Dental Attendance Research Articles

Albuminuria, C-reactive protein, and socioeconomic factors are associated with periodontal status in subjects with type 2 diabetes

Diabetes and periodontitis may increase risk of cardiovascular disease. Whether albuminuria, C-reactive protein (CRP), and socioeconomic factors, known as cardiovascular risks in subjects with poorly controlled diabetes, are independently associated with periodontal status in well-controlled diabetes remains to be elucidated. In 503 subjects with type 2 diabetes, the cross-sectional associations of clinical and socioeconomic factors with periodontal parameters were investigated. Periodontal parameters on all teeth included the probing pocket depth at 6 sites per tooth, bleeding on probing, the plaque score, tooth mobility, and the number of teeth. The subjects had a mean HbA1c value of 6.85% and a median CRP value of 0.06mg/dL, and 27.9% of the subjects had albuminuria. Albuminuria and CRP values had significant associations with several periodontal parameters, whereas other variables including HbA1c did not. Subjects with albuminuria had significantly higher HbA1c, CRP, and % sites of pocket depth ≥ 4mm than subjects with normoalbuminuria; additionally, those with high CRP (≥ median) had significantly higher body mass index, HbA1c, % sites of pocket depth ≥ 4mm, and plaque score than those with low CRP. In multiple linear regression analysis, albuminuria, CRP, education, smoking, and dental attendance exhibited significant associations with periodontal parameters, independent of the effect of age, sex, body mass index, and diabetes therapy. Albuminuria, CRP, education, smoking, and dental attendance were independently associated with periodontal parameters even in subjects with a mean of HbA1c of 6.85%, implying the importance of these factors for the prevention of cardiovascular disease.

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.

Decision tree analysis for factors associated with dental caries in school-aged children in Japan.

Our study aimed to elucidate the interactive relationship between factors associated with dental caries in school children using decision tree analysis. Cross-sectional study Methods: Participants were recruited from public primary schools (9-12 years, 4th to 6th grade) and junior high schools (12-13 years, 1st grade) in Japan. A total of 1775 students (928 boys and 847 girls) were analyzed. Questionnaire survey, oral examination, and saliva test were performed. Multiple logistic regression and decision tree analysis were performed. Multiple logistic regression showed an association between dental caries and toothpaste use, dental attendance and the presence of Streptococcus mutans. Decision tree analysis showed that students with non-regular dental attendance were at a significantly higher risk of dental caries at the late stage of primary school. At the early stage of primary school, high levels of Streptococcus mutans and male sex were factors associated with dental caries. In students with low levels of Streptococcus mutans, using toothpaste occasionally was associated with a high risk of dental caries. In early primary school years, S. mutans may be a useful screening and diagnostic tool for dental caries. In students with high levels of S. mutans, sex may be associated with dental caries. Furthermore, in students with low levels of S. mutans, regular use of toothpaste should be encouraged, and in late primary school years, regular dental attendance should be encouraged to prevent dental caries.

Dental attendance after treatment under dental general analgesia (DGA): a data-based follow-up study

AimsTo investigate dental attendance of patients in different age groups after dental general analgesia (DGA) and procedures performed on these patients during the DGA and in dental care after the DGA during the follow-up period of almost 3 years.MethodsThe study population consisted of 66 patients who were treated under DGA at a municipal health centre in Oulu, Finland between September 2010 and June 2011. The electronic patient files of the DGA patients were accessible for data collection for the follow-up period of nearly 3 years. The statistical analyses included Chi square tests and logistic regression modelling.ResultsApproximately every sixth (14.9%) dental visit was missed or cancelled and nearly half (43.9%) of the studied subjects had at least one missed or cancelled appointment. The factors increasing the risk of missed or cancelled appointments and dental avoidance were endodontic treatment (OR 3.62), need of more than five dental restorations (OR 3.47), tooth extractions due to caries (OR 2.22), and male gender (OR 1.80). A total of 45.5% of the patients received non-invasive procedures.ConclusionsPatients who need DGA are evidently risk patients considering dental attendance. Nearly half of the patients in this study had non-attended or cancelled appointments. DGA patients’ need of treatment after DGA is extensive, even comparable to the amount of procedures generally performed under DGA. The quality or amount of preventive procedures do not appear to be at the required level to reduce the number of non-attended appointments.

Translating prenatal oral health clinical standards into dental education: results and policy implications.

