Oral Health-related Problems Research Articles

La santé buccodentaire : quel rôle pour l’infirmière au Québec ?

Various international health care organizations strongly recommend the implication of non-dental health care professionals in oral health. Consequently, nurses are currently often required to question their ability to manage patients’ oral health-related problems, as well as the very meaning of their management of patients in such situations. The purpose of this paper is to draw attention to the role of the nurse in the management of oral health. Professional associations and academic institutions involved in the development of nursing professional skills, and health policymakers involved in decisions concerning the geographical distribution of nursing personnel and adoption of laws in Quebec, act in a disconnected manner, independently from dental professionals and without taking into account the actual oral health care needs of the various categories of beneficiaries.The ever-growing elderly population, in a context of limited financial resources and other austerity measures, have contributed over time to diminishing access to oral health services, especially for vulnerable populations. Care orientation is fundamental to the nurse-patient relationship and nurses encounter many difficulties in addressing patients’ oral health-related needs, leading to various ethical and deontological implications. In the multidisciplinary environment of the health care system, it is therefore necessary to support nurses in their clarification of their contemporary role in the oral health of their patients.

Oral health status of six-year-old children in Qatar: findings from the national oral health survey.

Oral health has a significant impact on physical, social and mental well-being of an individual. Qatar, like the rest of the world, is experiencing higher prevalence of oral health-related problems. To examine the oral health status and extent of preventive and curative needs among six-year-old school children in Qatar by key demographic indicators. Secondary data analysis of 1124 six-year-old private and government primary school children from the 2011 Qatar National Oral Health Survey was performed. Dental caries lesions status of primary dentition was assessed according to the WHO criteria. Descriptive statistics were carried out, and comparison among groups was executed by running t statistics. Logistic regression was performed to interpret the impact of various predictors. Overall, 71.4% children presented with dental caries lesions with a higher prevalence among girls versus boys (73.8% versus 68.9%). The mean overall dmft was recorded as 4.2 with ±4.2 SD. Qatari children had 3.8 time odds of having dental caries lesions compared with non-Qatari children (P < 0.001). Overall, 18.9% of children showed signs of poor periodontal health. Odds of having more periodontal disease were significant in Qatari boys (OR = 3.1 CI = 2.0, 4.7, P < 0.001) compared to non-Qatari boys. On average, 3.6 teeth per student were in need of any treatment. This study indicated that only 28.6% of children aged six were free from caries lesions. The results urge to further strengthen the strategies and to improve oral hygiene by various evidence-based interventions.

Quality of life in patients undergoing orthognathic surgery - A two-centered Swedish study.

Surgical corrections of dentofacial deformities have both physical and psychological impact on quality of life (QoL). The objectives of the present study were to evaluate the impact of oral health related problems on QoL before and after a combination of orthodontic treatment and orthognathic surgery. Additionally, the study aimed to identify correlations between different dentofacial patterns and possible improvements due to treatment. In a prospective study, we evaluated fifty patients before start of treatment, 6 weeks and 6 months postoperatively. The questionnaires used were: OHIP-14 (Short Form Oral Health Impact Profile), a condition-specific QOL approach (Orthognathic Quality of Life Questionnaires; OQLQ) and a social-demographic questionnaire. There was a statistically significant improvement in the OHIP domains from baseline to 6 months follow-up and for the OQLQ, the improvement was significant both at 6 weeks and 6 months in relation to the baseline data. Significant improvement of quality of life over time is proved by both OHIP-14 and OQLQ in the present study. Socio-demographic and holistic considerations are important when evaluating treatment outcome after combined orthodontic and orthognatic surgery. However, longer follow-up would be beneficial.

