Population Oral Health Research Articles

Impact of self-perceived oral health and socio-economic factors on oral health-related behavior in Estonian adults.

To identify which socioeconomic factors are affecting oral health-related behavior and to provide suggestions for improving the population's oral health. Materials and methods: The survey includes population groups from age 35 and older from all 15 Estonian counties and major cities (n = 2,376). The study is based on data from a nationwide Estonian Adult Oral Health Survey questionnaire. In addition to analyzing eight aspects of oral health-related behavior and self-perceived oral health variables, the survey also includes participants' socio-economic and demographic characteristics. The study utilizes frequency tables (including cumulative distributions), means, correlations, and regression analysis as its methods. The mean number of beneficial behaviors reported by the participant was 4.2 (SD 1.6). The value of the oral health-related behavior index (OHBI, the number of reported behaviors from the eight) is initially determined by the optimal timing between meals, abstinence from smoking, and the choice of drinking water or refraining from any intake between meals. Participants with higher OHBI tended to rate their self-perceived oral health better. Adherence to beneficial dental health-related behavior in Estonian adults is primarily influenced by gender, educational level, type of settlement, and household income level. In order to significantly improve oral health and related behaviors, it is imperative to integrate dental services into universal health coverage and deliver ongoing oral health education for adults.

Toothbrushing programme in Saudi Arabia ‘TOPS’: a study protocol for a cluster randomised controlled trial in kindergartens, Riyadh

IntroductionDental caries among children is a major global health problem and is a particular public health challenge in Saudi Arabia. Dental caries cause pain, infection and negatively impact quality of...

Making the case for a new typology of dental care systems.

Dental care systems have the potential to influence population oral health and patterns of socioeconomic inequalities. Therefore, understanding the impact of the ways in which countries fund, provide, and organize their dental care services is key in the analysis of determinants of oral health. In this commentary we offer a synopsis of recent typologies of healthcare systems, based on a rapid review, and highlight that none of them fit dental care services given the separation of dental care from general healthcare provision in many countries. The paper also summarizes evidence on dental care systems as determinants of population oral health and argues why a new typology of dental care systems is needed. We argue that a typology must consider institutional arrangements, structures, and processes behind the provision of dental care, and that specific dimensions/variables that inform the typology should result from a process of discussion and consensus. Some methodological considerations for developing typologies are also discussed, including the challenges in the collection and analysis of data followed by an advanced cluster analysis. Despite their limitations, typologies have evolved into an essential tool for comparing the similarities and differences of healthcare systems across countries. Therefore, a dental specific typology for health systems will be useful for researchers, policymakers, and dental professionals to characterize the provision of dentalcare services in different countries. This will also enable examining their potential role as determinants of population oral health and inequalities.

The Impact of the COVID-19 Pandemic on Pattern of Antibiotic and Opioid Prescriptions by Dentists in Alberta, Canada.

After the shutdown of most dental services during the COVID-19 lockdown, the oral health community was concerned about an increase in prescribing opioids and antibiotics by dentists due to patients' limited access to dental offices. Therefore, the objective of this study was to investigate the impact of COVID-19 pandemic on the pattern of antibiotic and opioid prescriptions by dentists in Alberta, Canada. Data obtained from the Tracked Prescription Program were divided into antibiotics and opioids. Time periods were outlined as pre-, during-, and postlockdown (phase 1 and 2). For the number of prescriptions and average supply, each monthly average was compared to the corresponding prelockdown monthly average, using descriptive analysis. Time series analyses were conducted using regression analyses with an autoregressive error model. Data were trained and tested on monthly observations before lockdown and predicted for during- and postlockdown. A total of 1.1 million antibiotics and 400,000 opioids dispense were tracked. Decreases in the number of prescriptions during lockdown presented for antibiotics (n = 24,933 vs. 18,884) and opioids (n = 8892 vs. 6051). Average supplies (days) for the antibiotics (n = 7.10 vs. 7.55) and opioids (n = 3.92 vs. 4.05) were higher during the lockdown period. In the trend analyses, the monthly number of antibiotic and opioid prescriptions showed the same pattern and decreased during lockdown. The COVID-19 pandemic altered the trends of prescribing antibiotics and opioids by dentists. The full impact of COVID-19 pandemic on the population's oral health in light of changes in prescribing practices by dentists during and after lockdown warrants further investigation.

Evaluation of oral complications in children undergoing chemotherapy: An observational study.