To evaluate characteristics of pregnant women served through the University of North Carolina's (UNC) prenatal oral health program (pOHP) dental clinic and community healthcare pathways to inform efforts in promoting prenatal oral health policies. The pOHP provides medical and dental students and practitioners with interprofessional experiences caring for pregnant women. A retrospective chart audit captured 314 pregnant women who made appointments over 33 months. Descriptive statistics and bivariate comparisons were computed to assess factors associated with dental appointment attendance and treatment completion. There were 564 pregnant women, with mean age of 29 years and gestation of 25 weeks, referred to the pOHP dental clinic from UNC OB-GYN and 20 community sites. Only 56% (N = 314) scheduled an appointment. Of the 314 appointed women, 55% (N = 172) attended at least one appointment. The majority (87%) presented with acute and/or complex treatment needs. Medicaid status was positively associated with appointment attendance (P = 0.001). Less than half (42%) of the women completed treatment prior to delivery. Mean maternal age, gestational age, and weeks to estimated date of delivery (EDD) were not significantly associated with completed treatment. This study provides descriptive evidence of an academic, interprofessional program's ability to provide safety-net dental care to pregnant women in the state of North Carolina. Results underscore the need for dental services among pregnant women, signaling for promotion of prenatal oral health clinical standards and informing policy on the state and national levels to maximize dental coverage.

Time attitudes profile stability and transitions: An exploratory study of adolescent health behaviours among high school students

PurposeTime attitudes refer to individuals' feelings about the past, present, and future, and an increasing number of cross-sectional studies have demonstrated that positive time attitudes are significantly related to better health and well-being. We investigated time attitude profile membership and associated transitions longitudinally in United Kingdom-based adolescents, and assessed the relationship between time attitude profile development on health behaviours at + 21 months after the data collection involving time attitudes. MethodsParticipants were high school students (N = 1306; 41.8% female, Mage 12.5–14.5 years [waves 1–3]). The Adolescent and Adult Time Inventory – Time Attitudes Scale was employed to identify profiles, and a mover-stayer latent transition analysis was employed to examine developmental changes. Data were also gathered on sensation seeking, and a range of health indicators were assessed: Past week frequency of physical exercise, self-rated health, subjective life expectancy, lifetime cannabis and smoking, and dental attendance. ResultsStaying in a positive time attitude profile was related to higher subjective life expectancy, and less frequent use of cannabis and cigarettes (1.00 ≤ d ≤ 4.00). Further, moving to a positive profile predicted healthier outcomes for most health measures used. ConclusionsNotwithstanding the limitation that health outcomes in the present study were distal, the present study bolstered a developing cross-sectional literature supporting the association between positive time attitudes and better health and well-being outcomes. Future longitudinal studies which assess measures concurrently are required.

Consumption frequency of added sugars and UK children's dental caries.

To examine the association between consumption frequency of foods and drinks with added sugar and dental caries experience in the permanent teeth of 12- and 15-year-old children in England, Wales and Northern Ireland, using the Children's Dental Health Survey 2013 (CDHS) data. Four thousand nine hundred and fifty children aged 12 and 15 have the following information available: daily consumption frequency of foods and drinks with added sugar, tooth-brushing frequency, dental attendance, and water-drinking frequency. The children's dental caries experience was available as a DMFT score (number of decayed, missing, filled permanent teeth). A zero-inflated negative binomial model (ZINB) was used to fit the DMFT score. Lower socioeconomic status (SES), nonregular dental check-ups, and low water-drinking frequency were associated with higher consumption frequency of added sugar (all P<0.05). The consumption frequency of both drinks and foods with added sugar also differed by region (P<0.001), and children who more frequently consumed foods with added sugars also consumed drinks with added sugars more often (P<0.001). Using the Zero-Inflated Negative Binomial model, DMFT scores were not associated with consumption frequency of added sugars for children with caries (DMFT>0), but the chance of being free of obvious caries (DMFT=0) was lower for children with high frequency (≥4) of sugar-added foods than for children reported to have a sugar-free diet (OR=0.5, 95% CI [0.3, 0.8]). Consumption frequency of added sugars was associated with dental caries and a number of child demographic and lifestyle characteristics. Children who consume foods and drinks with added sugar more frequently are more likely to develop dental caries, but higher consumption frequency of drinking water in fluoridated areas might reduce dental caries. The findings add to the evidence for the association between children's dental caries and added sugar consumption.

