Oral Health Variables Research Articles

Evaluation of the effect of non‐surgical periodontal treatment on oral health‐related quality of life: estimation of minimal important differences 1 year after treatment

To evaluate an individually tailored oral health educational programme on patient-reported outcome compared with a standard oral health educational programme, assess change over time and determine minimal important differences (MID) in change scores for two different oral health related quality of life (OHRQoL) instrument after non-surgical periodontal treatment (NSPT). In a randomized controlled trial evaluating two educational programmes, patients (n = 87) with chronic periodontitis completed a questionnaire at baseline and after 12 months. OHRQoL was assessed with the General Oral Health Assessment Index (GOHAI) and the UK oral health-related quality-of-life measure (OHQoL-UK). In addition, patients' global rating of oral health and socio-demographic variables were recorded. The MID was estimated with anchor-based and distributions-based methods. There were no differences between the two educational groups. The OHRQoL was significantly improved after treatment. The MID was approximately five for OHQoL-UK with a moderate ES, and three for GOHAI with a Small ES, and 46-50% of the patients showed improvements beyond the MID. Both oral health educational groups reported higher scores in OHRQoL after NSPT resulting in more positive well-being (OHQoL-UK) and less frequent oral problems (GOHAI). OHQoL-UK gave a greater effect size and mean change scores but both instruments were associated with the participants' self-rated change in oral health. The changes were meaningful for the patients supported by the estimated MID.

A community-based oral health self-care intervention for Hispanic families

A community-based intervention is described that targets oral health self-care practices among Hispanic children in the United States and is being tested in an ongoing trial. Descriptive results of baseline oral health variables are presented. As of January 2013, 284 Hispanic children of ages 5-7 enrolled in the Healthy Families Study in Nashville, TN, USA. Families are randomized to one of two culturally appropriate interventions. At baseline, 69.6% of children brushed at least twice daily, and 40.6% brushed before bed daily. One-third of parents did not know if their children's toothpaste contained fluoride. This intervention fills the need for community-based interventions to improve oral health self-care practices that are culturally appropriate in Hispanic families.

Oral Health Impact Profile, EuroQol, and Assessment of Quality of Life instruments as quality of life and health‐utility measures of oral health

Oral-specific measures are often preferred to examine outcomes of oral disorders. However, generic measures can add additional information, including health utility. The aim was to assess the Oral Health Impact Profile (OHIP), EuroQol (EQ-5D), and Assessment of Quality of Life (AQoL) instruments in relation to oral health in terms of their discriminative and convergent validities. Data were collected from adults, 30-61 yr of age, in Australia by mailed survey during 2009 and 2010, including the OHIP-14, the EQ-5D, and the AQoL, a range of self-reported oral health variables, and by self-rated oral and general health. Responses were collected from 1093 subjects (a response rate of 39.1%). The OHIP, the EQ-5D, and the AQoL were associated with oral health variables, with effect sizes ranging from 0.6 to 1.1 for the OHIP, from 0.3 to 0.5 for the EQ-5D, and from 0.4 to 0.6 for the AQoL. The OHIP tended to be more strongly correlated with self-rated oral health (rho = -0.5) than with general health (rho = -0.3), whilst the EQ-5D and the AQoL were less strongly correlated with oral health (rho = -0.3 and -0.3, respectively) than with general health (rho = -0.4 and -0.5, respectively). Whilst the OHIP was more sensitive to differences in oral health, the generic measures of EQ-5D and AQoL both exhibited discriminative validity and convergent validity in relation to oral health variables, supporting their use in oral health studies.

