Oral Health Indicators Research Articles

Estudo dos Fatores de Risco à Cárie Dentária em Gestantes Conforme o Trimestre Gestacional

Objective: The aim was to analyze the occurrence of risk factors for dental caries in pregnant women, relating these factors to pregnancy trimester. Method: It was conducted a descriptive cross-sectional observational study, in which were selected 90 pregnant women. Clinical examination was performed to evaluate the amount of dental plaque (Simplified Oral Hygiene Index – SOHI) and caries experience (Permanent Decayed, Missing and Filled Teeth – DMFT). Unstimulated saliva was sampled for counting of total mutans streptococci (TMS) on mitis salivarius bacitracin agar. The correlation between pregnancy trimester and oral health indicators was verified by Spearman test, with confidence level of 95%. Results: The mean values obtained for SOHI were 1.0, 1.0 and 1.1 for the pregnant women in the 1st, 2nd and 3rd trimester, respectively. The values of caries experience for the pregnant women in the 1st, 2nd and 3rd trimester were, respectively, 4.6, 4.3 and 4.8. For the pregnant women in the 1st trimester, 63.4% presented moderate contamination by TMS, while the pregnant women in the 2nd (56.7%) and 3rd (53.4%) trimester demonstrated low contamination. No significant statistical correlation (p>0.05) was found between pregnancy semester and oral health indicators. Conclusion: The pregnant women of this study have significant frequencies of caries disease and its risk factors. No difference was found in the occurrence of risk factors between the pregnancy trimesters. DESCRIPTORS: Pregnant Women. Dental Caries. Risk factors.

Iniquidades raciais em saúde bucal no Brasil

To identify racial inequities in oral health between groups of adults selfdeclared as white, black, or mixed in Brazil. Secondary data were obtained from the national oral health survey of the Brazilian population (SB-Brasil 2002-2003) database. Initially, a cross-sectional study was conducted to compare the following outcome variables: caries, tooth loss, pain of dental origin, and need for prostheses according to race/color in a sample of 12 811 adults of both sexes, aged 35 to 44 years. In the second stage, an ecologic study was carried out with data aggregated by Brazilian state to contextualize racial inequity in a population of 6 918 black individuals (black and mixed). For that, the oral health outcomes studied in the first stage were correlated with human development and income distribution indicators. Significant differences were observed between the race/color groups for all oral health outcomes examined (P < 0.01). Correlations were found between oral health outcomes and indicators related to the human development profile, average family income, and income inequality by state for the group of Brazilian blacks. The results show racial inequity in oral health in Brazil for all the indicators analyzed (caries, tooth loss, pain, and need for prostheses), with greater vulnerability among the black population compared to whites. Contextual factors related to the human development profile, income distribution, and access to health care policies appear to play a key role in describing the vulnerability of populations to oral health problems.

Comparative assessment of validity and reliability of the Oral Impacts on Daily Performance (OIDP) frequency scale: a cross‐sectional survey among adolescents in Davanagere city, Karnataka, India

To evaluate reliability and validity of an abbreviated version of the Oral Impact on Daily Performance (OIDP) questionnaire and to analyse the interrelationship between OIDP scores, socio-demographic characteristics and oral health status among high school children in Davanagere city, Karnataka, India. This cross-sectional survey was conducted with 900 school children aged between 12 and 15. The subjects were randomly selected from six high schools. Selected subjects completed a survey instrument predesigned to measure subjective oral health indicators including the eight-item OIDP frequency scores. The study participants were clinically examined for dental caries, and they completed a self-administered questionnaire about demographic information and oral behaviours. 44% of the students reported at least one oral impact in the previous 6 months. The reliability of the instrument was measured in terms of Cronbach's alpha for the OIDP frequency. It was found to be 0.81. Eating was the most common performance affected (33%) followed by cleaning teeth (22%) and speaking (20%). The severity of impacts was low for relaxing and carrying out works. The OIDP frequency score has acceptable psychometric properties in the context of an oral health survey among high school children of Davanagere city, Karnataka, India.