Chemotherapy, a cornerstone treatment for childhood cancers, can negatively impact oral health. This study aimed to evaluate the prevalence and evolution of oral complications in these patients. A prospective observational study enrolled 44 children diagnosed with malignancy undergoing chemotherapy at a tertiary care institute in central India. Oral examinations were performed at baseline, with follow-ups at 3-6 and 9-12 months. Data collected included demographics, medical history, oral hygiene practices, and oral lesions. Blood counts and World Health Organization grading for mucositis were used. Descriptive statistics and appropriate statistical tests analyzed the data (P ≤ 0.05). Acute lymphoblastic leukemia (ALL) was the most prevalent malignancy. Children reported various oral complaints such as ulcers, bleeding gums, and difficulty eating. Mucositis prevalence significantly decreased over follow-up visits (baseline: 56.8% and second follow-up: 13.3%). Gingival inflammation was present, though mean scores decreased over time. Oral hygiene scores varied without significant changes. Caries experience scores increased from baseline to follow-up. This study identified a high prevalence of ALL and diverse oral complications in children undergoing chemotherapy. While mucositis severity lessened over time, other issues such as caries persisted. These findings highlight the critical need for preventive oral care strategies to safeguard this vulnerable population's oral health.

Leadership, regulatory approaches and policy to re-orientate health services towards health promotion.

Globally, oral conditions remain the most prevalent of all non-communicable diseases. Among the broad range of target goals and recommendations for action by the World Health Organization's Global Oral Health Strategy, we call out three specific actions that provide an enabling environment to improve population oral health including: (i) enabling population oral health reform through leadership, (ii) enabling innovative oral health workforce models, (iii) enabling universal health coverage that includes oral health. The aim of the article is to outline how leadership, regulatory approaches and policy in Australia can strengthen health promotion practice and can inform global efforts to tackle the complex wicked problems associated with population oral health. Examples in Australia show that effective leadership, regulatory approaches and well-designed policies can address the growing burden of non-communicable diseases, and are made possible through public health advocacy, collaboration and research.

Preparing trainees for change: "Teaching population oral health management".

Preparing trainees for change: "Teaching population oral health management".

Advancing the voice of women through doctoral education: Proposed models for dental hygienists and dental therapists.

The increase in scientific knowledge, oral healthcare, new dental hygiene workforce models, and the latest clinical skills, have elevated the need for doctoral prepared dental hygienists and dental therapists. These oral care providers need to be empowered with advanced preparation in education, research, and leadership. Therefore, the purpose of this paper is to present two curricular models for a doctorate of philosophy and a doctorate of oral health practice recognizing that students may have different goals and interests in educational pursuits. The doctoral program models support the conduct of research and scholarship, which supports the research infrastructure of the profession and emphasizes the dissemination of scholarly works. Creation of doctoral programs for dental hygienists and dental therapists provides opportunities to broaden choices and strive for autonomy throughout their careers. These programs may support the development of additional scholars and advanced practitioners who can contribute to the scientific body of knowledge and create policies and pathways to improve population oral health.

The ongoing fight for population oral health

The ongoing fight for population oral health

Modelling the Future Malaysian Clinician Dental Workforce using System Dynamics

Introduction: The aim of this operational research workforce project was to build, and test, a clinical dental workforce model for Malaysia to address population need/demand with a view to informing health policy. Methods: A system dynamics (SD) model was developed to take account of population oral health needs and demands and dental workforce supply nationally from 2010 to 2040. This involved building two sub-models: population need/demand; and dental workforce supply, drawing on evidence from two previous studies (student survey and interviews of key-stakeholders) supported by government data. The two sub-models were integrated in relation to clinical time to explore potential of over- or under-supply of clinical hours; were latter converted to clinical workforce numbers. The SD model was tested and validated as an acceptable baseline model for Malaysia using existing workforce data. Results: A SD model was developed to model the need, supply and demand for dental care in two sectors from 2010 to 2040. There is a short-term need for an expanded dental workforce to meet the needs of the population but there is a potential oversupply of dentists and therapists from 2040, or earlier. The level of public demand for both primary and secondary dental care is expected to increase respectively from the year 2010 to 2040, varying in relation to demographic and health trends across public and private sectors. Conclusion: The study suggests there is are current requirements for an expanded dental workforce to serve the population needs/demand and potential for oversupply from 2040, or earlier.

