Oral Health Need Research Articles

Oral Health Needs Among Adults in the United States With Chronic Diseases

Oral and dental diseases may be associated with other chronic diseases. Using data from the National Health and Nutrition Examination Survey 1999-2004, the authors calculated the prevalence of untreated dental diseases, self-reported poor oral health and the number of missing teeth for adults in the United States who had certain chronic diseases. The authors used multivariate analysis to determine whether these diseases were associated with indicators of dental disease after controlling for common risk factors. Participants with rheumatoid arthritis, diabetes or a liver condition were twice as likely to have an urgent need for dental treatment as were participants who did not have these diseases. After controlling for common risk factors, the authors found that arthritis, cardiovascular disease, diabetes, emphysema, hepatitis C virus, obesity and stroke still were associated with dental disease. The authors found a high burden of unmet dental care needs among participants with chronic diseases. This association held in the multivariate analysis, suggesting that some chronic diseases may increase the risk of developing dental disease, decrease utilization of dental care or both. Dental and medical care providers should work together to ensure that adults with chronic diseases receive regular dental care.

Effect of Implementing Dental Services in Israeli Psychiatric Hospitals on the Oral and Dental Health of Inpatients

Effect of Implementing Dental Services in Israeli Psychiatric Hospitals on the Oral and Dental Health of Inpatients

Methods and Software for Estimating Health Disparities: The Case of Children's Oral Health

The National Center for Health Statistics recently issued a monograph with 11 guidelines for reporting health disparities. However, guidelines on confidence intervals (CIs) cannot be readily implemented with the complex sample surveys often used for disease surveillance. In the United States, dental caries (decay) is the most common chronic childhood disease-5 times more common than asthma. Racial/ethnic minorities, immigrants, and persons of lower socioeconomic position (SEP) have a greater prevalence of caries. The authors provide methods for applying National Center for Health Statistics guidelines to complex sample surveys (health disparity indices and absolute and relative difference measures assessing associations of race/ethnicity and SEP to health outcomes with CIs); illustrate the application of those methods to children's untreated caries; provide relevant software; and report results from a simulation varying prevalence. They use data on untreated caries from the California Oral Health Needs Assessment of Children 2004-2005 and school percentage of participation in free/reduced-price lunch programs to illustrate the methods. Absolute and relative measures, the Slope Index of Inequality, the Relative Index of Inequality (mean and ratio), and the Health Concentration Index were estimated. Taylor series linearization and rescaling bootstrap methods were used to estimate CIs. Oral health differed significantly between White children and all non-White children and was significantly related to SEP.

A study of the prosthodontic and oral health needs of an ageing psychiatric population

Life expectancy has increased worldwide, with India (having 8% who are senior citizens), falling into the "Greying Country" category. This ageing population constitutes a high-risk oral health group, vis-à-vis impaired manual dexterity, cognitive deterioration and unmet treatment needs, which could be compounded by psychiatric morbidity. To assess oral health status and prosthodontic need of ageing psychiatric patients. One hundred and twenty-five patients, aged 50 years or above, admitted to the Department of Geriatric Mental Health, King George's Medical University, Lucknow, Uttar Pradesh, India, were examined for prosthodontic, oral health status and need, the study population being divided into groups on the basis of Bristol Activities Scale of Daily Living. Depressive symptoms (which increased with age) and psychiatric morbidity were found to be more in females. About 98% of the population showed probing depths of more than 3 mm, with mean number of decayed/missing teeth and inability to maintain oral/denture hygiene (p < 0.001) increasing in higher disability levels. While 91.3% of the population wearing a prosthesis required new dentures, 33.3% of the study population had unfulfilled partial denture need and 28.4% had unfulfilled upper/lower complete denture need. Ageing psychiatric subjects require dental education and treatment to meet their needs.

A survey on the knowledge, attitude and behavior of Greek elementary school students about oral health and dental care

The objective of this study was to evaluate the knowledge, attitude and behavior of Greek elementary school students in terms of oral health and dental care. Data on students’ oral health and dental treatment as well as, the factors that define these variables were collected and evaluated by a self-administered questionnaire for a sample of 595 students. The results revealed that irregular brushing was common. Apart from the use of toothbrush and toothpaste, extra aids for oral hygiene were also in use. The role of parents in supervising the oral hygiene habits of their children was concentrated only in giving advice. The students knew the causes of gingivitis and caries and how to protect their dental health. Also, they were aware of the mouth and dental structure on the general body health. Toothache was the driving reason of visiting the dentist. Irregular visits to the dentist were mentioned, even though they knew the importance of regular dental visits. The feeling of fear, in general, and fear of dental tools and dental wheel were referred to be the main reason for not visiting the dentist on a regular basis. Students were not encouraged by their parents for regular dental visits. The outcomes of this study show that Greek elementary students knowledge, attitude and behavior towards oral health and dental care need to be improved through oral health behavior programs.

