after confirming its factorial validity and to examine the relationships between these beliefs, self-rated oral health, oral health behaviors and socio-demographic factors. Material and methods. The MOHLCS was administered to a sample of 1200 subjects aged ≥18 years in Istanbul chosen using a quota-sampling method (response 88%). The relationship between the MOHLCS and oral health behaviors, self-rated oral health and socio-demographic factors was assessed after confirming the factorial validity of the MOHLCS. Results. The MOHLCS demonstrated satisfactory internal reliability. Factor analysis results showed a new four-factor solution, namely Internal, Dentist, Chance, and Socialization agents. Multivariate analysis showed that female gender, younger age, higher socioeconomic status, more frequent daily toothbrushing, and regular dental check-ups were associated with higher Internal beliefs, while older age, lower educational level, lower socioeconomic status, low toothbrushing frequency, and symptom-orientated dental attendance were associated with higher Chance beliefs. Being unmarried and low toothbrushing frequency were associated with lower Dentist beliefs. Males and older subjects had lower Socialization agents beliefs. Internal, Dentist and Chance beliefs were significantly associated with self-rated oral health. Conclusions. Compared with the original factor structure, the new factor structure had better goodness of fit for this sample. Self-rated oral health, socio-demographic factors, and oral health behaviors were significantly associated with oral health control beliefs. These beliefs may be useful for planning oral health promotion programs and for formulating advice given by oral health professionals about their patients' oral health behaviors.

Purpose: The purpose of this study was to analyze the factors associated with self-rated poor oral health and chewing discomfort among Korean elderly people in the Korea National Health and Nutrition Examination Survey(KNHANES).Materials and Methods: Data from the 7th(2016-2018) KNHANES were downloaded from the KNHANES website.Participants were older adults aged 70 years who responded to a questionnaire about their self-rated oral health or chewing discomfort. Multivariate logistic regression analysis was performed by dividing demographic and oral health factors into three models, and odds ratios with 95% confidence intervals were presented.Results: For self-rated poor oral health, up to 1.59 times increase in caries in permanent teeth and up to 1.84 times increase in severe periodontitis, and up to 2.41 times increase in negative perceptions for those with 20 or more natural teeth compared to those without. In terms of chewing discomfort, depending on the model, those with a middle school diploma or less had up to 2.05 times more discomfort than those with a college degree or higher. Having severe periodontitis was associated with up to 1.68 times more discomfort, and having fewer than 20 natural teeth was associated with up to 2.46 times more discomfort.Conclusion: Some demographic factors and a number of oral health factors were found to be associated with self-rated poor oral health and chewing discomfort in older adults. Further in-depth analyses that reflect additional factors that were not included in the study are necessary.

