Dental Attendance Pattern Research Articles

Differential Psychological Factors Associated With Unnecessary Dental Avoidance and Attendance Behavior During the Early COVID-19 Epidemic.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 is challenging the dental community to an unprecedented degree. Knowledge of the increased risk of infection in dental settings has been disseminated to the public and guidelines have been formulated to assist dental attendance decision-making. However, dental attendance behaviors incompatible with treatment need is not uncommon in clinical settings. Important gaps remain in the knowledge about how psychological factors are affecting dental attendance behaviors during the COVID-19 epidemic. In this cross-sectional study, a questionnaire survey was performed during February and March 2020. A total of 342 and 294 dental patients who attended and avoided dental visits, respectively, were included. The participants were classified into four groups based on dental attendance behavior and emergent/urgent dental treatment need. Bivariate analysis was performed to investigate factors associated with dental attendance. Multivariable logistic regression based on principal component scores was performed to identify major psychological constructs associated with unnecessary dental avoidance and attendance. Among all the factors explored, inability to wear masks during dental treatment (P < 0.001; effect size: 0.32) was most closely associated with the overall pattern of dental attendance among participants. Multivariable regression suggested that unnecessary dental avoidance was associated with perceived risk of infection in general and in dental settings (odds ratio [95% CI]: 0.62 [0.53, 0.72]; p < 0.001), perceived impact of COVID-19 and dental problems on general health (0.79 [0.65, 0.97]; 0.021), and personal traits such as trust and anxiety (0.77 [0.61, 0.98]; 0.038). Unnecessary dental attendance was associated with optimism toward the epidemic (1.68 [1.42, 2.01]; <0.001) and trust (1.39 [1.13, 1.74]; 0.002). Multidisciplinary efforts involving dental and medical professionals as well as psychologists are warranted to promote more widespread adoption, among the general public, of dental attendance behaviors compatible with dental treatment need during the COVID-19 epidemic.

Determinants of Dental Caries Experience Among Adolescents in Kazakhstan: A Cross-Sectional Study

The aim of the present study was to estimate the mean, prevalence, and severity of dental caries, and to identify the factors associated with these characteristics in a population of school-aged children from four regions in Kazakhstan. A total of 2,149 school children aged 11-15 years from four regions of Kazakhstan were examined; the overall response rate was 68%. Results from dental examinations and standardized questionnaires were used to gather sociodemographic and oral health behavior information. The overall prevalence of dental caries was 74%, and obviously decayed teeth were found in 44% of the participants; only 6% had missing teeth and 24% had their teeth treated. Age, region, ethnicity, dietary habits, and dental attendance pattern were found to be significantly associated with the predicted degree of caries experience among those with caries experience. The high prevalence of dental caries might be related to rapid westernization in Kazakhstan and associated nutritional transition. Moreover, an increased burden of untreated caries in less advantaged populations was observed. Parental education and material deprivation may be very important determinants of oral health among adolescents in Kazakhstan.

Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study.

ABSTRACTObjective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

Socio-behavioral factors, oral hygiene level and periodontitis prevalence in a 35-44-year-old Greek adult population: A cross-sectional survey.