Oral health in Brazil: the challenges for dental health care models

This paper discusses adult oral health in Brazil according to three perspectives: 1) the available epidemiological evidence about the population's oral-health-related epidemiological situation, especially adults and the elderly population, in relation to two high prevalence oral injuries (dental caries and tooth loss), 2) the main health care models for dealing with this situation, by analyzing the related historical processes in order to reveal the likely social, political and epidemiological implications of the different models, and 3) lastly, the possible challenges to Brazilian dentistry or collective oral health in overcoming these obstacles. The main results of the study indicate that, from an epidemiological point of view, Brazil is undergoing a transition in dental caries and tooth loss, which is not yet reflected in the profile of the elderly, but which is tentatively evidenced in young adults. Tooth loss remains high. Certain aspects of society's economic and political superstructure have an important impact on oral health indicators and existing inequalities. Oral health care models have a relative importance and must not be neglected. Vestiges of ideological movements, like preventive medicine, may explain the current impasse in collective oral health practices, such as the preeminence of Finalized Treatment (FT) in clinics and of preventive care in schools fostered by community-based programs. It is therefore important to develop conceptual, theoretical reflections and to increase the objects of intervention, their purposes and their modus operandi. The practice of dentistry according to these alternative models is still being constructed. New studies related to the different formats of these new practices are recommended.

Determinantes de salud oral en población de 12 años

AimTo determine caries prevalence and risk factor associated to caries experience and oral health self perception in 12 year-old school children. The study makes comparisons between urban and rural children of Maule Region, Chile. Subjets and MethodsCross sectional study in a convenience sample of 285 school children from four counties. Oral examinations were carried out by one calibrated clinician. Demographic variables, DMFT index, oral hygiene index, oral health self perception were measured, as well as the last visit to the dentist. ResultsCaries prevalence was 63.9%. No statistical difference was found based on gender and residence area. Boys had 3.17 (95% IC 1.62–6.20) times more risk to have a DMFT = 0 than girls. Oral hygiene was also associated to DMFT=0 (OR=0.24 95% IC 0.10–0.57). Oral hygiene was associated to residence area and socioeconomic status. Urban boys were 5.6 times more at risk to have an optimal hygiene than rural boys (95% IC 2.68–11.95). Children from low and medium socioeconomic status were prevented to have an optimal hygiene (OR= 0.17 95% IC 0.04–0.66). Oral health self perception was not associated to any studied variable. ConclusionRural school children had the worst oral health indicators. These results show oral health inequities in 12 year-old school children. Thus, it is necessary to design health promotion and diseases prevention strategies according to their needs.

Validity and reliability of the Oral Impacts on Daily Performance (OIDP) scale in the elderly population of Bosnia and Herzegovina

To adapt the Oral Impacts on Daily Performance (OIDP) index for elderly people in Bosnia and Herzegovina and test its validity, reliability and responsiveness to change. Clinical measures alone may not be adequate for assessing the oral health of individuals. Subjective oral health indicators tested within a particular cultural context may not be relevant across cultures. The study population comprised 231 free-living adults aged 65 years or older. The OIDP was cross-culturally adapted from English into the Serbian language and its psychometric properties were tested. Data were collected using a clinical examination and a questionnaire containing the OIDP. In terms of reliability, Cronbach's alpha coefficient was 0.82 and the intraclass correlation coefficient 0.88. The very high correlation of OIDP with self-rated oral health (r = 0.78) verified criterion validity, while construct validity was demonstrated through its significant and graded associations with other subjective health measures. OIDP change scores on a treated subsample showed moderate effect size (0.59) and were associated with perceptions of oral health change, providing evidence for its responsiveness to change. The Bosnian version of the OIDP showed satisfactory validity, reliability and responsiveness to change confirming its appropriateness for use among older populations in Bosnia and Herzegovina.