Factors associated with parents’ and adolescents’ perceptions of oral health and need for dental treatment

The aim of this study was to characterize the association between clinical and psychosocial factors as they related to perceptions by parents and adolescents to the adolescent's oral health status and treatment need. Additionally, the degree to which adolescent's and parent's perceptions of oral health and treatment need were related was examined. Data from the Pennsylvania oral health needs assessment for 530 parent-adolescent pairs were used to address the objectives of this study. Comparisons between clinical oral health measures, psychosocial factors, and the parent- and adolescent-reported perceptions of the adolescent's oral health status were made using descriptive and inferential statistics, including exploratory factor analysis and path analysis. Parents and adolescents exhibited only modest concordance on ratings of the adolescent's oral health status and need for dental treatment. Furthermore, parents tended to rate their adolescent's oral health status as better than did the adolescent. The results of the path analysis showed that adolescents based their ratings of oral health status more on oral symptoms, while parents rated their adolescent's oral health more on esthetic or psychosocial factors. Adolescents and parents based their perceptions of oral health status and treatment need on different underlying factors. Additionally, adolescents' perceptions of their oral health status and treatment needs did not appear to be communicated to their parents.

Patients’ Normative Oral Health Needs in a Tertiary Dental Hospital

Patients’ Normative Oral Health Needs in a Tertiary Dental Hospital

Association between dental fear and dental attendance among adults in Finland

Objective. Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Material and methods. The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: “How afraid are you of visiting a dentist?” Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Results. Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. Conclusion. Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear.

Basic Oral Health Needs: A Public Priority

Is there a way to support a special ethical status for unmet oral health needs within our pluralistic, liberty-loving American society? Some people in American society, perhaps many people, believe that some kinds of human needs have special ethical importance. But very few people outside the oral health professions have ever considered that unmet oral health needs might belong to this category. This article will examine why some kinds of needs are thought to have special ethical importance and propose that certain categories of oral health care are needs that fit this description. Without thinking these issues through, we who argue for improved access to oral health care will remain unable to provide an adequate answer to a very legitimate question, namely: improved access to what? When this task has been completed, the article will consider some of the implications of such a view for our society.

Basic Oral Health Needs: A Professional Priority?

The inadequacy of access to oral health care is a complex problem facing society. Many in society who need care are unable to obtain it or do not seek it for a variety of reasons. Most commonly, these are the unfunded, who simply have inadequate resources; the "unaccepted," who may not have dental coverage or have types of coverage that are not accepted by private practitioners; the inaccessible, who may be homebound or live in sparsely populated or low-income geographic areas without dental providers; the unconvinced, who may have resources but do not believe in or recognize the need for treatment; and the unmotivated, who may realize that they need care but for them it is not a priority. While the oral health care professions cannot be expected to shoulder the entire burden to "fix" inadequate access to care, we believe that they have important responsibilities. True professions have a unique relationship with society that places them in positions of trust. With this trust comes the responsibility for public policy advocacy and to actively participate in identifying realistic ways to reduce the access problem. The leadership of organized dentistry, as well as educational institutions, and practitioners themselves must be committed to improving access and thereby the health of those currently underserved.

Interprofessional Educational Partnerships in School Health for Children with Special Oral Health Needs

Dental caries is an infectious yet preventable disease that is rampant in some subpopulations in the United States, in particular among individuals with neurodevelopmental/intellectual disabilities (ND/ID). This article reports on the implementation and evaluation of the Louisiana State University Health Sciences Center (LSUHSC) School of Dentistry interprofessional school health educational model to improve oral health assessment and referral for children with ND/ID in an inner-city school system. During this project, dental hygiene students and elementary school nurses were paired to assess the oral health status of 255 inner-city children with developmental disabilities, improve referral/access to dental care for those identified as having need, and propose dental hygiene curriculum changes that would incorporate participation in a "real-life public health setting" for those with ND/ID. Following the program, 66 percent of dental hygiene students said their likelihood of participating in future oral health programs had increased and 75 percent of school nurses rated the educational process as very good or excellent. Modifications in dental hygiene curricula that provide students with training and experience in oral health risk assessment and referral for people with ND/ID is recommended to address the new Commission on Dental Accreditation educational standards 2-18 and 2-26 (implemented January 1, 2005) and dental standard 2-26 (implemented January 1, 2006), which state that dental hygiene and dental graduates must be competent in assessing the treatment needs of patients with special needs.