Oral health and obesity indicators

BackgroundIn western Sweden, the aim was to study the associations between oral health variables and total and central adiposity, respectively, and to investigate the influence of socio-economic factors (SES), lifestyle, dental anxiety and co-morbidity.MethodsThe subjects constituted a randomised sample from the 1992 data collection in the Prospective Population Study of Women in Gothenburg, Sweden (n = 999, 38- > =78 yrs). The study comprised a clinical and radiographic examination, together with a self-administered questionnaire. Obesity was defined as body mass index (BMI) > =30 kg/m2, waist-hip ratio (WHR) > =0.80, and waist circumference >0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders.ResultsThe mean BMI value was 25.96 kg/m2, the mean WHR 0.83, and the mean waist circumference 0.83 m. The number of teeth, the number of restored teeth, xerostomia, dental visiting habits and self-perceived health were associated with both total and central adiposity, independent of age and SES. For instance, there were statistically significant associations between a small number of teeth (<20) and obesity: BMI (OR 1.95; 95% CI 1.40-2.73), WHR (1.67; 1.28-2.19) and waist circumference (1.94; 1.47-2.55), respectively. The number of carious lesions and masticatory function showed no associations with obesity. The obesity measure was of significance, particularly with regard to behaviour, such as irregular dental visits, with a greater risk associated with BMI (1.83; 1.23-2.71) and waist circumference (1.96; 1.39-2.75), but not with WHR (1.29; 0.90-1.85).ConclusionsAssociations were found between oral health and obesity. The choice of obesity measure in oral health studies should be carefully considered.

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.

The association between clinical oral health and general quality of life: a population‐based study of individuals aged 50–74 in Southern Brazil

Few studies have assessed the impact that oral health status and prosthetic rehabilitation have on the general quality of life (QoL) of individuals and there is a lack of information about the association between prosthetic status and QoL. Therefore, the objective of this study was to investigate the association between clinical oral health variables and general QoL in individuals aged 50-74years in Porto Alegre. This cross-sectional study consisted of 720 participants aged between 50 and 74years residing in three health districts of Porto Alegre, Southern Brazil. They were selected through multistage proportional random sampling. Data were collected through (i) interview using structured questionnaire on demographic data and the World Health Organization Abbreviated Instrument for Quality of Life Assessment (WHOQOL-BREF) to assess QoL, (ii) oral clinical examination using criteria recommended by the World Health Organization (WHO) and the Epidemiological Survey SB/Brazil in 2000. The interviews and clinical examinations were performed at their homes by four pairs of trained and calibrated researchers. The scores of QoL were categorized by their median into low (≤median) and high (>median). The association between outcomes and the factors studied was analysed by Poisson Regression using multiple backward methods, with adjustment for robust variance, and Svyset function scheduled following the stages of the research. The physical domain of WHOQOL-BREF was associated with use of upper prosthesis and educational level. The psychological domain score was related to level of education. The decayed, missing and filled teeth (DMFT), gender and educational level were associated to the social relations domain. In the environment domain, an association with use and need of lower prosthesis, age and educational level was observed. Clinical oral health variables such as DMFT and use and need of prosthesis were associated with general QoL in this population.

The Impact of Oral Health on Taste Ability in Acutely Hospitalized Elderly

ObjectiveTo investigate to what extent various oral health variables are associated with taste ability in acutely hospitalized elderly.BackgroundImpaired taste may contribute to weight loss in elderly. Many frail elderly have poor oral health characterized by caries, poor oral hygiene, and dry mouth. However, the possible influence of such factors on taste ability in acutely hospitalized elderly has not been investigated.Materials and MethodsThe study was cross-sectional. A total of 174 (55 men) acutely hospitalized elderly, coming from their own homes and with adequate cognitive function, were included. Dental status, decayed teeth, oral bacteria, oral hygiene, dry mouth and tongue changes were recorded. Growth of oral bacteria was assessed with CRT® Bacteria Kit. Taste ability was evaluated with 16 taste strips impregnated with sweet, sour, salty and bitter taste solutions in 4 concentrations each. Correct identification was given score 1, and maximum total taste score was 16.ResultsMean age was 84 yrs. (range 70–103 yrs.). Total taste score was significantly and markedly reduced in patients with decayed teeth, poor oral hygiene, high growth of oral bacteria and dry mouth. Sweet and salty taste were particularly impaired in patients with dry mouth. Sour taste was impaired in patients with high growth of oral bacteria.ConclusionThis study shows that taste ability was reduced in acutely hospitalized elderly with caries activity, high growth of oral bacteria, poor oral hygiene, and dry mouth. Our findings indicate that good oral health is important for adequate gustatory function. Maintaining proper oral hygiene in hospitalized elderly should therefore get high priority among hospital staff.