Diet, nutritional status and oral health in hunter‐gatherers from the central‐northern coast of Patagonia and the Chubut river lower valley, Argentina

AbstractArchaeological research in central‐northern Patagonia (Atlantic coast and lower the valley of Chubut river) showed that this area was used since at least the Middle Holocene. Stable isotope analyses (13C and 15N) of human bone samples indicate that hunter‐gatherers living in that area had a terrestrial‐marine diet including guanaco meat, land plants, mollusks and pinnipeds. Despite this general trend, intersite variability and changes through time were noted, especially after the late Holocene. These results have been reinforced by archaeofaunal, technological and bioarchaeological records. In this paper, three hypotheses are examined: (a) the diet of these populations was complete and rich enough to ensure good health status and avoid nutritional deficiencies; (b) carbohydrate consumption increased progressively after 1000 BP, when pottery technology was adopted and (c) this kind of mixed diet would have been qualitatively more nutritious than that of other populations of the region, which would have resulted in better nutritional and healthy conditions. These three hypotheses are compared with dental results obtained from 563 permanent teeth from 45 individuals (34 adults and 11 juveniles from both sexes), rescued from burial sites. Indicators of oral health were assessed through the observation of caries, abscesses, wear, pulpar cavity exposure and ante mortem loss. Features of nutritional status such as enamel hypoplasia, porotic hyperostosis and cribra orbitalia were also examined. Given the availability of direct radiocarbon dating for most of the sample, three temporal series were determined: ‘Before 1000 BP’, ‘1000–5000 BP’ and ‘Post‐contact’. No evidence of alimentary stress or iron deficiency was found in individuals from the three series, which accounts for healthy and good nutritional life conditions. After 1000 BP, the results show a progressive increase in the caries percentage and a decrease in abscesses, dental wear and ante mortem losses frequency. This is possibly related to more consumption of processed foods in the last 1000 years. These results were compared with similar studies based on samples from different environments and latitudes of Patagonia. Evidence suggests that mixed diets (marine‐terrestrial) would have been more appropriate and nutritionally complete than exclusively marine or terrestrial diets. Copyright © 2010 John Wiley &amp; Sons, Ltd.

Using General Estimating Equations to Analyze Oral Health in the Moche Valley of Perú

ABSTRACTThis study introduces a new method for analyzing oral health indicators and thus reconstructing diet. To this end, we examined the dental remains of 173 individuals recovered from the site of Cerro Oreja in the Moche Valley of Perú, who lived during the Salinar (400–1 BC) or Gallinazo (AD 1–200) phases. The infectious and degenerative conditions analyzed include: dental caries, dental wear, dental abscess, antemortem tooth loss and dental calculus, all of which have been used to track dietary and thus subsistence‐related economic and sociopolitical changes. Data were analyzed using generalized estimating equations, an extension of generalized linear models. Significant changes in the frequency of occurrence of most dental conditions suggest that during the period of study, there was an increase in the consumption of agricultural products. However, these changes in oral health did not equally affect females and males. By the end of the Gallinazo phase, significant sex differences developed, with females more often affected by dental caries and males displaying greater mean molar wear scores. Copyright © 2011 John Wiley &amp; Sons, Ltd.

Comparison of Oral Health Indicators in Type 2 Diabetes Mellitus Patients and Controls

Introduction: India leads the world with largest number of diabetic subjects earning the dubious distinction of being termed the ‘diabetes capital of the world’. Oral manifestations of diabetes mellitus are devastating, these include gingival and periodontal diseases, bone loss, dental caries, alterations in salivary flow and others. Materials and methods: In our study, sample consists of 50 patients with type 2 diabetes mellitus (study group) and 50 nondiabetic patients (control group) of age range of 35 to 70 years. The oral indicators used in the study are orthopantomogram, decayed-missing-filled teeth index, oral hygiene index-simplified, periodontal index, gingival index, body mass index, waist circumferences, fasting blood sugar, postprandial glucose and random fasting blood sugar should be replaced by random blood sugar. Results: In our study, statistically body mass index (p < 0.01), waist circumference (p < 0.001), periodontal disease index (p < 0.01), gingival index (p < 0.01) and bone loss (p < 0.001) were higher in diabetic group than nondiabetic group and were significant. And, periodontal index of smokers is significantly higher than compared with nonsmokers diabetic patients. Conclusion: The results of present study demonstrate that gingival index, periodontal index and bone loss measurements in diabetic patients are significantly higher than nondiabetic patients. Smoking is also a promoting factor of periodontal disease in diabetic patients.