Socioeconomic and psychosocial correlates of oral health

BACKGROUND Oral health significantly influences overall well-being, health care costs, and quality of life. In Saudi Arabia, the burden of oral diseases, such as dental caries and periodontal disease, has increased over recent decades, driven by various lifestyle changes. OBJECTIVE To explore the associations between proximal (direct) and distal (indirect) influences that affect oral pain (OP) and self-rated oral health (SROH) status in the Kingdom of Saudi Arabia (KSA) using an adapted conceptual framework. METHODS This retrospective cross-sectional study used data from a national health survey conducted in KSA in 2017. The sample included adults (N=29,274), adolescents (N=9910), and children (N=11,653). Sociodemographic data, health characteristics, and access to oral health services were considered distal influences, while frequency and type of dental visits, tooth brushing frequency, smoking, and consumption of sweets and soft drinks were considered proximal influences. Path analysis modeling was used to estimate the direct, indirect, and total effects of proximal and distal influences on OP and SROH status. RESULTS The mean age of adult respondents was 42.2 years; adolescents, 20.4 years; and children, 10.58 years. Despite OP reports from 39% of children, 48.5% of adolescents, and 47.1% of adults, over 87% across all groups rated their oral health as good, very good, or excellent. A higher frequency of tooth brushing showed a strong inverse relationship with OP and a positive correlation with SROH (<i>P</i><.001). Frequent dental visits were positively associated with OP and negatively with SROH (<i>P</i><.001). Sweet consumption increased OP in adolescents (β=0.033, <i>P</i>=.007) and negatively affected SROH in children (β=–0.086, <i>P</i><.001), adolescents (β=–0.079, <i>P</i><.001), and adults (β=–0.068, <i>P</i><.001). Soft drink consumption, however, was associated with lower OP in adolescents (β=–0.034, <i>P</i>=.005) and improved SROH in adolescents (β=0.063, <i>P</i><.001) and adults (β=0.068, <i>P</i><.001). Smoking increased OP in adults (β=0.030, <i>P</i><.001). Distal influences like higher education were directly linked to better SROH (β=0.046, <i>P</i>=.003) and less OP (indirectly through tooth brushing, β=–0.004, <i>P</i><.001). For children, high household income correlated with less OP (β=–0.030, <i>P</i>=.02), but indirectly increased OP through other pathways (β=0.024, <i>P</i>=.003). Lack of access was associated with negative oral health measures (<i>P</i><.001). CONCLUSIONS Among the KSA population, OP and SROH were directly influenced by many proximal and distal influences that had direct, indirect, or combined influences on OP and SROH status.

Drinking careers: A twenty-five-year study of three Navajo populations: By Stephen J. Kunitz and Jerrold E. Levy. Yale University Press, New Haven, 1994, 280 pp., $28.50

BackgroundOral health significantly influences overall well-being, health care costs, and quality of life. In Saudi Arabia, the burden of oral diseases, such as dental caries and periodontal disease, has increased over recent decades, driven by various lifestyle changes.ObjectiveTo explore the associations between proximal (direct) and distal (indirect) influences that affect oral pain (OP) and self-rated oral health (SROH) status in the Kingdom of Saudi Arabia (KSA) using an adapted conceptual framework.MethodsThis retrospective cross-sectional study used data from a national health survey conducted in KSA in 2017. The sample included adults (N=29,274), adolescents (N=9910), and children (N=11,653). Sociodemographic data, health characteristics, and access to oral health services were considered distal influences, while frequency and type of dental visits, tooth brushing frequency, smoking, and consumption of sweets and soft drinks were considered proximal influences. Path analysis modeling was used to estimate the direct, indirect, and total effects of proximal and distal influences on OP and SROH status.ResultsThe mean age of adult respondents was 42.2 years; adolescents, 20.4 years; and children, 10.58 years. Despite OP reports from 39% of children, 48.5% of adolescents, and 47.1% of adults, over 87% across all groups rated their oral health as good, very good, or excellent. A higher frequency of tooth brushing showed a strong inverse relationship with OP and a positive correlation with SROH (P<.001). Frequent dental visits were positively associated with OP and negatively with SROH (P<.001). Sweet consumption increased OP in adolescents (β=0.033, P=.007) and negatively affected SROH in children (β=–0.086, P<.001), adolescents (β=–0.079, P<.001), and adults (β=–0.068, P<.001). Soft drink consumption, however, was associated with lower OP in adolescents (β=–0.034, P=.005) and improved SROH in adolescents (β=0.063, P<.001) and adults (β=0.068, P<.001). Smoking increased OP in adults (β=0.030, P<.001). Distal influences like higher education were directly linked to better SROH (β=0.046, P=.003) and less OP (indirectly through tooth brushing, β=–0.004, P<.001). For children, high household income correlated with less OP (β=–0.030, P=.02), but indirectly increased OP through other pathways (β=0.024, P=.003). Lack of access was associated with negative oral health measures (P<.001).ConclusionsAmong the KSA population, OP and SROH were directly influenced by many proximal and distal influences that had direct, indirect, or combined influences on OP and SROH status.