The oral health and treatment needs of schoolchildren in Trinidad and Tobago: findings of a national survey

To describe the oral health and treatment need of schoolchildren in Trinidad and Tobago. Cross-sectional survey using stratified cluster sampling. Participants were children in primary (aged 6-8 years) and secondary school (aged 12 and 15 years). Main outcome measures were DMFT/dmft, treatment need, and fluorosis. Examinations were completed on 1064 children. The dmft of the 6-8-year-olds was 2.54 (95% CI = 2.32, 2.76). For 12-year-olds, the DMFT was 0.61 (95% CI = 0.51, 0.71), whereas for 15-year-olds, the DMFT was 1.06 (95% CI = 0.87, 1.25). Most of the caries experience in 6-8-year-olds was from decayed teeth. Sixty-seven per cent of the sample (95% CI = 64%, 69%) had some type of treatment need. Most frequently occurring need was for fillings at 42% (95% CI = 40%, 44%) with 28% (95% CI = 26%, 31%) of the total sample needing two or more surface fillings, followed by fissure sealants at 33% (95% CI = 30%, 36%) and caries-arresting care at 12% (95% CI = 10%, 14%). Extraction of one or more teeth was needed in 13% (95% CI = 11%, 15%) of children. Rates of fluorosis were negligible. The caries experience of 12- and 15-year-old children were low but was high for schoolchildren aged 6-8 years, in terms of prevalence and severity. Effective oral health promotion strategies need to be implemented to improve the oral health of primary schoolchildren in Trinidad and Tobago.

Oral Health Attitudes, Knowledge, and Behavior Among School Children in North Jordan

The aim of this study was to assess the knowledge, attitude, and behavior of school children towards oral health and dental care as well as to evaluate the factors that determine these variables. School children (n=557) of an average age of 13.5 years attending public schools in North Jordan were recruited into this study. The subjects completed a questionnaire that aimed to evaluate young school children's behavior, knowledge, and perception of their oral health and dental treatment. The participants' oral hygiene habits (such as tooth brushing) were found to be irregular, and parents' role in the oral hygiene habits of their children was limited. The study population showed higher awareness of caries than periodontal conditions. Irregular visits to the dentist were found to be common, and toothache was the major driving factor for dental visits. Children had positive attitudes toward their dentists; nevertheless, they indicated that they feared dental treatment. The children in this study also recognized the importance of oral health to the well-being of the rest of the body. Parents were not proactive in making sure that their children received regular dental care. Parents' knowledge and attitudes about the importance of oral health care and their fears about dental treatment influenced their children's dental care. The results of this study indicate that children's and parents' attitudes toward oral health and dental care need to be improved. Comprehensive oral health educational programs for both children and their parents are required to achieve this goal.

Oral Health Needs of the Head and Neck Radiotherapy Patient: 2. Oral and Dental Care Before, During and After Radiotherapy

Head and neck cancer represents a heterogeneous group of neoplasms affecting a number of sites in the aerodigestive tract, histologically primarily epithelial in type. Most are sensitive to a treatment regime of ablative surgery followed by radiotherapy. The incidence of head and neck cancers is approximately 11.8 per 100,000 population and is the 8th commonest cancer in males and the 16th in females. Treatment comprises ablative surgery with, in 60% of cases, radiotherapy. The oral and dental sequelae of such treatment, and their management, is described. Many of these cancers will manifest with oral signs and symptoms, thus placing the GDP in the unique position of being able to detect and positively influence outcomes. As well, the GDP has a vital, proactive role to play in supportive care before, during and following surgery and radiotherapy.