장애인의 미충족 치과치료 실태조사

이 연구는 장애인 대상 치과진료 필요자 중 치과의료 서비스 미충족율과 그 이유를 조사하고, 미충족 치과치료에 따른 구강상태를 분석하였다. 국민건강영양조사 참여 대상 중 만 19세 이상 장애등록 응답자 444명을 선정하였고, 그 중 구강검진과 설문조사를 완료한 대상자 375명을 최종분석하였다. 장애유형은 6종류(지체장애, 뇌병변장애, 감각장애, 발달장애, 정신장애, 내분비장애)로 분류하였다. 연구대상자 중 미충족 치과치료 대상자는 128명이었으며, 최근 1년 동안 치과진료를 받지 못한 가장 주된 이유는 '경제적인 이유로'에 대한 항목이 49.2%으로 가장 많았으며, '다른 문제에 비해 덜 중요하다고 느껴서'에 대한 항목이 18.0%이었다. 치주질환과 영구치우식경험을 가진 장애인 중 미충족 치과치료 빈도와 진행정도가 높은 것으로 확인하였다. 치과진료 자원의 가용성 측면에서 장애인 수 대비 적절한 치과진료 서비스를 충분히 제공하여 치과진료 서비스의 원활한 이용이 요구된다. This study analyzed the rate of unmet dental care service for the disabled who were judged to require the dentistry due to oral health-related problems and those reasons, and also examined the oral health status according to the unmet dentistry. 375 subjects, who were 19 years or older and completed oral health examination and a survey, among 444 responded positive of disability registration after participation in National Health and Nutrition Examination Survey(NHANES), were analyzed. Disability type was classified into 6 kinds(physical disability, brain lesions, sensory defect, developmental disability, mental disorder, endocrine disorder). Participants had 128 of their dental care needs unmet when it was required. 'Financial burden' was the main reason, with the subject of 49.2%, followed by 'lower on the priority scale' were 18.0%. The high frequency and progression permanent teeth caries experiencs and periodontal status of their dental disease were confirmed. In availability aspect of dentistry resources, it is required for using dentistry service smoothly through providing sufficient proper dental care service comparing with the number of the disabled.

Impact of body mass index on oral health during orthodontic treatment: an explorative pilot study.

To answer the question: is there a correlation between body mass index (BMI), oral health, and patient cooperation during multibracket (MB) appliance therapy? All adolescent MB patients started and finished between 2007 and 2012 were analysed. According to their pre-treatment BMI, patients were divided into one of the following groups: normal weight, overweight, or obese. Using the patients' records, the cooperation during treatment was classified as good, bad, or poor and the treatment duration was calculated. Using pre- and post-treatment photographs, white spot lesion (WSL) formation and gingivitis before and after MB therapy were assessed. Of the 175 subjects, 138 had a normal BMI (79 per cent), 22 were overweight (12.5 per cent), and 15 obese (8.5 per cent). Whereas 42.8 per cent of the normal weight patients showed a good cooperation, only 22.7 per cent of the overweight and 20.9 per cent of the obese patients cooperated sufficiently. On average, normal weight patients were treated for 22.2 months, overweight patients for 23.0 months, and obese patients for 27.7 months. Normal weight patients developed less WSL (41.3 per cent) during MB treatment than overweight (50 per cent) or obese (66.7 per cent) patients. Furthermore, patients with a normal weight or overweight had less gingival inflammation (79.5 per cent) after treatment than obese individuals (93.3 per cent). An increased BMI appears to be a risk factor for less cooperation, a longer treatment duration, and more oral health-related problems during MB treatment, indicating that these patients require special attention during orthodontic therapy.

Relationship between the sense of coherence and quality of life among institutionalized elders in Bengaluru city India: A questionnaire study

Introduction: Aged people living in residential homes have a higher prevalence of depression and stress which cause oral health-related problems, contributing to excessive morbidity, than do those who live in communities. Aim: To find the relationship between senses of coherence (SOC) and quality of life (QoL) using Geriatric Oral Health Assessment Index (GOHAI) among elderly residents of old age homes in Bengaluru city, India. Materials and Methods: A cross-sectional study was conducted among elderly residents of Bengaluru city, India. Data were collected using a validated questionnaire which record demographic details, oral hygiene practices, and oral health habits. SOC and oral health-related QoL was measured using 13-item short version of the SOC scale and 12-item GOHAI scale. Chi-square test and Pearson's correlation coefficient test were used for statistical analysis. All variables showing significant association ( P Results: A total of 376 elderly residents participated in the study and completed the questionnaire. Among them 150 (39.9%) were men and 226 (60.1%) were women. SOC was statistically significant with gender ( P = 0.008), marital status ( P = 0.003), dentition status ( P = 0.000), smoking ( P = 0.043), and alcohol consumption ( P = 0.043). Age ( P = 0.036), gender ( P = 0.045), dentition status ( P P = 0.042) were found to be associated with GOHAI, there also exist a strong Pearson's correlation ( r = 0.712) between SOC and GOHAI scores. Conclusions: A strong positive correlation was found between SOC and GOHAI scores indicating elder's with low SOC had low GOHAI scores and vice versa. The elders in residential homes were found to have more self-reported oral health-related functional problems, so dental health education must be focused on the special needs of the disabled, dependant and socio – economically deprived geriatric population to improve their QoL.