Background and PurposeThe purpose of this study was to investigate the relationships among attitudes and practice about oral health, socioeconomic status, subjective oral symptoms, self-rated oral health, and oral health-related quality of life (OHRQoL) in a group of people from eastern China.MethodsBetween January 2021 to February 2022, 2502 (87.4%) of the 2863 participants completed an online questionnaire. OHRQoL, Socio-demographics characteristics, attitudes and practice toward oral health, self-rated oral health and subjective oral symptoms were all covered by the questionnaires. Based on the hypothetical model, structural equation modeling with the bootstrap method was used to examine the interactions and the strength of the correlations between the measured variables.ResultsThe final model demonstrated acceptable data fit. Socioeconomic status (β = −0.051), attitudes (β = −0.100) and practice (β = −0.127) toward oral health, self-rated oral health (β = −0.493) and subjective oral symptoms (β = 0.294) were all significantly correlated with OHRQoL. Socioeconomic status was directly linked to attitudes (β = 0.046) and practice (β =0.070) about oral health, and attitudes play the role of intermediary between practice and socioeconomic status (β = 0.018). OHRQoL was indirectly linked with attitudes mediated by practice (β = −0.092), practice mediated by subjective oral symptoms (β = −0.107), subjective oral symptoms mediated by self-rated oral health (β = 0.031). OHRQoL was correlated with income, educational level, and socioeconomic status. Self-rated oral health was related to educational level and socioeconomic status.ConclusionIn a sample of eastern China residents, OHRQoL was influenced by socioeconomic status, attitudes and practice toward oral health, subjective oral symptoms, and self-rated oral health.

Abstract: Social isolation is associated with worse health; however, few studies have examined the health effects of isolation among African Americans. The purpose of this study is to evaluate associations between social isolation and self-rated physical and oral health from the National Survey of American Life, a nationally representative sample of African Americans. Social isolation was operationalized to reflect both objective isolation (lack of contact) and subjective isolation (lack of emotional closeness). Self-rated physical and oral health were regressed on objective and subjective isolation while controlling for marital status, gender, age, family income, education, and health behaviors. Poorer self-rated physical health was associated with objective isolation, while poorer self-rated oral health was associated with subjective isolation. This study contributes to the small literature of the impact of social isolation on health among African Americans; furthermore, it is the first to examine the relationship between isolation and self-rated oral health in this population.

This essay addresses the controversy over whether structural or assimilation theories best explain the labor market incorporation of international migrants in the United States with a case study of recent Central American migrants in Washington, D.C. It considers the structural factors and human capital variables that influence wage levels and employment mobility for Central American women versus those that affect Central American men. Data from a study of 50 Central American households indicate that the variables affecting wage levels and employment mobility are clearly differentiated on the basis of gender. Structural factors have greater significance for men, while human capital variables appear to influence wage levels for women, to a limited extent. But gender factors and structural barriers in the Washington, D.C. area economy pose blocks to women 's occupational success and render them incapable of fully utilizing their human capital advantages. Within the nascent literature on recent Central American migrants to the United States, the theoretical question whether structural or assimilation theory best explains their economic incorporation in U.S. labor markets has yet to be tested. The question issues from the debate about whether the structure of the labor market has greater significance for immigrant economic success than immigrants' individual characteristics (i.e., human capital). Utilizing census data from 1980, one study (Wallace 1986) compares recent Central American and Mexican immigrants and finds that Central American immigrants in California possess significant human capital advantages over Mexican immigrants, including higher education, occupation, and English levels. Yet Central American men earn the same as Mexican men despite these advantages. Wallace surmises that Central Americans might be entering the same stratified labor market as Mexican immigrants and that structural theory would explain men's economic position. Certain groups of Central American women, on the other hand, demonstrate a slight earnings advantage over Mexican female immigrants, leading to the supposition that Central American women follow assimilationist predictions for economic incorporation. The data presented here on Central American migrants to Washington, D.C. broaden the debate about immigrant economic incorporation with a case study of a city that previously did not have an established, low-paid Latino labor force (as in California). In addition, the Washington, D.C. area is representative of a labor market in which professional and service jobs, rather than production and assembly jobs, predominate. In assessing the factors that account for differences in Central American men's and women's wage levels and employment mobility, this study carefully considers the problem of gendered patterns in labor market incorporation. The findings for Central American men support the predictions of structural theory that occupational success depends more on the economic context than on the immigrants' skills. But while superficially, Central American women appear to follow the predictions of assimilation theory as in Wallace's study, this pattern may be limited to low income and low status occupations, as he cautions. This paper posits that wage levels and