BackgroundSub-optimal oral hygiene is considered as a primary risk factor for periodontitis occurrence. Various socio-behavioral determinants may contribute either independently or by influencing adversely the oral hygiene (OH) level. The aim of the present study was to examine the periodontal status of 35-44-year-old Greek adults and determine the contribution of risk indicators, including the socio-behavioral aspects and the population’s oral hygiene level, on disease prevalence. Material and MethodsIn 1218 participants, Community Periodontal Index (CPI), Loss of Attachment (LoA) and simplified Oral Hygiene Index (OHI-S) were calculated. Multivariable regression models examined the effect of socio-behavioral factors with/without the inclusion of OHI-S level on pocket depth (PD)≥4mm and LoA≥4mm presence. Results11.8% of the participants had healthy periodontium, whereas 37.3% and 5.6% presented with shallow and deep pocketing, respectively. 60.4%, 28.8%, and 10.8.% of the adults demonstrated LoA≤3mm, 4-5mm, and ≥6mm, accordingly. Fair and poor oral hygiene significantly increased the likelihood for PD≥4mm (OR=4.8-20.3) and LoA≥4mm (OR=3.3-6.0) presence. ‘Emergency-oriented dental visiting pattern’ significantly elevated the chance for PD≥4mm presence (OR=1.7). ‘Lower education level’ ‘urban location’, and ‘using an interdental brush’ were significantly independently linked to LoA≥4mm occurrence (OR=1.7-2.1, 1.5, and 2.0, respectively). Lower educated individuals demonstrated inferior oral hygiene status, which in turn elevated significantly the chances of PD≥4mm presence. Smoking more than 10 cigarettes/day, emergency-oriented dental attendance pattern and not flossing were linked to worse oral hygiene levels, which consequently increased significantly the likelihood of LoA≥4mm occurrence. ConclusionsFair and poor oral hygiene contribute strongly to periodontitis occurrence. Various socio-behavioral factors may influence adversely oral hygiene maintenance, leading to periodontitis manifestations. Key words:Community periodontal index, periodontal attachment loss, oral hygiene, adults 35-44, cross-sectional survey, socio-behavioral indicators.

Rare genetic diseases affecting skeletal development and oral health disparities among children and adolescents: a pathway analysis

To examine the relationships of rare genetic diseases affecting skeletal development, socio-demographic characteristics, and oral health-related behaviours with dental clinical measures in children and adolescents. A cross-sectional study paired by age, gender and social class included 61 children and adolescents with osteogenesis imperfecta (n=40) or mucopolysaccharidoses (n=21) and those without genetic rare diseases (n=60). Participants were selected at two referral hospitals for rare genetic diseases in the city of Belo Horizonte, Brazil. Caregivers completed a questionnaire to obtain age, gender, caregiver's schooling, social class, patterns of dental attendance and duration of breastfeeding. Oral hygiene, dental caries, dental anomalies and malocclusion were assessed through dental examinations. The relationships between variables were estimated through Pathway analysis using the maximum likelihood method. Rare genetic diseases affecting skeletal development were directly associated with dental caries (β=0.22), dental anomalies (β=0.36) and malocclusion (β=0.29). They were also inversely linked to a preventive pattern of dental attendance (β = -0.25). Rare genetic diseases affecting skeletal development were associated with poor oral hygiene (β=0.28) and shorter breastfeeding duration (β = -0.21). Rare genetic diseases affecting skeletal development were linked indirectly with dental caries, a reduced pattern of dental attendance and poor oral hygiene (β=0.43). Patterns of dental attendance mediated the link between rare genetic diseases affecting skeletal development and malocclusion (β = -0.05). Rare genetic diseases affecting skeletal development were associated with poor oral health. Patterns of dental attendance and poor oral hygiene mediated the link between rare genetic diseases affecting skeletal development and dental clinical measures.

Psychometric Properties of the Japanese Version of the Single Dental Anxiety Question: A Cross-sectional Online Survey

Background: Assessment of dental anxiety using a validated questionnaire is important for its management and survey. Objective: The aim of this cross-sectional online survey was to evaluate the psychometric properties of the Japanese version of the Single Dental Anxiety Question (SDAQ). Methods: The single question was translated into Japanese following the forward-backward method. Four hundred Japanese internet monitors (age 20–79 years) were included in the study. Sensitivity–specificity analysis and the Kappa coefficient were calculated against the Modified Dental Anxiety Scale (MDAS) using the 19 cutoff score for high dental anxiety. Criterion validity was evaluated using age, gender, dental attendance pattern, negative dental experiences, and subjective oral health. Results: Among these subjects, 11% were found to have high dental anxiety on the MDAS score and 9% rated themselves as very afraid of SDAQ. The Kappa coefficient between the MDAS cutoff score and the SDAQ classification was 0.58, the sensitivity was 0.56, and the specificity was 0.97. The SDAQ was associated with gender (P = 0.018), dental attendance pattern (P = 0.020), negative dental experiences (P &lt; 0.001), and subjective oral health (P &lt; 0.001). Conclusion: The Japanese version of the SDAQ has good criterion and construct validity but lower sensitivity than the original version. It can be used to assess dental anxiety in large dental surveys or clinical settings where a multi-item questionnaire is not feasible.