Effect of oral health dental state and risk of malnutrition in elderly people

To determine the risk of malnutrition in both institutionalized and non-institutionalized elderly people of the region of Murcia in Spain. A cross-sectional study was carried out on 465 participants (213 men and 252 women) aged 65 years or older, and representative of the population of the region of Murcia in Spain. The nutritional condition was determined with the Mini Nutritional Assessment screening tool. The following clinical oral health variables were recorded: number of teeth in the mouth, use of removable dentures and hygiene. The prevalence of malnutrition was 7% in the study population, whereas the risk of malnutrition was 49%. A greater prevalence was recorded in the older and in the institutionalized participants. There were no significant differences in terms of malnutrition or the risk of malnutrition between the participants with or without dentures or between the dentate or edentulous participants. Age and institutionalization are parameters to be taken into account for detecting the risk of malnutrition in elderly people.

Oral health and the symptoms of schizophrenia

The objectives of this study were to evaluate the oral health of a group of schizophrenic outpatients and a control group without psychiatric illness. The study also aimed to assess the influence of positive and negative symptomatology on oral health among outpatients with schizophrenia. The DMF-T Index (sum of decayed, missing and filled teeth) and the Community Periodontal Index of Treatment Needs (CPITN) were assessed in both groups. We evaluated the psychopathological state of the patient group using the Positive and Negative Syndrome Scale (PANSS). The schizophrenic patients had higher scores than the control group with respect to decayed teeth (4.39 vs. 0.72), missing teeth (5.66 vs. 1.50), the DMF-T index (13.51 vs. 7.8) and CPITN (2.32 vs. 1.04); and lower scores for filled teeth (3.53 vs. 5.54). The PANSS negative subscale score correlated positively with the oral health variables studied, whereas the PANSS positive subscale score correlated negatively and exclusively with the number of missing teeth. Age and smoking status affected oral health in both groups, but even when the influence of these factors was considered, the oral health of the patients was poorer than that of the control group.

Dental caries risk indicators among Australian Aboriginal young adults

To determine dental caries risk indicators among a birth cohort of Australian Aboriginal young adults (n=442). Data were from the Aboriginal Birth Cohort study, a prospective longitudinal investigation of Aboriginal individuals born 1987-1990 at an Australian regional hospital. Models representing demographic, socioeconomic, behavioural, dental service utilization and clinical oral health variables were tested using multivariate regression. The percent DT>0 was 72.9 (95% CI 68.7-77.1), mean DT was 4.19 (95% CI 3.8-4.6), percent DMFT>0 was 77.4 (95% CI 73.5-81.3) and mean DMFT was 4.84 (95% CI 4.4-5.3). After controlling for other covariates, risk indicators for percent DT>0 included soft drink consumption every day or a few times a week (PR 1.25, 95% CI 1.08-1.45), not consuming milk every day or a few times a week (PR 1.16, 95% CI 1.04-1.30) and sweet consumption every day or a few times a week (PR 1.18, 95% CI 1.04-1.33). Risk indicators for mean DT included sweet consumption every day or a few times a week (B=1.14, 95% CI 0.27-2.02), nonownership of a toothbrush (B=0.91, 95% CI 0.10-1.87) and presence of plaque (B=2.46, 95% CI 0.96-3.96). Those with 4 + occupants in their house the previous night had 1.2 times the prevalence of having DMFT>0 than their counterparts with less household occupants (95% CI 1.01-1.49). Percent DMFT>0 was also associated with consumption of soft drink every day or a few times a week (PR 1.18, 95% CI 1.04-1.34) and consumption of sweets every day or a few times a week (PR 1.23, 95% CI 1.10-1.37). Mean DMFT was higher among those who consumed sweets every day or a few times a week (B = 0.13, 95% CI 0.05-0.22) and who had dental anxiety (B=0.10, 95% CI 0.01-0.19). In an Australian Aboriginal young adult cohort, risk indicators for dental caries included social determinants such as household size, dietary behaviours such as regular consumption of soft drink and sweets, dental behaviour such as nonownership of a toothbrush and dental anxiety.