The Feasibility of Data Collection in Dental Practices, Using Codes for the International Caries Detection and Assessment System (ICDAS), to Allow European General Dental Practitioners to Monitor Dental Caries at Local, National, and International Levels

To determine whether or not European general dental practitioners can carry out comprehensive dental caries assessments of the teeth of selected quotas of their patients during routine dental check-ups, as an alternative or complement to the work of specialised, salaried, dental epidemiologists. Dentists from several European countries were invited by local coordinators to be trained to carry out dental disease assessments. For caries, they used the International Caries Detection and Assessment System (ICDAS), as part of a wider oral health indicators project with a European perspective. They attended training events and recruited and examined patients in their own practices before completing questionnaires, which they returned to a central data-processing facility. Ninety-six dentists returned questionnaires giving their opinions of the data-collection system after performing ICDAS assessments on 1216 patients. Mean times for assessments varied between countries from 7.8 to 14.06 minutes and were dependent on the age of the patient and the number and general condition of the teeth present. Given a choice of six difficulty/ease options for both understanding and applying the system, 89% of the dental examiners chose one of the two categories indicating the least difficulty for understanding and 73% chose one of these two categories for applying. Volunteer general dental practitioners (GDPs) from six European countries were able successfully to perform data collection for survey work in addition to their routine practice. If larger numbers of GDPs across Europe are prepared to undertake this type of work for selected quota samples, it should be possible to collect data to monitor caries levels among patients who attend dental practices at local, national, and international levels, provided that the time taken is considered and remunerated appropriately.

Tooth Wear Related to Marine Foraging, Agro‐Pastoralism and the Formative Transition on the Northern Chilean Coast

ABSTRACTOcclusal surface wear scores were examined in a sample of 200 Formative period (1500 bc–ad 500) skeletons from the lower Azapa Valley in northwest Chile. Wear rate and plane (angle) were additionally evaluated using a subsample of paired first and second mandibular molars. The Formative period represents the transition from marine foraging to agro‐pastoral dependence in the region, and differences in oral pathology indicate that diet varied by site location (coast vs valley interior) but not by archaeological phase (early vs late). We predicted that occlusal wear would demonstrate similar patterns, resulting from differences in food consistency, and therefore hypothesised that in coastal groups consuming greater quantities of foraged foods, occlusal surfaces should wear faster and exhibit flat molar wear, whereas among valley interior groups consuming greater quantities of agro‐pastoral products, these should wear slower but exhibit more angled molar wear. Heavier posterior tooth wear was identified among coastal residents, but rate and angle of molar occlusal attrition did not differ significantly by location. Heavier overall wear and a steeper molar wear plane were identified during the early phase indicating that food consistency varied somewhat over the course of the Formative period. Overall, the results indicate that, although limited differences in tooth wear exist by site location, wear varied more over time likely reflecting a gradual transition from foraging to agro‐pastoral dependence in the lower Azapa Valley. Although oral health indicators point to differences in dietary investment by location, maintenance of a mixed subsistence economy likely sustained a comparative consistency of foodstuffs. Copyright © 2011 John Wiley &amp; Sons, Ltd.

Exploring Socioeconomic Disparities in Self-Reported Oral Health Among Adolescents in California