Oral Health Needs of the Head and Neck Radiotherapy Patient: 1. Epidemiology, Effects of Radiotherapy and Role of the GDP in Diagnosis

Head and neck cancer represents a heterogeneous group of neoplasms affecting a number of sites in the aerodigestive tract, histologically primarily epithelial in type. Most are sensitive to a treatment regime of ablative surgery followed by radiotherapy. The incidence in Ireland of head and neck cancers is approximately 11.8 per 100,000 population and is the 8th commonest cancer in males and the 16th in females. Many of these cancers will manifest with oral signs and symptoms thus placing the GDP in the unique position of being able to detect and positively influence outcomes: the GDP also has a vital, proactive role to play in supportive care before, during and following surgery and radiotherapy. The aim of this paper is to review the rationale for the different treatment modalities and the oral/dental side-effects of each.

Cigarette smoking, snuff use and alcohol drinking: coexisting risk behaviours for oral health in young males.

The use of oral moist snuff (snus) is widespread among Swedish men, but little is known about the use in adolescents. The aim of this study was to describe patterns of snuff dipping, smoking and alcohol drinking in a sample (n = 6287) of 9th grade male students participating in a census survey in the Stockholm region. About 20% of the sample reported use of snus, and more than two-thirds of snus users were also cigarette smokers. Among current nonusers of tobacco (66% of the sample), 14% reported frequent binge drinking, in contrast to 49% among current exclusive cigarette smokers, 60% among exclusive snus users and 69% among users of both cigarettes and snus. The estimated mean annual consumption of alcohol was 5-10 times higher among tobacco users than among nonusers, with users of snus consuming more alcohol than smokers. Compared to non- or minimal drinkers, heavy alcohol drinkers had a disproportionately higher risk to report snus use, after adjustment for smoking behaviour (OR = 16.7, 95% CI 12.9-21.7). When the analysis was restricted to users of only one type of tobacco, heavy drinkers were twice as likely to report snus, rather than cigarette, use. Both tobacco use and alcohol drinking have been independently associated with a variety of pathological oral conditions in adults. These behaviours coexist in early adolescence. Their effect on oral health need to be investigated in prospective studies and should be of concern to the dental professionals.

The association of early childhood caries and race/ethnicity among California preschool children.

This paper explores the role of race/ethnicity in the occurrence of early childhood caries (ECC) among California Head Start (HS) and non-HS preschool children. Using oral examination and questionnaire data from the 1993-94 California Oral Health Needs Assessment of Children, we computed the prevalence of ECC using various definitions and fitted logistic regression models to explore the effect of race/ethnicity on ECC, separately for HS and non-HS children, adjusting for bedtime feeding habits and other covariates. Among 2,520 children, the largest proportion with a history of falling asleep sipping milk/sweet substance was among Latinos/Hispanics (72% among HS and 65% among non-HS) and HS Asians (56%). HS Asians and Latinos/Hispanics had the largest prevalence of ECC (30%-33%) and untreated caries (49%-54%). The estimated risk for ECC was more than three times higher in HS Asians compared to HS whites and among non-HS African Americans and Asians compared to non-HS whites controlling for socioeconomic status variables. The risk of ECC was also significantly higher among children who fell asleep while sipping milk or any sweet substance compared to those who did not. Studies of the cultural/behavioral patterns that may be specific to ethnic subgroups with the highest risk for ECC seem essential to the development of effective prevention strategies.

About Children's Oral Health Needs

Disparities in children's oral health are an important and solvable health problem in the United States today. Many parts of the dental and public health communities are actively engaged in efforts aimed at addressing these disparities. Much progress has been made in explicating the issues, developing the scientific and clinical knowledge base needed for primary prevention and treatment, and beginning the development of new training and community-based approaches. But much more is still needed, and there is a great deal that the pediatric community can do to help.

Determining the Dental Treatment and/or Oral Health Needs of Applicants for Long-Term Care Insurance Benefit

Determining the Dental Treatment and/or Oral Health Needs of Applicants for Long-Term Care Insurance Benefit

The bedfordshire PDS orthodontic pilot.

Throughout the 50-year history of the NHS, the Government has sought to cash limit the GDS. PDS (Personal Dental Services) pilots represent another attempt at cash limiting and a new system for delivering dental services in NHS practice. The development of the Bedfordshire Orthodontic PDS pilot is described. The basis is the prioritization of orthodontic services to child patients with the greatest oral health need through a cost and volume contract with the local Health Authority. A brief outline of the Bedfordshire PDS contract is given. The experiences of the first 9 months of the PDS pilot are related.