Association between disability status and dental attendance in Australia-A population-based study.

Disability is a key social determinant of health. The objective of this study was to test the association between disability status and irregular dental attendance among the Australian population, and to examine whether the observed association varied among adolescents. Data on 17501 participants from The Household, Income and Labour Dynamics in Australia (HILDA) were analysed. The main outcome examined was irregular dental attendance (two or more years since last dental visit) with disability as the primary exposure. Multivariable logistic regression models were fitted to test the associations between disability and dental attendance pattern. Models were adjusted for age, gender, country of birth, region of residence, education and income. Analysis was repeated among adolescents (15- to 24-year-old) to examine for variations in observed association. One in four participants reported having a disability. Unadjusted model showed that the odds for irregular dental attendance were 1.40 times greater (95%; CI, 1.30-1.51) in those with disability than those without disability. After adjusting for all covariates, participants with disability had 1.20 times higher odds (95%; CI 1.10-1.30) of irregular dental attendance than those without disability. Irregular dental attendance was 1.41 times greater (95%; CI 1.10-1.80) in those with disability aged 15-24years than those without disability. Australian individuals with disability are more likely to have irregular dental attendance than those without.

The Dental, Oral, Medical Epidemiological (DOME) Study: Protocol and Study Methods.

To develop and present the methods utilized for the Dental, Oral, Medical Epidemiological (DOME) study. The DOME is an electronic record-based cross-sectional study, that was conducted to measure the dental, periodontal, and oral morbidities and their associations with systemic morbidities, among a nationally representative sample of young to middle-aged adults military personnel from the IDF (Israel Defense Forces). To that end, we developed a strict protocol including standardized terminology, data collection, and handling. Data for the DOME study was derived simultaneously from three electronic records of the IDF: (1) a central demographic database, (2) the dental patient record (DPR), and (3) the medical computerized patient record (CPR). The established DOME repository includes socio-demographic, dental and medical records of 132,354 young to middle-age military personnel from the IDF, who attended the dental clinics during the year 2015. Records of general military personnel (N > 50,000), with no recorded dental visits during the study period, served as a control group regarding all other parameters except dental. The DOME study continues and is currently collecting longitudinal data from the year 2010 until 2020. The IDF employs a standardized uniform administrative and clinical work-up and treatment protocols as well as uniform computerized codes. We describe the standardized definitions for all the parameters that were included: socio-demographics, health-related habits, medical and dental attendance patterns, and general and dental health status. Multicollinearity analysis results of the sociodemographic and medical study parameters are presented. Standardized work-up and definitions are essential to establish the centralized DOME data repository to study the extent of dental and systemic morbidities and their associations.

Psychometric evaluation of the child oral impacts on daily performances (C-OIDP) for use in Turkish primary school children: a cross sectional validation study

BackgroundAs patient-reported outcome, the Child Oral Impacts on Daily Performances (C-OIDP) has been commonly used for assessing children’s oral health needs in order to facilitate oral health service planning. It was translated and cross-culturally adapted into Turkish in 2008. Since then, there is no study to assess its psychometric properties in Turkish child population. This cross–sectional study aimed to investigate the psychometric properties and factor structure of the Turkish version of the C-OIDP for use in Turkish primary school children.MethodsThe Turkish translated version was tested on a convenience sample of primary school children aged 11 to 12 years attending two public schools in Istanbul. Data were collected by clinical examinations, face-to-face interviews and self-completed questionnaires. The internal consistency, test–retest reliability, construct validity using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), criterion related validity (concurrent and discriminant) were evaluated.ResultsA total of 208 children were subjected to the tested the C-OIDP. Overall, 93.7% of them reported at least one oral impact in the last 3 months. The most frequently affected performances were “eating” (72.1%) and “cleaning mouth”, while the performance with the lowest impact was “studying” (13%). The internal consistency and reproducibility of the C-OIDP were acceptable, with a Cronbach’s alpha of 0.73 and an intra-class correlation coefficient of 0.83. The EFA yielded a two-factor model termed “functional limitation” and “psychosocial limitation”. CFA identified the two- factor model which fit the data better than the previously proposed three-factor model, namely physical, psychological and social health. Having malocclusion, the presence of gum disease, reported history of oral problems in the mouth, dissatisfaction with oral health, bad self-rated oral health and having a problem-oriented pattern of dental attendance were found to be the most important factors related to worse oral health- related quality of life, supporting its criterion–related validity.ConclusionThis study provided preliminary evidence the psychometric properties of the C-OIDP index among Turkish school children aged 11–12 years. It may be applied to evaluate the oral health impact on quality of life in this population.