Socioeconomic factors are associated with disparities in oral health among adolescents; however, the underlying reasons are not clear. The authors conducted a study to determine if known indicators of oral health can explain such disparities. The authors examined data from a 2007 California Health Interview Survey of adolescents. The outcome of interest was self-reported condition of the teeth; covariates were socioeconomic status (SES) (that is, family poverty level and parental education) and a range of other variables representing health-influencing behaviors, dental care and other social factors. The authors conducted analyses by using logistic regression to explain disparities in self-reported condition of the teeth associated with SES. The authors found that socioeconomic disparities decreased substantially after they added all potential explanatory variables to the model, leaving poverty level as the only variable associated with differences in the self-reported condition of the teeth. Adolescents living below the federal poverty guidelines were more likely to report that the condition of their teeth was fair or poor than were adolescents who were least poor (odds ratio = 1.58; 95 percent confidence interval, 1.04-2.41). In multivariate analyses, further oral health disparities existed in relation to behaviors that influence health, social environment and dental care. The results of this study showed that a number of factors decreased, but did not eliminate, the observed relationship between SES and oral health in Californian adolescents. Most of these explanatory factors are modifiable, indicating that socioeconomic differences associated with oral health among adolescents may be amenable to change. Practice Implications. By promoting a healthy lifestyle (including healthy diet, exercise and regular dental attendance) and conveying to patients in languages other than English how to maintain oral health, dentists may be able to ameliorate the effects of socioeconomic disparities in oral health.

Evaluation of Oral Therapeuthical and Surgical Treatment Needs among Retirement Age Population in Different Countries

Evaluation of Oral Therapeuthical and Surgical Treatment Needs among Retirement Age Population in Different Countries Oral health in connection with quality of life is affected by such functional factors as dental decay and its complications, untreated tooth roots, oral mucosal diseases and inflammations, precancerous diseases, cancers, pain in temporomandibular joints, xerostomia and partially or fully edentulous jaws. It has been noted in literature that among retirement age population the number of remaining teeth has increased and the number of untreated decayed teeth in developed countries for the last 20 years has decreased. Despite this fact the need to improve measures of oral health remains actual in this age group due to increasing prevalence of diagnosed oral diseases and number of extracted teeth and roots. Oral health indicators among retirement age population living in nursing homes in such countries as Canada, USA, UK, Finland, Denmark, Germany, Turkey, Brazil, Australia and Lithuania differ from the same age group indicators among self-dependent old people able to take care of themself. Oral health indicators of nursing homes residents in many countries are significantly worse than oral health indicators of the corresponding age group population. The proposed evaluation data of oral hygiene, periodontal status, DMF-T index, quality of existing and needs of new prosthodontics as well as oral mucosal disorders among retirement age population provides an important insight into therapeutic and surgical treatment provision in different countries.

The relationships between cognitive ability and dental status in a national sample of USA adults

There are very few studies on the relationship between cognitive ability and dental status in middle aged and younger adults. We postulate that lower cognitive ability is directly related to poorer dental status and that this relationship operates through the relationship between cognitive ability and health-related behaviors. The objectives of this study are (1) to examine the relationship between two measures of cognitive ability, Symbol Digit Substitution Test (SDST) and Serial Digit Learning Test (SDLT) and decayed, missing, filled and sound tooth surfaces, (2) to examine the relationship between cognitive ability and two health-related behaviors, dental visits and smoking, (3) and to test if the aforementioned relationship is independent of socioeconomic position. Data were from the Third National Health and Examination Survey. We examined the relationship between SDST and SDLT, and the oral health indicators and the behavioral factors using a series of regression models. Individuals with lower cognitive ability had higher means of decayed and missing tooth surfaces and lower means of sound and filled tooth surfaces. Poorer cognitive ability was associated with poorer behaviors; lower levels of dental attendance and higher levels of smoking. The relationship between cognitive ability and dental status was further demonstrated in the regression analysis. For a higher unit of SDST the rate ratio for decayed tooth surfaces was 1.91 (CI 1.53–2.38) which attenuated to 1.40 (CI 1.13–1.73) after adjusting for age, sex, ethnicity, income, dental attendance and smoking, but remained significant. Similar results were obtained for all oral health outcomes. This study found a relationship between cognitive ability and dental status and related behaviors among middle aged and younger adults. The relationship was independent of income and ethnicity. These findings support the theories put forward on a relationship between cognitive ability and health operating through health-related behaviors.