Self Perceived Stress and Oral Health Related Quality of Life Among Tribal Gypsies in Chennai

Introduction: Certain ethnic groups continue to practice traditional values and beliefs while remaining geographically or socially isolated. These groups also tend to rely on traditional indigenous methods of treatment rather than accessing oral health treatments when necessary. Past studies of the tribal Narikuravar population's oral health state and understanding of oral hygiene measures revealed that both were in very poor condition, necessitating greater dental care. Poor oral health also implies that their general health will be compromised, affecting their ability to work as well. Aim: To assess the self-perceived stress and oral health-related quality of life among tribal gypsies in Chennai Materials and methods: The study was conducted among the Narikuravar tribal gypsies living in Thirumullaivoyal, Chennai, in April 2022. The present study included 320 study participants in total. Using the perceived stress scale (1983) and the OIDP scale, the tribal population's self-perceived stress and oral health quality of life were evaluated. To determine the statistical significance with , descriptive statistics and Pearson's correlation test were used. Results: Our study shows a high-stress level of 30.6%, a Moderate stress level of 56.3%, and a low-stress level of 13.1% among tribal gypsies in Chennai. The correlation between stress levels and sleeping and relaxation among tribal gypsies in Chennai shows a high association between high-stress levels and their impact on everyday life. A chi-square test was done, and the association was found to be statistically significant, P-value Conclusion: Many nomads had oral health perceptions significantly correlated with their traditional habits, and their oral health had worsened. To enhance their oral health status, steps must be taken to increase their access to care and reduce barriers.

Oral Health, Social and Emotional Well-Being, and Economic Costs: Protocol for the Second Australian National Child Oral Health Survey.

Given the significant investment of governments and families into the provision of child dental care services in Australia, continued population oral health surveillance through national oral health surveys is imperative. The aims of this study are to conduct a second National Child Oral Health Survey (NCOHS-2) to (1) describe the prevalence, extent, and impact of oral diseases in contemporary Australian children; (2) evaluate changes in the prevalence and extent of oral diseases in the Australian child population and socioeconomic subgroups since the first National Child Oral Health Study (NCOHS-1) in 2012-2013; and (3) use economic modeling to evaluate the burden of child oral disease from the NCOHS-1 and NCOHS-2 and to estimate the cost-effectiveness of targeted programs for high-risk child groups. The NCOHS-2 will closely mimic the NCOHS-1 in being a cross-sectional survey of a representative sample of Australian children aged 5-14 years. The survey will comprise oral epidemiological examinations and questionnaires to elucidate associations between dental disease in a range of outcomes, including social and emotional well-being. The information will be analyzed within the context of dental service organization and delivery at national and jurisdictional levels. Information from the NCOHS-1 and NCOHS-2 will be used to simulate oral disease and its economic burden using both health system and household costs of childhood oral health disease. Participant recruitment for the NCOHS-2 will commence in February 2024. The first results are expected to be submitted for publication 6 months after NCOHS-2 data collection has been completed. Thematic workshops with key partners and stakeholders will also occur at this time. Regular surveillance of child oral health at an Australian level facilitates timely policy and planning of each state and territory's dental public health sector. This is imperative to enable the most equitable distribution of scarce public monies, especially for socially disadvantaged children who bear the greatest dental disease burden. The last NCOHS was conducted in 2012-2014, meaning that these data need to be updated to better inform effective dental health policy and planning. The NCOHS-2 will enable more up-to-date estimates of dental disease prevalence and severity among Australian children, with cost-effective analysis being useful to determine the economic burden of poor child dental health on social and emotional well-being and other health indicators. PRR1-10.2196/52233.

Oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh: A cross-sectional multi-stage cluster survey.

Community health depends on the leadership duties of a diverse population, such as village volunteers. Hence, a study was conducted to assess oral health status, treatment needs, and patterns of utilization of dental services among village volunteers in Andhra Pradesh state. A cross-sectional study was conducted among 400 village volunteers in Andhra Pradesh state, India. A multi-stage cluster sampling procedure was employed in sample selection. A questionnaire was used to review the pattern of utilization of dental services. World Health Organization Oral Health assessment form 1997 was used to evaluate oral health status and treatment needs. Data collected were analyzed using IBM SPSS Statistics for Windows, Version 25.0. Descriptive statistics were done. Out of 400, 18% had never visited the dental clinic in their lifetime. The majority (33.5%) considered that dental problems were not a serious concern. Dental caries was seen in 69.5%, and 78.5% were presented with periodontal conditions. About 19.8% and 24.3% had crowding and spacing in incisal segments, respectively. The prevalence of oral mucosal disorders and dental fluorosis was 4.25% and 8.75%, respectively. Overall, 94% of the study participants needed dental treatment for various reasons. This study provides sufficient evidence to conclude that this population's oral health was poor, with increasing unmet dental treatment needs. Selected interventions and strategies should focus on these factors to decrease the burden of oral diseases among village volunteers.