Utilization of dental services among low and middle income pregnant, post-partum and six-month post-partum women

BackgroundThis study aims to explore the difference in the utilization pattern of dental services among pregnant, post-partum and six-month post-partum women.MethodsThis cross-sectional questionnaire survey was performed at two maternity and child care hospitals in India that primarily cater to middle and low income communities. Data were collected from 3 groups: 1) pregnant women in their first trimester; 2) post-partum women (< 48 h after delivery); and 3) six-month post-partum women. The primary outcome of interest was dental service utilization during pregnancy. Self-perceived oral health (SPOH) was calculated based on the four global dimensions- knowledge, function, quality of life and social. Multiple logistic regression analysis was carried out to assess the effect of each independent variable after adjustment for the effect of all other variables in the model.ResultsResponses of 450 (150 pregnant, 150 post-partum and 150 six-month post-partum) women were analyzed (response rate = 72%). Significant differences in the dental attendance pattern was observed between the study groups (p < 0.01). Dental attendance among pregnant and six-month post-partum women were 60 and 75%, respectively, however, only about 15% of the post-partum women reported to have sought dental care within the 6 months prior to the study. Post-partum women had the highest SPOH scores, indicating poor self-perceived oral health, followed by pregnant and then six-month post-partum women, which was statistically significant (p < 0.05). A significantly higher percentage of post-partum women reported to have poor oral and general health, as compared to both, pregnant and six-month post-partum women (p < 0.01). Higher percentage of women reporting ‘good’ oral and general health had sought dental care compared with others (p < 0.01). After adjusting for all the other variables in the model, women with lower levels of education (ORa = 1.42; 95% CI: 1.01–2.00), women with poor self-perceived oral health (ORa = 1.08; 95% CI: 1.02–1.14) and post-partum women (ORa = 0.15; 95% CI: 0.09–0.24) were found to be less likely to seek regular dental care.ConclusionPattern of dental service utilization among women in this population varied according to their pregnancy status, level of education and self-perceived oral health.

Association of Clinical Parameters, Oral Hygiene, and Dietary Practices with Active Caries Lesions among Children with Early Childhood Caries

Aim: To find whether there is an association of clinical parameters, dental attendance pattern, oral hygiene, and dietary practices with the presence of active caries lesions among children with early childhood caries (ECC). Materials and methods: In this cross-sectional study, 171 children of 3–5 years of age with at least one decayed/filled tooth surface were examined. The presence or absence of visible plaque and decayed, missing, or filled-surface (dmfs) score were recorded. Each tooth surface was scored as per International Caries Detection and Assessment System (ICDAS) II criteria followed by supplemental lesion activity assessment (LAA) criteria, which was used to classify the lesions as active/inactive. A structured questionnaire regarding oral hygiene, dietary practices, and dental visit frequency was filled by parents of the children. Results: Of the 740 surfaces examined, 82.6% were active caries lesions. Previous dental visit, sweet score, presence of visible plaque, and ICDAS score above 4 were significantly associated with active carious surfaces. Conclusion: Factors associated with active caries lesions are the presence of visible plaque on the tooth surface, cavitation extending to dentin, and higher frequency of sugar consumption by the child. Clinical significance: Improper oral health practices can contribute to the activity of the caries lesions. Parental education on oral health practices, particularly plaque control measures, decreasing sugar exposures in the diet, and regular visits to the dentist for completion of the restorative therapy may help to render the lesions inactive