Does oral health say anything about survival in later life? Findings in a Swedish cohort of 80+ years at baseline

Oral health is an integral part of general health; oral health contributes to and is influenced by a nexus of inputs from biological, psychological, and social functioning. Little is known about the relationship between markers of oral health and subsequent survival in late life. The aim of this study was to examine the relative importance of oral health indicators in the context of demographic and psychosocial variables on subsequent survival during an 8-year period in a population-based sample of the oldest-old. The study sample comprised 357 individuals with a median age of 86 years who were selected from participants in the comprehensive longitudinal Origins of Variance in the Old-Old: Octogenarian Twins (OCTO-Twin) study, which examined monozygotic and dizygotic twins aged 80 years and older on five occasions at 2-year intervals. The OCTO-Twin study includes a broad spectrum of biobehavioural measures of health and functional capacity, personality, well-being, and interpersonal functioning. Oral health variables were number of teeth, per cent decayed and filled surfaces (DFS%), and periodontal disease experience. A longevity quotient (LQ), the ratio between years actually lived and those statistically expected, was determined. The survival categories were shorter than expected, as expected, or longer-than-expected. Multivariate analyses and the Kaplan-Meier method were used in the survival analyses. No associations between LQ and number of teeth, edentulousness, and periodontal disease experience were found. But survival of men with severe periodontal disease experience was shorter than expected. DFS% was significantly associated with survival. Individuals with a low number of decayed and filled surfaces (DFS) had a shorter-than-expected survival time compared with those with high DFS scores. The overall predictor of survival was cognitive status, independent of age and gender when dental variables were analysed in the context of psychosocial factors. In addition, number of teeth, smoking, and better financial status in childhood and during working life were also significant predictors. Oral health was significantly associated with subsequent survival in a sample of oldest-old individuals, although psychosocial factors were stronger predictors.

Self‐Esteem and Socioeconomic Disparities in Self‐Perceived Oral Health

To determine if psychosocial factors explain the socioeconomic disparities in self-perceived oral health that persist after controlling for oral status variables. Data came from the participants in the Canadian Community Health Survey 2003 who were residents in the city of Toronto. Oral health variables included self-rated oral health, a 13-item oral health scale, denture wearing, and having a tooth extracted in the previous year. The last two measures were regarded as proxy indicators of tooth loss. Psychosocial variables included a self-esteem scale, a depression scale, and single items measuring life satisfaction, life stress, and sense of cohesion. Socioeconomic status was assessed using total annual household income. Interviews were completed with 2,754 dentate persons aged 20 years and over. Bivariate analyses confirmed that there were income gradients in self-rated oral health and scores on the oral health scale. Linear regression analyses confirmed that these persisted after controlling for age, gender, denture wearing, and having a tooth extracted in the previous year. In the model predicting self-rated oral health self-esteem, life satisfaction, stress, a sense of cohesion, and depression also contributed to the model, increased its explanatory power, and reduced the strength of but did not eliminate the association between income and self-rated oral health. Broadly, similar results were obtained when the oral health scale score was used as the dependent variable. In both analyses and all models, denture wearing had the strongest and most enduring effect. Psychosocial factors partly but do not wholly explain the socioeconomic disparities in self-perceived oral health in this population after controlling for tooth loss and denture wearing. Other variables need to be added to the models to increase their explanatory power.

Oral health and nutritional biochemical variables in adult patients with AIDS

Oral health and nutritional biochemical variables in adult patients with AIDS

Factors Associated with Oral Health–Related Quality of Life in Community‐Dwelling Elderly Persons with Disabilities

To examine, in community-dwelling elderly persons with disabilities, the association between oral health-related quality of life (OHRQOL) as measured using the 14-item Oral Health Impact Profile (OHIP-14) and specific oral health, health, and disability status variables; life satisfaction; living alone; and low income. Observational cross-sectional. A Medicare demonstration conducted in 19 counties in three states. Six hundred forty-one disabled, cognitively intact, community-dwelling individuals aged 65 and older. The subjects' OHRQOL was assessed using the OHIP-14, which was scored using three different methods. Data on oral health, health and functional status, life satisfaction, prior health services use, and sociodemographics were collected using interviewer-administered questionnaires. The participants' mean age was 79.1, and they were dependent in an average of 1.8 activities of daily living (ADLs); 43.1% were edentulous, 77.4% wore a denture, 40.4% felt that they were currently in need of dental treatment, and 64.7% had not had a dental examination in the previous 6 months. Seven of the 16 variables of interest had significant bivariate relationships using three OHIP scoring methods. Logistic regression analysis found that poor OHRQOL was significantly associated with perceived need for dental treatment (odds ratio (OR)=2.61), poor self-rated health (OR=2.29), poor (OR=2.00) and fair (OR=1.73) mental health, fewer than 17 teeth (OR=1.74), and relatively poor cognitive functioning (OR=1.52). OHRQOL is associated with some (perceived need for dental treatment, poor self-rated health, worse mental health, fewer teeth, and relatively poor cognitive status) but not all (e.g., ADL and instrumental ADL dependence) measures of oral health, health, and disability status and not with life satisfaction, living alone, or low income.