Exploring fluoride-free content on Twitter: A topic modeling analysis

Abstract Social media discussions about the hypothetical side effects of fluoride-containing products have contributed to forming and strengthening health beliefs underpinning the anti-fluoridation movement. Given the importance of content analysis in mitigating online misinformation, this study aimed to investigate fluoride-free content on Twitter. Firstly, 21,169 tweets published in English between May 2016 and May 2022 concerning the keyword ‘fluoride-free’ were collected using the Twitter API. After the data preprocessing, Latent Dirichlet Allocation (LDA) topic modeling was conducted to identify the salient terms and topics inside the collected tweets. Then, the similarity between topics was calculated by an intertopic distance map. Furthermore, an investigator manually reviewed a sample of tweets that featured the most representative word groups associated with particular topics to determine the main issues. Finally, additional data visualization was performed using Elastic Stack software to analyze the total count and relevance of each topic related to fluoride-free records over time. The topic modeling analysis demonstrated a significant distance between the topics from a coherence score of 0.542, confirming the identification of three different issues: ‘healthy lifestyle’ (topic 1), ‘consumption of natural/organic oral care products’ (topic 2), and ‘recommendations for using fluoride-free products/measures’ (topic 3). Moreover, the number of fluoride-free publications decreased between 2016 and 2019 but increased again in 2020. Thus, recent increases in fluoride-free tweets appear driven by public concerns about adopting a healthy lifestyle, including the consumption of natural and organic products. Therefore, public health authorities, health professionals, and legislators must acknowledge the dissemination of fluoride-free content on social media to implement effective strategies to counteract its potential harm to the population's oral health. Key messages • People are concerned about the hypothetical side effects of fluoride-containing measures and products. • The consumption of fluoride-free content on social media is associated with adopting a healthy lifestyle.

Inequalities in oral health service utilisation in Ireland: results from the Healthy Ireland Survey

Abstract Background Good oral health is important for overall health and wellbeing; poor oral health disproportionately affects disadvantaged groups and is associated with various non-communicable diseases, many of which have shared risk factors, including diabetes and cardiovascular disease. Regular dental attendance with risk assessment optimises oral health. Due to an ageing dentate population, demands on oral health services are predicted to increase in Ireland. This cross-sectional assessment of oral health service utilisation aimed to inform equitable national resource allocation. Methods Secondary analysis of the Healthy Ireland Survey 2022, a telephone-delivered survey of a representative sample of the Irish public aged ≥15 years, was conducted. Prevalence of dental attendance in the preceding year was measured with 95% Confidence Intervals (CIs). Logistic regression determined factors associated with dental attendance using Adjusted Odds Ratios (aORs). Results Response rate was 40.4% (N = 7,455). Most participants (81.3%) self-reported good or very good overall oral health; 49.3% had attended dental services in the previous year. Compared to comparative counterparts those of higher educational level (aOR 1.28 95% CI 1.09-1.50), those with private health insurance (aOR 1.66 95% CI 1.48-1.86) and those with no missing teeth (aOR 2.91 95% CI 2.19-3.85) were significantly more likely to have attended dental services in the previous year. Conversely, compared to those aged 25-34 years, those aged 65+ had significantly lower odds of dental attendance in the previous year. Conclusions Disparities in oral healthcare utilisation identified in this study suggest potential unmet population oral health needs. Combined with population ageing and a growing scarcity of dentists available to provide care to disadvantaged groups such coverage gaps are key considerations for Irish oral healthcare planning, namely implementation of Ireland's National Oral Health Policy ‘Smile agus Sláinte’ 2019. Key messages • In this nationally representative cross-sectional survey of Irish adults notable disparities in oral health service utilisation were evident, especially among older adults. • Aligning with the universal health coverage agenda, suggested unmet population oral health needs are key considerations for national and international oral healthcare planning and resource allocation.

Adults' estimated prevalence of healthy behavior in society and self-reported oral health status and behaviors.

To assess Mashhad residents' self-perceived oral health level (OHL) and behaviors in relation to their perceptions of those of their fellow citizens. Cross-sectional telephone survey of 384 individuals recruited from communication centers. The interviews followed a validated Persian schedule with three main sections: 1) background information, 2) questions regarding self-reported OHL, and 3) questions regarding respondents' perceptions of the OHL of their fellow citizens. Participants' mean self-rated OHL and tooth brushing frequency were higher than those of their fellow citizens. The correlation between self-reported and the estimated decayed and missing (DMT) was highest in the middle and lowest in the upper classes. Perceptions of the self- and others' OHL and DMT were positively correlated, with the latter being more so. Education level, age, and tooth brushing frequency affected self-perceived OHL and DMT. Participants' perceived OHL could be explained by their estimation of the general population's oral health. These findings suggest that social norm interventions could nudge improving oral health behaviors.