Oral health concerns with sweetened medicaments: Pediatricians' acuity.

Background:Administration of sweetened medicaments poses many oral health related problems in children due to the lack of awareness among the pediatricians regarding their ill effects.Purpose:To assess pediatricians’ awareness and attitudes toward the use of liquid pediatric medicines and their relationship with dental caries and erosion.Materials and Methods:A cross-sectional descriptive study was conducted among the pediatricians residing in Nellore city. Data were obtained from 55 pediatricians using questionnaires.Results:Among the respondents, 95.6% prescribed liquid medicaments, 51.1% expressed that they may be associated with dental effects, 60% were not aware regarding the sweetness of medicaments, whereas majority of them (77.8%) opined that children complained regarding the taste, 73.3% stated that sugar substitutes were used as sweetening agents, 70.9% believed that they were not acidic, 68.9% did not recommend brushing after intake of medicines, 90% failed to deliver oral health instructions, and 54.5% believed that lack of oral hygiene was a contributing factor for development of dental caries.Conclusion:Majority of the respondents prescribed liquid medicaments and were unaware regarding the sweetening agents and acidity, which cause ill effects on the dental hard tissues. Most of them neither recommended nor delivered oral hygiene instructions (OHI) after prescribing sweetened liquid medicaments. Hence, OHI should be delivered to enhance the oral health related quality of life in children.

Enhancing pharmacists’ role as oral health advisors

ObjectiveTo examine the expanded role of pharmacists as oral health advisors. SettingU.S. community pharmacies. Practice descriptionCounseling patients on issues related to oral health. Practice innovationThe traditional role of pharmacists (i.e., dispensing medications) has evolved to include a broader range of functions associated with primary health care. Pharmacists are important members of the health care team and have an important role in addressing oral health–related problems. The pharmacist role in addressing oral health issues in the United States should be expanded. ConclusionStudies are needed to examine the extent of pharmacist training in oral health, the degree to which pharmacists who receive oral health training incorporate it into their practices, and pharmacist interest in relevant continuing education. Data gathered from such studies will be invaluable in developing appropriate training standards, model curricula, and clinical best practices.

Use of Syndromic Data to Determine Oral Health Visit Burden on Emergency Departments

In a syndromic dual use application, North Carolina emergency department (ED) visits for oral health-related problems were studied using BioSense patient records stratified by age group, patient residence county, and payment method. After a case definition process using both chief complaints and diagnosis codes, the study obtained population-based visit rates and revealed age- and county-specific problems consistent over three full years ending 30Jun2011 and worsening in selected counties. The state total ED burden for oral health problems was ~2% (0.2% - 9.7% by county).

Oral health conditions and frailty in Mexican community-dwelling elderly: a cross sectional analysis

BackgroundOral health is an important component of general well-being for the elderly. Oral health-related problems include loss of teeth, nonfunctional removable dental prostheses, lesions of the oral mucosa, periodontitis, and root caries. They affect food selection, speaking ability, mastication, social relations, and quality of life. Frailty is a geriatric syndrome that confers vulnerability to negative health-related outcomes. The association between oral health and frailty has not been explored thoroughly. This study sought to identify associations between the presence of some oral health conditions, and frailty status among Mexican community-dwelling elderly.MethodsAnalysis of baseline data of the Mexican Study of Nutritional and Psychosocial Markers of Frailty, a cohort study carried out in a representative sample of people aged 70 and older residing in one district of Mexico City. Frailty was defined as the presence of three or more of the following five components: weight loss, exhaustion, slowness, weakness, and low physical activity. Oral health variables included self-perception of oral health compared with others of the same age; utilization of dental services during the last year, number of teeth, dental condition (edentate, partially edentate, or completely dentate), utilization and functionality of removable partial or complete dentures, severe periodontitis, self-reported chewing problems and xerostomia. Covariates included were gender, age, years of education, cognitive performance, smoking status, recent falls, hospitalization, number of drugs, and comorbidity. The association between frailty and dental variables was determined performing a multivariate logistic regression analysis. Final models were adjusted by socio-demographic and health factorsResultsOf the 838 participants examined, 699 had the information needed to establish the criteria for diagnosis of frailty. Those who had a higher probability of being frail included women (OR = 1.9), those who reported myocardial infarction (OR = 3.8), urinary incontinence (OR = 2.7), those who rated their oral health worse than others (OR = 3.2), and those who did not use dental services (OR = 2.1). For each additional year of age and each additional drug consumed, the probability of being frail increased 10% and 30%, respectively.ConclusionsUtilization of dental services and self-perception of oral health were associated with a higher probability of being frail.