BackgroundOral health perception is an influential predictor of both current and future health among the elderly. However, limited research has focused on self-rated oral health among older patients attending tertiary dental care. Therefore, this study aimed to explore the potential factors associated with self-rated oral health among elderly patients attending a university dental hospital in Thailand.MethodsThis telephone-based cross-sectional study was carried out among elderly patients older than 60 years who attended at least one dental visit at the university dental hospital in 2020. Hospital numbers (HN) were used to identify eligible candidates for this study. We calculated the sample size by assuming a finite population of 70,028 elderly patients with valid telephone numbers. The minimum sample required for this study was 398 participants. Trained interviewers conducted telephone calls between July 2021 and January 2022 using the validated modified oral health questionnaire. Self-rated oral health was assessed using a conventionally used global oral health question: “How would you describe your dental health?” with three response options: good, fair, and poor. Descriptive statistics, Fisher’s exact test, and binary logistic regression were performed to analyze the data.ResultsA total of 836 telephone numbers were called. There were 402 (48.10%) elderly patients who agreed to and completed the telephone interview. Most of the study participants were women (61.4%) between 61–74 years of age (83.1%) with a mean age of 69.18 years. Bivariate analyses showed associations between poor self-rated oral health and lower subjective oral functions: chewing discomfort (p < 0.001) and speaking discomfort (p = 0.013). However, the multivariate regression model indicated a significant association between poor self-rated oral health and chewing discomfort (p < 0.001). Therefore, elderly patients with chewing discomfort were more likely to perceive poor oral health.ConclusionsThese findings indicate that difficulty chewing could be a potential factor influencing self-rated adverse oral health among older patients attending the university dental hospital. Furthermore, our study adds that the predictive power of a single-item self-measurement supports its value as a standard measure to predict oral health risk in tertiary care institutions, as well as primary care settings and community-based survey research. Therefore, healthcare providers should routinely evaluate self-rated oral health among elderly patients to detect early signs and symptoms of oral health problems, assess the success of dental treatments, and monitor general health and well-being.

BackgroundSelf-rated oral health is a valid and useful summary indicator of overall oral health status and quality of life. However, few studies on perception of oral health have been conducted among Japanese young adults. This study investigated whether oral health behavior, subjective oral symptoms, or clinical oral status were associated with self-rated oral health in Japanese young adults.MethodsThis cross-sectional survey included 2,087 students (1,183 males, 904 females), aged 18 and 19 years, at Okayama University, Japan. A self-administered questionnaire was distributed and an oral examination was performed.ResultsIn a structural equation modeling analysis, the score of decayed, missing and filled teeth (DMFT) significantly affected self-rated oral health (p <0.05) and the effect size was highest. Malocclusion, subjective symptoms of temporomandibular disorders (TMD) and stomatitis, and poor oral health behavior significantly induced self-rated poor oral health with small effect sizes (p <0.05). Clinical periodontal conditions and Oral Hygiene Index-simplified were not related to self-rated oral health.ConclusionSelf-rated oral health was influenced by subjective symptoms of TMD and stomatitis, oral health behavior, the score of DMFT, and malocclusion. The evaluation of these parameters may be a useful approach in routine dental examination to improve self-rated oral health in university students.