Fit for Purpose? The Suitability of Oral Health Outcome Measures to Inform Policy.

Oral health research and program evaluation should consider alternative outcome measures for population oral health other than the DMFT index.

Prioritizing population oral health through public policy in Australia: the Victorian experience.

Dental caries, a non-communicable disease, is one of the most prevalent diseases globally and share common modifiable risk factors with obesity such as excess sugar intake. However, prioritization by governments to improve population oral health has been limited and is typically excluded from the discourse of public health policy development. Therefore, interventions that target dental caries can have other co-benefits including obesity prevention. In Victoria, Australia, local government authorities have a regulatory requirement to develop their Municipal Health and Wellbeing Plans. The aim of this paper is to identify whether prioritization for oral health by local government authorities in Victoria has changed through the subsequent renewal of the Victorian Public Health and Wellbeing Plans 2011-2015 and 2019-2023. Three desktop audits for all publicly available Municipal Health and Wellbeing Plans by local government authorities in Victoria were conducted between 2014 and 2022. Key terms related to oral health was searched within these policy documents and categorized into six indicators: (i) included oral health as a priority, (ii) linked healthy eating and oral health, (iii) supported the Achievement Program, (iv) included the Smiles 4 Miles program, (v) advocated for fluoridated drinking water, and (vi) included other strategies related to oral health. Overall, there was statistically significant reduction in five of the six indicators, with the exception for prioritization of other strategies related to oral health such as targeting excess sugar intake and smoking. A multi-sectoral approach, that includes oral health would be advantageous to address the growing burden of non-communicable diseases.

New Public Health Approach to Oral Health Care Accessibility in a Pandemic

Introduction
 Poor access to oral healthcare has continually been a major setback to achieving universal oral healthcare. And this is more important in low-to-medium-income communities where a significant portion of the populations cannot afford oral treatments. This situation has contributed to the increased prevalence of oral health diseases. Historically, pandemics have been known to cause a further reduction in access to healthcare with the resultant effects of a burgeoning burden of oral diseases. This review article aims at describing the impact of COVID-19 pandemic on access to population-based dental care and to suggest a new approach to mitigating the effects of lockdown, which practically hinders populations’ access to care during pandemics. These are with a view to improving pandemic preparedness and enhancing population access to oral healthcare in times of restrictions. 
 Areas covered
 This is a review article that focused on COVID-19 pandemic and how it impacted access to oral healthcare. The article also highlighted the new approaches that could be adopted to consistently make oral healthcare obtainable by all despite physical restrictions. Literature searches of key terms were carried out using PubMed and Google Scholar.
 Expert opinion
 So much has been known about the impact of reduced access to oral healthcare. However, ideas on service modification and/or adoption of new methods of improving population-based access to oral care, especially during periods of global health crises have not been proposed.
 Keywords: Access to oral health, Community dentistry, Coronavirus, COVID-19, Dental public health practice, Oral health, Oral health promotion, Population oral health, Universal oral health care

The role of science communication and academic health advocacy in improving population oral health and tackling inequalities.

Oral conditions are a public health problem globally and stark oral health inequalities exist between and within countries. Yet, oral diseases are rarely considered as a health priority and evidence-informed policy generation is challenging. Science communication and health advocacy are critical in that respect. However, due to time limitations, research workload and other factors, academics are usually hindered from participating in such lengthy endeavours. Here, we make the case that 'science communication and health advocacy task forces' should be a priority at academic institutions. The two main duties of these task forces are knowledge transfer about the burden of oral conditions and patterns of inequalities, and their underlying social and commercial determinants, and advocacy and mediation between the stakeholders involved directly or indirectly in policy making. These interdisciplinary task forces, including both academics and non-academics, should collectively have skills that include (1) knowledge about oral health, dental public health and epidemiology, (2) ability to communicate clearly and coherently and make the case in both lay and scientific language terms, (3) familiarity with digital and social media platforms and ability to create visual aids, videos and documentaries, (4) good negotiation skills and (5) maintaining scientific transparency and avoiding getting involved in confrontation with political parties. In the current context, the role of the academic institutions should not only be the production of knowledge, but also the active transferability and application of this knowledge towards public benefit.