Bioarchaeological analysis of diet during the Coles Creek period in the southern Lower Mississippi Valley

The timing of the dietary shift from foraging to maize agriculture, and the speed at which such practices were adopted, are important considerations in the cultural evolution of the New World. In the southern Lower Mississippi Valley, maize agriculture traditionally was believed to have been practiced during the Coles Creek period (A.D. 700-1200); however, direct evidence for maize is lacking in the archaeological record prior to A.D. 1000. The present study examines Coles Creek diet from a bioarchaeological perspective. Oral-health indicators, including abscesses, antemortem tooth loss, calculus, carious lesions, periodontal disease, and tooth wear, were evaluated in a regional, temporal context. Data were collected from 288 dentitions from eight sites in the southern Lower Mississippi Valley that range in date from 800 B.C. to A.D. 1200. The sample then was separated into Pre-Coles Creek and Coles Creek categories and statistical analyses were used to assess temporal variation in pathology load. Results indicate that pathology load in the Coles Creek sample is slightly heavier than the Pre-Coles Creek sample; however, the differences are not substantial. Furthermore, data suggest that regional differences in resource exploitation existed between the Lower Mississippi Valley and populations elsewhere in the eastern United States. Specifically, the presence of starchy native plants other than maize in the diet likely contributed to a high pathology load for early hunter-gatherers. Ultimately, data from this study complement the archaeological, botanical, and zooarchaeological records and indicate that Coles Creek subsistence was not based on maize agriculture.

Inequity in a market-based health system: Evidence from Canada's dental sector

We study the extent and drivers of income-related inequity in utilization of dental services in Canada using the concentration-index approach that has been widely applied to study inequity in physician and hospital services. Because dental care is almost wholly privately financed in Canada, our estimates provide a benchmark for income-related inequity of utilization in private health systems. Although a number of studies document a link between income and utilization, our study is one of the few measuring income-related inequity in dental care utilization. A unique feature of our study is that we analyze separately inequity in total dental visits and in preventive visits. This is important because the case for equity is much clearer for preventive dental care. We also examine the impact of controlling for need using a wider variety of need indicators than previous analyses. We confirm that most oral health indicators perform poorly as need adjustors because they reflect past dental care use: individuals with higher levels of utilization also are in better oral health. Our most important finding is that access to preventive care is the most "pro-rich" type of dental care utilization and that income-related inequity in preventive dental care utilization is three times larger than what is measured for specialist services utilization in Canada.

Health promoting schools and their impact on the oral health of mentally disabled people in Brazil

Health promotion aims to ensure that the population has improved living and health conditions, and schools are appropriate environments in which to do this. The purpose of this study was to investigate the impact of health promotion in terms of oral health in special schools for mentally disable pupils in Brazil. The study was cross-sectional and adopted a qualitative and quantitative approach, using triangulation methods to observe the reality. An epidemiological survey was performed in order to analyse the oral health status; a semi-structured questionnaire and participative observation were used for the qualitative analysis of the health promotion activities undertaken in the schools; case studies were carried out to evaluate the profile of oral health status in the context of the schools. The sample was comprised of 383 school-children aged 2-19, stratified among 7 schools, Curitiba/Paraná/Brazil. The analysis was performed by means of frequency distribution and associations between variables, using the SPSS 16.0 program. The oral health status prevalences in the population studied were dental caries, 49.3%; bleeding gums, 23.8%; dental trauma, 11% and toothache in the last 3 months, 17,8%. Dental caries and bleeding gums experience was associated with the level of the mother's education (p<0.00) and age group (p<0.00). Dental trauma and toothache in the last 3 months were associated with the level of the mother's education (p<0.00 and p<0.00, respectively). Analysis of the dimensions of health promotion demonstrated that health is being promoted in all the schools studied. However, the analysis of oral health indicators per school revealed a possible interference of socio-demographic aspects in the results. It was concluded that the analysed special schools for the mentally disabled promote health. However, the socio-demographic profile of this population appears to have greater influence on vulnerability than the school context in relation to oral health status.