Predisposing, enabling, and need characteristics of dental services utilization among socially deprived schoolchildren

To test the relationship of predisposing, enabling and need characteristics with dental services utilization and pattern of dental attendance among 12-year-old schoolchildren living in a socially deprived urban area. A cross-sectional study was carried out involving 358 children enrolled in public schools located in a deprived area of the city of Manaus, Brazil. Predisposing, enabling, and need characteristics were selected according to Andersen's behavioral conceptual model. Self-completed questionnaires were used to collect the predisposing characteristics (child's gender, sense of coherence, self-esteem, oral health beliefs). Parents or guardians provided data on enabling characteristics, including dental health insurance and socioeconomic status. Evaluated need characteristics included oral clinical status assessed through dental examinations conducted by five calibrated examiners. Structural equation modeling was used to test the predictors of dental services utilization and pattern of dental attendance. Predisposing characteristics, including male gender and low parents/guardians sense of coherence predicted poor dental services utilization and inadequate pattern of dental attendance, respectively. Low socioeconomic status and poor oral clinical status were linked to poor dental services utilization and worse children's pattern of dental attendance. The present findings suggest that predisposing (child's gender and parental sense of coherence), enabling (socioeconomic conditions) and evaluated need characteristics (oral clinical status) are associated with dental services utilization among children.

Does individual and neighbourhood social capital in early childhood influence oral health-related quality of life?

Design Prospective cohort study with seven years of follow-up. Cohort selection All children aged under six years, who attended one of 15 randomly selected health centres in the municipality of Santa Maria, a city in Southern Brazil on National Children's Vaccination Day in 2010. Exposure measurement Individual social support was measured by a questionnaire which asked parents if they had attended a volunteer group in the previous 12 months and if they participated in any groups related to the child's school. Neighbourhood social capital was measured for each of the 15 neighbourhoods, by indicating the presence or absence of each of the following three types of community assets: social-class associations; workers associations; and cultural community centres. Outcome measurement Oral health-related quality of life (OHRQofL) was assessed using the Brazilian version of the Child Perception Questionnaire, for 8-10-year-olds (CPQ8-10). This includes a 5-point Likert score across 25 questions relating to oral symptoms, functional limitations, emotional well-being, and social well-being. The total mean score for each exposure group was calculated, ranging from 0-100, where higher scores indicate poorer OHRQofL. Data analysis The association between individual and neighbourhood social capital at baseline and oral health-related quality of life at follow-up was assessed using a multi-level Poisson regression model to create incidence-rate-ratios where a ratio greater than 1 indicates poorer OHRQofL. Other variables included in the model were: sex; household income; household crowding; dental attendance behavior; presence of dental caries; and presence of increased maxillary overjet. Results Of the 639 children originally enrolled in the study, 449 children were included at follow up (70.3%). Children who lived in a community that had a social-class association (IRR 0.79, 95% CI 0.67-0.93) or workers association (IRR 0.79, 95% CI 0.78-0.93) at baseline had lower oral health impact scores (better oral health-related quality of life) seven years later. The presence of cultural community centres was not associated with OHRQofL. Parental involvement with school activities at baseline was also associated with better OHRQofL at follow up (IRR 1.23, 95% CI 1.14-1.34), but participation in a voluntary network was not. Other variables that had a significant association with OHRQofL were: sex; household income; household crowding; dental attendance pattern; caries incidence; and increased maxillary overjet.Conclusions Oral health-related quality of life was influenced by individual and neighbourhood social capital.

Long-term regular dental attendance and tooth retention among British adults: A cross-sectional analysis of national survey data.