The reasons why social inequality is associated with oral health outcomes is poorly understood. This study investigated whether stratification by different measures of socio-economic status (SES) helped elucidate these associations. Cross-sectional survey data were used from Australia's 2004-06 National Survey of Adult Oral Health. The outcome variable was poor self-rated oral health. Explanatory variables comprised five domains: demographic, economic, general health behaviour, oral health-related quality of life and perceived need for dental care. These explanatory variables were each stratified by three measures of SES: education, income and occupation. The overall proportion of adults reporting fair or poor oral health was 17.0% (95% CI 16.1, 18.0). Of these, a higher proportion were older, Indigenous, non-Australian born, poorly educated, annual income <$20 000, unemployed, eligible for public dental care, smoked tobacco, avoided food in the last 12 months, experienced discomfort with their dental appearance, experienced toothache or reported a need for dental care. In stratified analyses, a greater number of differences persisted in the oral health impairment and perceived need for dental care domains. Irrespective of the SES measure used, more associations between self-rated oral health and dental-specific factors were observed than associations between self-rated oral health and general factors.

BackgroundThe present study aimed to elucidate the associations among self-rated oral health, clinical oral health status, oral health behaviors, subjective oral symptoms, and oral health-related quality of life (OHRQoL) in a group of Japanese university students.MethodsOf 2051 participants, 2027 (98.83%) students received an optional oral examination and answered a questionnaire including items regarding age, sex, self-rated oral health, oral health behaviors, subjective oral symptoms, and OHRQoL [The Oral Health Impact Profile (OHIP)-14]. On oral examination, the decayed, missing, and filled teeth (DMFT) score, Community Periodontal Index (CPI), the percentage of teeth showing bleeding on probing (%BOP), and malocclusion were recorded. Structural equation modelling (SEM) analysis was used to test associations.ResultsThe mean score (± SD) of OHIP-14 was 1.92 ± 5.47. In the SEM analysis, the final model showed that self-rated oral health, oral pain, malocclusion, and the DMFT score were directly associated with the OHRQoL, and subjective symptoms of temporomandibular disorders (TMD) and recurrent aphthous stomatitis were both directly and indirectly associated (p < 0.05). CPI, %BOP, and oral health behaviors were excluded from the final model.ConclusionsOHRQoL was associated with self-related oral health, subjective symptoms of TMD, oral pain and stomatitis, DMFT, and malocclusion in this group of Japanese university students.

BackgroundThe aims of this study were to determine self-rated oral health and dental attendance habits among Swedish adults, with special reference to the role of social inequalities, after the Swedish dental care reform in 2008.MethodsThe study is based on a survey questionnaire, sent to 12,235 residents of a Swedish county, in 2012. The age group was 16–84 years: 5,999 (49%) responded. Using chi-square statistics, differences in prevalence of self-rated oral health and regular dental attendance were analysed with respect to gender, age, educational level, family status, employment status and country of birth. Self-rated poor oral health was analysed by multivarite logistic regression adjusting for the different socio-demographic factors, financial security and having refrained from dental treatment for financial reasons.ResultsThree out of four respondents (75%) reported fairly good or very good oral health. Almost 90% claimed to be regular dental attenders. Those who were financially secure reported better oral health. The differences in oral health between those with a cash margin and those without were large whereas the differences between age groups were rather small. About 8% reported that they had refrained from dental treatment for financial reasons during the last three months. Self-rated poor oral health was most common among the unemployed, those on disability pension or on long-term sick leave, those born outside the Nordic countries and those with no cash margin (odds ratios ranging from 2.4 to 4.4). The most important factor contributing to these differences was having refrained from dental treatment for financial reasons.ConclusionThe results are relevant to strategies intended to reduce social inequalities in oral health, affirming the importance of the provision of equitable access to dental care.