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.

Factors Associated With Access to Dental Services of Adults With Physical Disabilities in Thailand

OBJECTIVES: To determine factors associated with access to dental services of community-dwelling adults with physical disabilities in Thailand.METHODS: This cross-sectional study was conducted at the Center of Independent Living, community club for individuals with disabilities in Pathum Thani province, Thailand, in February 2018. Individual participants were interviewed by a trained interviewer using a structured questionnaire that consisted of (1) questions on demographic characteristics and (2) adapted questions that were based on the modified Penchansky and Thomas’s dimensions of access (accessibility, availability, acceptability, affordability, accommodation and awareness). Enter method of binary logistic regression analysis was used.RESULTS: We included 198 individuals with physical disabilities. Most participants had not attended dental care services in the previous 12 months (77.3%) and gave negative responses for all questions regarding the dimensions of access. Although we did not observe any statistically significant differences in age and the six dimensions of access between participants who had attended at least one dental appointment and those who had not, in multivariate analysis, we found a statistically significant association indicated that participants who had education &amp;lt; primary were 3.35 times more likely to had not attended at least one dental appointment (p = 0.002).CONCLUSION: Our findings have uncovered factors associated with access to dental services of community-dwelling adults with physical disabilities in Thailand. Individuals with physical disabilities are in need of oral health education programs regarding proper oral health behaviors such as regular dental services attendance, appropriate oral hygiene practices and dental care benefits.

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.

Patterns of dental visits and their predictors among male adolescents.

Improved oral health outcomes, including better quality of life, are associated with dental attendance. Visiting a dental office is an important mode of behavior, especially among adolescents; however, the factors that influence the patterns of dental visits are not fully understood. The objective of this study was to investigate the frequency of visiting a dental office and its predictors among male adolescents. This cross-sectional study involved a sample of 376 male adolescents (13-14 years old). Multi-stage random sampling was used to recruit participants from public schools in Dammam, Saudi Arabia. World Health Organization (WHO) oral health questionnaire for children was used for data collection. The χ2 test and multiple logistic regression analyses were performed to investigate the predictors of dental attendance. Fifty-one percent of studied adolescents (n = 192) visited the dentist during the last 12 months. Pain was the most common reason for the dental visit (22.9%), followed by a treatment or a follow-up (16.2%), and a routine dental check-up (9.3%). The participants with pain were 16.29 times more likely to visit a dental office than those without pain. Similarly, adolescents who had routine dental check-ups (odds ratio (OR) = 7.54, 95% confidence interval (CI) = 3.75, 15.15) and treatment or follow-ups had significantly higher odds (OR = 15.21, 95% CI = 7.22, 32.04) of making a dental visit than those without check-ups and treatment. In addition, the perception of good health of gums (OR = 2.49, 95% CI = 1.33, 4.66) and difficulty in chewing (OR = 2.00, 95% CI = 1.02, 3.92) were associated with dental attendance. Visiting a dental office was common among male adolescents. Pain was the most important reason and a predictor for dental attendance, and a small proportion of adolescents made dental visits for routine dental check-ups. Oral health literacy should be improved through awareness programs in schools. Adolescents should be encouraged to regularly visit the dentist to maintain optimal oral health.

Health visitors' views on promoting oral health and supporting clients with dental health problems: a qualitative study.

Inequalities in dental decay in young children persist, resulting in high admission rates for general anaesthetics for tooth extractions. Health visitors have the potential to improve dental attendance and oral health in families least likely to engage with dental services. There is little evidence on health visitor views on this. Semi-structured interviews were conducted with a purposive sample of 17 health visitors working in both affluent and deprived areas in a single UK city. Interviews were audio recorded, transcribed, anonymized and analysed following a constructivist grounded theory approach. Knowledge of oral health was high and health visitors requested oral health education specific to the communities they worked in. Health visitors reported effective, formal referral processes to other health services but not to primary NHS dental services even when dealing with infants in pain. Health visitors interviewed were largely unaware of specific NHS dental services which reduce barriers to dental care including interpreting services and dental services for children with additional needs. Health visitors interviewed were knowledgeable and enthusiastic about oral health but not about dental services. Inadequate links with NHS dental services may limit their effectiveness in oral health improvement and this needs to be addressed.