Clinical Reasoning in Dentistry: A Conceptual Framework for Dental Education

This study presents a conceptual framework for clinical reasoning by dental students. Using a think-aloud method with six vignettes, the researchers interviewed eighteen dental students from two stages of training about oral health-related problems influenced by biopsychosocial factors. Verbatim transcripts of the interviews were analyzed to identify the processes and strategies of clinical reasoning used by the students to produce treatment plans. The process included 1) rituals to collect information; 2) forward and backward reasoning to generate and test clinical hypotheses; 3) pattern recognition from integrated scripts of knowledge and experience; and 4) decision trees to assess options and outcomes. The process was supplemented by scientific, conditional, collaborative, narrative, ethical, pragmatic, and part-whole reasoning strategies. Senior students showed a keen awareness of the contextual determinants of care and emphasized patients' motivations for treatment. In contrast, junior students focused more on problems associated with individual teeth as they struggled to integrate the information within each vignette. In this article, the processes and strategies for reasoning used by both groups of dental students are abstracted and then illustrated by a model of clinical reasoning that accommodates the complicated contexts in which clinical problems usually arise.

Self-reported problems before and after prosthodontic treatments according to newly created Turkish version of oral health impact profile

The aim of the study was to assess patients’ socio-demographic factors with their removable prosthesis in general, as well as to assess their problems with the functional limitation, physical pain, psychological discomfort, physical disability, social disability, and handicap investigate impaired oral health-related quality of life (OHRQoL) in patient treated with removable dentures before treatment and at 1 and 12 months after treatment. The first part of the questionnaire was comprised of 20 questions. It was designed in four different sections as: (i) general socio-demographic factors, (ii) general health, (iii) experience and use of dental and denture care, and (iv) anamnestic sign and symptoms of temporomandibular disorders (TMD). A statistical analysis system (SAS) was used for data management and analysis. Patient-reported problems were studied using the item list contained in the Turkish version of the oral health impact profile (OHIP) in a convenience sample of 136 prosthodontic patients before ( m 0), 1 month after ( m 1), and 12 months ( m 2) after treatment were then examined by using two-way ANOVA with repeated measurement. Differences in OHRQoL were present when item-specific prevalence was stratified by time of total scores; gender, residential area, working status, self-reported general health, smoking status, denture type, importance of the convenient dental care, trauma story, self-reported TMD/pain, and self-reported TMD/difficulty opening mouth wide. At baseline, the most prevalent frequently reported problems “difficulties chewing” (49.3%), “digestion worse” (40.4%), “take longer to complete a meal” (36%), “food catching” (30.9%), and “dentures not fitting” (29.4%), and m 2 the most prevalent frequently reported problems were “avoid going out” (25%), “difficulties chewing” (17.6), “sore jaw” (15.5%), and “take longer to complete a meal” (14%). The study confirmed that denture status is by far the strongest predictor of impaired OHRQoL compared to socio-demographic factors. Subjects with strong or moderate values had significantly fewer oral health-related problems (OHIP-extent) of time of total scores. The number of problems decreased substantially after prosthodontic treatment. The profile of pretreatment and post-treatment problems differed substantially, but in general, only a few problems remained after adaptation to new dentures.

Oral health‐related quality of life of periodontal patients

The purpose of this study was to assess the oral health-related quality of life of patients presenting to a periodontal specialist by means of six questions, and to assess the perceived oral health by means of one question. Self-assessments of oral health were associated with clinical characteristics. Logistic regression models were used to associate self-assessments with clinical characteristics in a cross-sectional study. On the six-item questionnaire, close to 20% (295/1480) of the patients reported that teeth, gums or dentures had an impact fairly often or very often on one or more items (eating, relaxing, avoiding going out, feeling self-conscious, pain or discomfort). On the single question requesting a self-assessment of oral health, 42% (628/1468) rated their oral health as fair or poor. Both common oral health-related quality of life problems and worse perceived oral health were associated with having more than eight teeth with>5 mm periodontal pockets (odds ratio=1.45, 95% confidence interval=1.01-2.08; and odds ratio=2.83, 95% confidence interval=2.08-3.84, respectively), compared with patients who had fewer than three teeth with>5 mm periodontal pockets. Oral health-related problems in patients presenting to a periodontal specialist office negatively affect their quality of life. If some of the findings of this study can be confirmed in other studies, it could change the perception of chronic periodontitis as a silent disease.