Factor structure of a conceptual model of oral health tested among 65‐year olds in Norway and Sweden

No studies have tested oral health-related quality of life models in dentate older adults across different populations. To test the factor structure of oral health outcomes within Gilbert's conceptual model among 65-year olds in Sweden and Norway. It was hypothesized that responses to 14 observed indicators could be explained by three correlated factors, symptom status, functional limitations and oral disadvantages, that each observed oral health indicator would associate more strongly with the factor it is supposed to measure than with competing factors and that the proposed 3-factor structure would possess satisfactory cross-national stability with 65-year olds in Norway and Sweden. In 2007, 6078 Swedish- and 4062 Norwegian adults borne in 1942 completed mailed questionnaires including oral symptoms, functional limitations and the eight item Oral Impacts on Daily Performances inventory. Model generation analysis was restricted to the Norwegian study group and the model achieved was tested without modifications in Swedish 65-year olds. A modified 3-factor solution with cross-loadings, improved the fit to the data compared with a 2-factor- and the initially proposed 3-factor model among the Norwegian [comparative fit index (CFI) = 0.97] and Swedish (CFI = 0.98) participants. All factor loadings for the modified 3-factor model were in the expected direction and were statistically significant at CR > 1. Multiple group confirmatory factor analyses, with Norwegian and Swedish data simultaneously revealed acceptable fit for the unconstrained model (CFI = 0.97), whereas unconstrained and constrained models were statistically significant different in nested model comparison. Within construct validity of Gilbert's model was supported with Norwegian and Swedish 65-year olds, indicating that the 14-item questionnaire reflected three constructs; symptom status, functional limitation and oral disadvantage. Measurement invariance was confirmed at the level of factor structure, suggesting that the 3-factor model is comparable to some extent across 65-year olds in Norway and Sweden.

Satisfaction with teeth and life‐course predictors: a prospective study of a Swedish 1942 birth cohort

This study aimed to assess the stability or change in satisfaction with teeth among Swedish adults between the ages of 50 and 65 yr, and to identify the impact of socio-demographics and of clinical and subjective oral health indicators on participants' satisfaction with teeth during that period. Self-administered standardized questionnaires were used as part of a longitudinal study. In 1992, 1997, 2002, and 2007 all residents (born in 1942) of two Swedish counties were invited to participate in the study. A total of 63% women and 66% men reported being satisfied with their teeth between 50 and 65 yr of age. The corresponding figures, with respect to dissatisfaction, were 7% and 6% respectively. Generalized estimated equation models revealed a decline in the odds of being satisfied with advancing age, which was particularly important in subjects with lower education, tooth loss, and smokers. Consolidation in oral health perceptions starts before age 50, suggesting early intervention before that age. Promotion of a healthy adult lifestyle and improved access to quality oral healthcare might increase the likelihood of people being satisfied with their teeth throughout the third age-period in both genders.

Oral health and risk for head and neck squamous cell carcinoma: the Carolina Head and Neck Cancer Study

Recent reports have linked oral health and periodontal disease indicators with increased risk of squamous cell carcinoma of head and neck (SCCHN). Thus far, evidence has been inconclusive; our objective was to study the association between oral health and SCCHN risk in the context of a large population-based study. A population-based case-control study of incident SCCHN, the Carolina Head and Neck Cancer Study was carried out in 2002-2006 in 46 counties in North Carolina. Controls (n = 1,361) were frequency matched with cases (n = 1,289) on age, race, and gender. Oral health was assessed using interview data on tooth loss and mobility, mouthwash use, and frequency of dental visits. Subjects were 26-80 years old (median age = 61). The distribution of tooth loss among controls was 0-5 teeth = 60%; 5-14 = 15%; and 16-28 = 25%. After controlling for covariates, tooth loss did not yield any notable association with SCCHN (16-28 vs. 0-5 lost teeth: OR: 1.21, 95% CI: 0.94, 1.56). Self-reported history of tooth mobility was moderately associated with increased SCCHN risk (OR: 1.33, 95% CI: 1.07, 1.65); however, the association did not persist among never smokers. Routine dental visits were associated with 30% risk reduction (OR: 0.68, 95% CI: 0.53, 0.87). These data provide support for a possible modest association of periodontal disease, as measured by self-reported tooth loss indicators, but not tooth loss per se, with SCCHN risk.