Determinants of oral health-related quality of life in a cross-cultural German-Canadian sample

The knowledge on the determinants of oral health-related quality of life (OHQoL) is still fragmentary. The aim of this study was to examine the influence of different socio-economic, behavioral, and clinical variables on OHQoL in a cross-cultural patient sample in Germany and Canada. The study had a cross-sectional design. It was conducted at five examination sites at clinics managed by the Technische Universitat Dresden (Germany) and the University of Alberta (Canada), with the sites representing different cultural and socio-economic variables. Incoming patients satisfying the defined inclusion and exclusion criteria were asked to participate. Subjects who had been to a dentist within the last 3 months were excluded to avoid bias related to recent experiences associated with ongoing treatment. OHQoL was measured with the 49-item version of the OHIP (Oral Health Impact Profile) questionnaire (OHIP-49) together with age, gender, attendance and a set of oral health variables. The OHIP questions are organized into seven dimensions: functional limitation, physical pain, psychological discomfort, physical disability, psychological disability, social disability, and handicap. All questions refer to the experiences of the subject in the preceding 12 months. Descriptive, univariate, and multivariate methods were applied in data analysis. Based on the results of the multivariate logistic regression analysis, only gender, removable denture wearing, and treatment need in endodontics, surgery, and prosthetics remained as significant explanatory variables in the final model for impaired OHQoL. With the OHIP subscale handicap being the dependent variable, missing anterior teeth (regardless of replacement), treatment need in surgery, and the time of the last dental visit were significant indicators of high – i.e. unfavorable – scores. In this patient sample, impaired OHQoL was associated with several factors. The examination site, however, was not among the explanatory variables in the final models, as had been expected, thus indicating the absence of cross-cultural differences.

Sense of coherence as a determinant of the oral health‐related quality of life: a national study in Finnish adults

Our aim was to investigate the relationship among the oral health-related quality of life, the sense of coherence (SOC), and socio-economic and demographic factors, oral behavioural variables and oral health variables. The sample of this study consisted of 4,039, 30-64-yr-old dentate adults (1,899 men and 2,140 women). The questionnaire and home interview included information about socio-economic and demographic factors, behavioural and attitudinal variables (such as oral health behaviours and oral health variables), the SOC (12-item) and the Oral Health Impact Profile scales (OHIP-14). Subjects with a strong or moderate SOC were found to have significantly fewer problems attributed to oral conditions (OHIP) than those with a weak SOC. The SOC was also associated with all of the subscales of the OHIP, and the association was most evident in psychological discomfort, psychological disability and handicap subscales. The SOC appears to be a determinant of the OHIP, independently of oral health, oral health behaviour and socio-economic factors. A psycho-social aspect is strongly embodied in the oral health-related quality of life of individuals.

Nursing home executive directors' perception of oral care in long-term care facilities.

Oral health in long-term care (LTC) facilities has been repeatedly documented as less than ideal. The complex nature of this environment has made it difficult to understand and improve the oral health status of residents through education and training. The purpose of the study was to investigate how the executive directors (EDs) of LTC facilities value oral health and to determine facility variables, which may influence how oral care is delivered. A mail survey of the EDs of all LTC facilities in Ohio (n = 1018) was conducted with 338 responses received after secondary follow-up (33.2% response rate). The 30-item survey included information concerning the nursing facility, the EDs, the EDs' perception of the level of oral health care, and value statements rated on a Likert-like scale. The results of the survey showed that more than two-thirds of the EDs were female and that most facilities were proprietary (70.3%). ED gender was not statistically associated with any of the oral health variables. Fifty-three percent of the EDs rated their residents' oral health as fair or poor but were still satisfied with the oral care provided at their facilities. The apparent discontinuity between perceived levels of oral health and satisfaction with oral care suggests that EDs are distanced from the oral care of their residents or they do not acknowledge oral health care needs. While the survey results revealed important facility characteristics and administrators' perceptions about oral health, the most important aspect of this project was the low response rate despite secondary follow-up. That, coupled with the negativity expressed upon follow-up, suggests a larger issue that may affect oral health in nursing facilities: oral health continues to have a low priority in this setting. Continuing efforts to improve oral health and educate LTC professionals about oral health's influence on general health is critical for managing the oral health of future generations of aging adults.