To explore the association between long-term pattern of dental attendance and tooth retention among British adults. This study analysed data from 2970 dentate adults who participated in the Adult Dental Health Survey. Data were collected through home interviews and clinical examinations. Individuals were categorized into four trajectories according to their responses to three questions on dental attendance over their life span. The four trajectories were always, current, former and never regular attenders. Tooth retention was measured as the number of natural teeth retained and having a functional dentition (20 or more teeth). Associations were examined in regression models adjusted for demographic (sex, age and country of residence), socioeconomic (education, equivalized household income and social class) and clinical factors (untreated caries and periodontal disease). Never and former regular attenders had fewer teeth retained (rate ratios with 95% confidence interval: 0.93 [0.89-0.97] and 0.97 [0.96-0.99], respectively) and lower odds of having functional dentition (odds ratios with 95% CI: 0.36 [0.22-0.60] and 0.53 [0.34-0.83], respectively) than always regular attenders after adjusting for demographic, socioeconomic and clinical characteristics. However, no differences in number of teeth retained or having a functional dentition were found between always and current regular attenders. Long-term regular dental attendance was associated with greater tooth retention. Never and former regular attenders had fewer teeth retained than always regular attenders. No difference in tooth retention was found between always and current regular attenders.

Is detecting oral cancer in general dental practices a realistic expectation? A population-based study using population linked data in Scotland.

To examine, for the first time on a population-basis via data linkage, whether early detection by general dental practices (GDP) is a realistic expectation by i) estimating the number of OC cases/year a dentist in Scotland may encounter over time, accounting for the deprivation level of practice location and dental registration/attendance rates, and ii) assessing whether patients attended GDPs two years pre-diagnosis. Scottish Cancer Registry data on all OC cases (2010-2012), published NHS Scotland dental workforce and registration/participation statistics, and individual patient data linked with NHS dental service activity were analysed. Dentists were estimated to potentially encounter one case of OC every 10 years, OCC every 16.7 years, and OPC every 25 years. However, 53.7% of OC patients had made no dental contact two years pre-diagnosis. Strategies for early detection must consider the rarity of OC incidence and poor dental attendance patterns. These results highlight the importance of improving access and uptake of dental services among those at highest risk to increase the opportunities for early detection.

Children's experiences following a CBT intervention to reduce dental anxiety: one year on.

To investigate children's ongoing experiences of dental care and use of strategies to manage their dental anxiety following cognitive behavioural therapy (CBT). A child self-completed postal questionnaire. Hospital, community and general dental practice. Questionnaires were sent to 44 children, aged 10–17 years who had been referred to specialist services due to their dental anxiety. Children had all previously received a guided CBT self-help intervention to reduce their dental anxiety and, on completion of treatment, had been discharged to their referring dentist. Questionnaires were sent out 12–18 months later to ascertain dental attendance patterns and application of any strategies learnt from the previous CBT intervention. 22 responses (50%) were received from 16 girls and six boys. Eighty-two percent had subsequently accessed follow-up care with a general dental practitioner and over half of these had undergone a dental procedure, other than a check-up. Ninety-one percent reported feeling less worried about dental visits, than previously, and described a change in cognition, behaviours, and feelings that allowed them to manage their anxiety better. CBT has positive immediate and longitudinal effects in reducing children's dental anxiety. The challenge of adopting this evidence-based approach within primary care settings remains.

Influence of maternal characteristics and caregiving behaviours on children's caries experience: Anintergenerational approach.

This study adopted an intergenerational approach, aiming to answer the following research questions: (a) Are maternal oral health-related behaviours and oral health associated with dental caries in preschool children?; (b) Do maternal caregiving behaviours mediate the association between maternal oral health-related behaviours and dental caries in preschool children. Children aged 5years, enrolled in the 2004 Pelotas (Brazil) Birth Cohort, were investigated (n=1303). Children were dentally examined using WHO criteria to assess the number of decayed, missing and filled surfaces (dmfs), and their mothers were interviewed. Standardized direct, indirect and total effects of maternal characteristics (frequency of toothbrushing, dental anxiety, the pattern of dental attendance, self-perception about oral health and self-reported dental caries) on maternal caregiving behaviours and children's dmfs were assessed using path analysis. Mean dmfs was 4.1 (95% CI 3.6;4.5). Maternal oral health-related behaviours had no direct effect on children's dental caries: child dental attendance pattern partially mediates the effect of maternal dental attendance pattern on dental caries (87.8%; P<0.05) and partially mediates the effect of maternal dental anxiety (39.9%; P<0.001). Child frequency of toothbrushing mediates 28.0% (P<0.001) of the effect of maternal frequency of toothbrushing on dental caries. Socioeconomic factors directly influenced children's caries experience, whereas maternal oral health-related behaviours had no direct effect. It was observed an indirect effect of maternal dental anxiety and dental attendance pattern on children's dental caries mediated by caregiving behaviours, such as child dental attendance pattern and frequency of toothbrushing.