Oral health inequalities: Determinants of access to prevention and care in France

Oral diseases are unequally distributed according to a social gradient, which now constitutes a major public health problem. Acting against oral health inequalities requires a better understanding of the underlying mechanisms in order to identify the appropriate solutions to improve access to oral health promotion and dental care for deprived populations. A patient-centered model of health care access, describing the ideal interactions between individuals and the health care system was applied to the field of oral health in the French context. This model defines access to health care as the result of interactions between individuals and the health care system, in which health needs are perceived, health care is sought, health care structures are accessed and effectively used. Analysis is based on quantitative and qualitative bibliographic data acquired through an explanatory sociological approach. Socially deprived populations face many barriers preventing their access to dental care: the need for dental care is not necessarily perceived, and, when perceived, dental care is not immediately sought, accessibility to dental care structures is difficult and dental attendance is erratic. This review provides information to decision-makers in order to support regional health policies and to help implement public health strategies according to the principle of proportionate universalism. Two axes for action were identified, namely to integrate oral health promotion interventions within health promotion programmes and to gradually reorganize the dental care system to make it more accessible to everyone.

Applying the theory of planned behavior to self-report dental attendance in Norwegian adults through structural equation modelling approach

BackgroundUnderstanding factors that affect dental attendance behavior helps in constructing effective oral health campaigns. A socio-cognitive model that adequately explains variance in regular dental attendance has yet to be validated among younger adults in Norway. Focusing a representative sample of younger Norwegian adults, this cross-sectional study provided an empirical test of the Theory of Planned Behavior (TPB) augmented with descriptive norm and action planning and estimated direct and indirect effects of attitudes, subjective norms, descriptive norms, perceived behavioral control and action planning on intended and self-reported regular dental attendance.MethodSelf-administered questionnaires provided by 2551, 25–35 year olds, randomly selected from the Norwegian national population registry were used to assess socio-demographic factors, dental attendance as well as the constructs of the augmented TPB model (attitudes, subjective norms, descriptive norms, intention, action planning). A two-stage process of structural equation modelling (SEM) was used to test the augmented TPB model.ResultsConfirmatory factor analysis, CFA, confirmed the proposed correlated 6-factor measurement model after re-specification. SEM revealed that attitudes, perceived behavioral control, subjective norms and descriptive norms explained intention. The corresponding standardized regression coefficients were respectively (β = 0.70), (β =0.18), (β = − 0.17) and (β =0.11) (p < 0.001). Intention (β =0.46) predicted action planning and action planning (β =0.19) predicted dental attendance behavior (p < 0.001). The model revealed indirect effects of intention and perceived behavioral control on behavior through action planning and through intention and action planning, respectively. The final model explained 64 and 41% of the total variance in intention and dental attendance behavior.ConclusionThe findings support the utility of the TPB, the expanded normative component and action planning in predicting younger adults’ intended- and self-reported dental attendance. Interventions targeting young adults’ dental attendance might usefully focus on positive consequences following this behavior accompanied with modeling and group performance.

Perceived oral health and its association with symptoms of psychological distress, oral status and socio-demographic characteristics among elderly in Norway

BackgroundThere is poor knowledge about the extent to which psychological distress influences oral health in older people in Norway. The aim of this study was two-fold: i) to describe the oral health of Norwegian elderly and their levels of psychological distress; and ii) to examine the relationship of psychological distress with self-rated oral health, while controlling for oral status and socio-demographic characteristics, in Norwegian elderly.MethodsData were retrieved from a national cross-sectional survey conducted by Statistics Norway in 2012 and included information about self-rated oral health, psychological distress (measured using the Hopkins Symptom Checklist 25; HSCL-25), gender, age, civil status, smoking, self-reported number of teeth present and dental attendance for 949 non-institutionalised adults aged 65 years or older. Logistic regression was used to establish whether psychological distress predicts self-rated oral health, controlling for socio-demographic characteristics and oral status.ResultsAround 27% of the elderly reported having poor oral health, and 8 % had a HSCL-25 mean score ≥ 1.75, which indicates higher levels of psychological distress. Among the symptoms listed in the HSCL-25, the most frequently reported problems were lack of energy (1.7 ± 0.8) and difficulties falling and staying asleep (1.6 ± 0.7). The likelihood of reporting poor oral health was independently associated with having a mean HSCL-25 score ≥ 1.75 (OR = 1.89; 95% CI = 1.14–3.15), even when smoking (OR = 1.83; 95% CI = 1.17, 2.87) and having fewer than 20 teeth (OR = 3.49; 95% CI = 2.56, 4.76) were taken into account.ConclusionMost of the Norwegian elderly in our sample perceived themselves to have good oral health and reported relatively low levels of psychological distress. Higher levels of psychological distress can influence the oral health of the elderly independently of other factors such as smoking and having reduced number of teeth. Dental care professionals should consider screening their elderly patients for psychological distress and individualise the information about dental care for this specific population.