Self-assessed dental health, oral health practices, and general health behaviors in Chinese urban adolescents

The objectives of this study were: to describe perceived dental health status and oral health-related knowledge, attitudes, and behavior in Chinese urban adolescents; to assess the associations of oral health variables with socio-economic status and school performance; and to analyse the relative effect of socio-behavioral risk factors on perceived dental health, perceived need for dental care, and experience of dental symptoms. A cross-sectional survey of 2662 adolescents was conducted in eight capital cities in China; the response rate was 92%. The study population was chosen by multistage cluster sampling and covered three age groups: 11, 13, and 15 years. Data on dental and general health were collected by self-administered questionnaires. Self-assessment of dental health of Chinese adolescents was generally good, only 12% of the students answered that their teeth were “poor” or “very poor”, and 9% claimed having “poor” or “very poor” gums. Eleven percent of participants said that other students made fun of their teeth; 24% of the respondents were dissatisfied with the appearance of their teeth, and 41% claimed that they had experienced toothache or symptoms during the previous 12 months. Positive attitudes towards dental care were found in all age groups; 67% of adolescents brushed their teeth at least twice a day and 48% of the students used fluoridated toothpaste. Only 26% of the students visited a dentist during the previous 12 months. In all, 6% of the adolescents had tried cigarette smoking at least once, while 41% reported having tasted alcohol drinks. Multivariate regression analyses showed that perceived dental health status and needs were associated with gender, age, unhealthy lifestyles, poor school performance, and socio-economic status. The establishment of school-based health promotion programs in China is urgently needed, and promotion of oral health lifestyles should be integrated with other general health actions.

Influence of patient, visit, and oral health factors on dental service provision.

Service provision should reflect the oral health of the patient. However, patient and visit factors may influence service patterns and the appropriateness of care delivered. The aim of this study was to examine factors associated with variation in dental services and to assess whether variation by patient and visit characteristics persisted after controlling for oral health status. A random sample of Australian dentists was surveyed during 1997-98 (response rate = 60.3%). Private general practitioners (n = 345) provided data on service provision, as well as patient, visit and oral health variables from a log of a typical clinical day (n = 4,115 patients). Multivariate Poisson regression models were run for eight service areas (e.g., diagnostic, preventive, and restorative). Significant effects (P < .05) were observed for oral health factors in all eight models, visit factors in all eight models, patient demographics in four models, dental knowledge/behavior in one model, and area-based socioeconomic status in one model. After controlling for oral health, visit characteristics persisted as significant predictors of services, with nonemergency visits, insurance, and capital city location associated with more favorable service mix patterns. Higher socioeconomic status areas and payment scale ratings also were associated with a better service pattern in particular service areas. These findings show that a wide range of factors, in addition to oral health, contribute to variation in service provision.

Self‐perceived oral health among three subgroups of Asian‐Americans in New York City: a preliminary study

Abstract – Objectives: The aim of this preliminary study was to compare the perception of oral health among subgroups of Asian‐American residents of New York City, USA. Methods: A close‐ended questionnaire was administered to 255 Chinese, 134 Indian and 84 Pakistani adults, aged 18–65 years, during 1994–95. A comprehensive dental and oral examination was also performed. The associations of demographic and oral health variables with perceived oral health were evaluated using multivariate ordinal regression models. Results: When data were analyzed in a multivariate context, only ethnicity and income were significant predictors of perceived oral health, after adjusting for DMFT. The within‐group multivariate analysis of the three ethnic subgroups’ results were as follows: Among the Chinese there were no significant predictors, only income was strongly suggestive; among the Indians, number of missing teeth and number of years in the USA were significant predictors; and within the Pakistani group, DMFT was the only significant predictor. Conclusions: Results suggest that there are ethnic differences in the perception of oral health status even after adjusting for clinical variables as well as for demographic variables in this particular group of Asian‐American residents of New York City. Predictors associated with the perception of oral health are different for each ethnic group. When designing oral health promotion activities to diverse ethnic groups, the cultural characteristics of each subgroup should be considered.