Attitude and Behavior to Oral Health of 456 Patients Who Presented for Tooth Extraction at 2 Health Facilities in Southwestern Nigeria.

Introduction:Tooth loss can indicate the population’s oral health situation; majority of patients presenting for tooth extraction have poor oral health behavior and dental service utilization. Understanding the factors responsible for the poor attitude may help in designing targeted intervention to improve their oral health behavior. This study aims to find out the effects of dental health attitude and behavior on tooth mortality in a cohort of adults attending the oral surgery clinic for tooth extraction in 2 health facilities in southwestern Nigeria.Patients and Method:Cross-sectional study of consecutive adult patients who presented at the oral surgery clinic for tooth extraction. Clinical and demographic data, oral health habits, and pattern of previous dental clinic attendance were collected. Data analysis was done using SPSS version 19.0. Variables were subjected to univariate and multivariate logistic regression to evaluate factors influencing dental habit and dental service utilization.Results:The study comprised a total of 453 respondents, consisting of 239 nonattenders, 196 in-trouble attenders, and 18 regular attenders, with majority (59.4%) of them being low earners or not gainfully employed. Majority (64.8%) of the in-trouble attenders had attained tertiary education. Attendance pattern had no influence on the number of extractions needed.Conclusion:Despite high educational attainment and availability of dental services, most patients presenting for extraction have poor oral health habit and are problem-oriented attenders. Socioeconomic disparities and poor dental habits appear to be part of the major factors responsible for poor dental behavior among the study subjects.

Oral health behavior and attitudes among students of health and non-health oriented studies

Introduction: Unhealthy behavior such as neglecting to brush and floss, using tobacco and alcohol, and inadequate nutrition can adversely affect dental health. The frequency of dental visits is also of great importance in the early detection of different oral disorders. Our aim was to assess oral health behavior and attitudes among students of the 1st year of two health and non-health oriented studies of University of Sarajevo.&#x0D; Methods: We included 119 students of the 1st year of Faculty of Health Studies and 108 students of the 1st year of Faculty of Architecture of the University of Sarajevo. A self-administered questionnaire was used, comprising demographic data, data on oral hygiene habits, dental attendance pattern, a number of extracted teeth as well as problems with the appearance, comfort, and social life due to teeth problems.&#x0D; Results: Faculty of Architecture students significantly more often visit their dentist (χ2 = 24.174, df = 5, p = 0.00). Faculty of Health Studies students have significantly more extracted teeth (χ2 = 35.54, df = 4, p = 0.001). Dental health habits were significantly better at the students Faculty of Architecture (χ2 = 16.391, df = 2, p = 0.001). No significant difference between the groups about about avoiding encounters due to teeth and dentures problems.&#x0D; Conclusion: Oral health related attitudes may be better in students of non-health oriented studies, however, these results have to be confirmed by more investigations and larger studies.

Association of Maternal and Child Dental Anxiety With Dental Caries Experience and Dental Attendance Pattern of the Child

Introduction: Children with early childhood caries may have dental anxiety. Maternal anxiety can influence the child dental anxiety. Aims and Objective: To explore the association of maternal and child dental anxiety with the dental caries experience and the dental attendance pattern of the child. Materials and Methods: This cross-sectional study involved 227 mother–child dyads with children aged between 3 and 6 years. Mothers answered a questionnaire on dental attendance pattern. Corah’s dental anxiety scale was used to assess maternal anxiety, and facial image scale was used to assess dental anxiety in children. The “dmft” index of the child was recorded by a calibrated dentist. Statistical tests (Chi-square and Student’s t-tests) were employed to analyze the data, and P