Midwives' and women's views on accessing dental care during pregnancy: an Australian qualitative study.

Maternal behaviours during pregnancy are likely to play a significant role in the development of dental caries in children. Although midwives are well placed to discuss oral health and provide information to women, dental attendance by women during pregnancy is minimal. This study aimed to explore midwives' experience of facilitating pregnant women's access to dental care and to document women's experience of receiving dental information and care during pregnancy. Focus groups with midwives and telephone interviews with women who were referred to Monash Health Dental Services were conducted to explore their perspectives and experiences. The qualitative data was thematically analysed. Three focus groups with 13 midwives and telephone interviews with eight women who recently gave birth were conducted. Three key themes were identified: maternal oral health knowledge; barriers to accessing dental information and care during pregnancy; and suggested recommendations. This study highlighted the barriers that exist for midwives to discuss oral health with women and refer women to dental care, and women's experiences of accessing dental care during pregnancy. Ongoing collaboration between the maternity and dental services is required to strengthen midwives' knowledge, confidence and practise in supporting women to access dental care during pregnancy.

Changes in oral health-related quality of life (OHRQoL) related to long-term utilization of dental care among older people

Objective: To examine whether long-term utilization of dental care, treatment with fillings and crowns and persistent tooth loss between age 50 and 65 years associate with subsequent changes in OHRQoL from age 65 to 70 years.Method: In 1992, a census of 50-year-olds received invitation to participate in a questionnaire survey. Of 6346 respondents, 3585 completed follow-ups in 1997, 2002, 2007 and 2012. OHRQoL was measured using the Oral Impacts on Daily Performances (OIDP) inventory.Results: Around 70.4%, 11.2% and 18.4% confirmed respectively, no change, worsening, and improvement in OIDP scores between age 65 and 70 years. Compared to those being permanent non-routine dental attenders, ORs of improving and worsening of OIDP were respectively, 0.4 and 0.6 if being a permanent routine dental attender. ORs for improving OIDP was 1.6 if reporting persistent specialist attendance and 2.5 if having received crowns and fillings. Participants with permanent tooth loss were most likely to both worsen and improve OIDP.Conclusion: Long-term routine dental attendance and permanent tooth loss occurred as predictors simultaneously for improvement and worsening of OIDP. Accumulation of advantages and disadvantages throughout the life-course increases and decreases the probability of improvement and worsening in OIDP among older people in Sweden.

PHS70 - Factors Associated with Non-Persistent Surveillance after Diagnosis of Oral Potentially Malignant Disorders

Individuals diagnosed with oral potentially malignant disorders (OPMDs) are recommended to receive regular surveillance in addition to oral screening once every two years through the National Oral Screening Program in Taiwan. However, their adherence to regular surveillance after the OPMD diagnosis is poor, and some of them are diagnosed with oral cavity cancer at an advanced stage nonetheless. This study, therefore, aimed to examine factors associated with non-persistent surveillance. Individuals who were diagnosed with OPMDs through the oral screening program were identified from the oral screening database. Patterns of surveillance after the diagnosis of OPMDs and use of health services were retrieved from their National Health Insurance claims database. Persistence of surveillance was defined as regular follow-up physician visits or oral screening without a gap longer than seven months. Cox proportional hazards regression model was adopted to identify factors associated with the risk of non-persistent surveillance. Of 11,341 subjects identified in this study, the mean age was 53 years old, and 93% of them were male. Female, poverty, Charlson Comorbidity Index < 2, living in city area, betel nut chewing, cigarette smoking, and no dental attendance in one year prior to the OPMD diagnosis were associated with a higher risk of non-persistence surveillance. This study identified factors associated with the risk of non-persistent surveillance after the diagnosis of OPMDs. The information is of importance for planning interventions to improve persistent surveillance in order to detect development of oral cavity cancer at an earlier stage.