Self-rated Oral Health Research Articles

Associations between perceived self-efficacy and oral health behaviours in adolescents.

Self-efficacy is a strong health predictor as it affects patients' certainty about their ability to perform recommended behaviours to improve their health. The aim of this study was to examine the associations between perceived self-efficacy and oral health behaviours among adolescents. A convenience sample of adolescents aged 12 to 18 years old was recruited from the University of Alberta dental clinic. Demographics, oral health behaviours, self-rated oral health and task-specific and general self-efficacy were assessed using a questionnaire with three sections. For the comparisons of outcomes across different categories, Student t-test, multivariate regression and chi-squared tests were used. A total of 252 adolescents with average (SD) age of 14 (1.7) years participated in the study; 60% were girls; 81% were born in Canada; 56% were White; and 61% had dental coverage. Demographic characteristics had no significant correlation with general self-efficacy. However, correlation coefficients indicated that younger adolescents had higher dietary self-efficacy (negative correlation), girls had higher toothbrushing and dental visit self-efficacy, and those with dental coverage had higher dental visit self-efficacy. A significant association was found between toothbrushing, dietary habits and dental visits self-efficacy (subscales of task-specific self-efficacy) and their respective outcomes (frequency of toothbrushing, sugar intake and regular dentist visits). General self-efficacy was significantly associated with frequency of toothbrushing and participant's self-rated oral health. Higher task-specific and general self-efficacy correlated with better oral health behaviours among adolescents. Therefore, behavioural interventions should be designed to enhance self-efficacy among adolescents in order to improve their oral health outcomes.

Oral Health Literacy, Sense of Coherence and Associations With Poor School Performance.

This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self-reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. This was a cross-sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self-administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self-rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health-related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC.

Using Andersen's behavioural model to examine individual and contextual factors associated with dental service utilization in Brazil.

The study aimed to examine individual and contextual factors associated with the frequency of dental service utilization among adolescents, adults and older adults Brazilians. This cross-sectional study used secondary data from the Brazilian 2019 National Health Survey (94 114 individuals). The outcome 'when was your last dental appointment?' was categorized into three groups: up to 1 year, more than 1 year and never had a dental appointment. Andersen's behavioural model was used to select contextual and individual variables. Multinomial logistic regression analysis was performed to calculate the odds ratio (OR) and 95% confidence intervals (95% CI). The following variables showed increased probability to the outcome had the last dental appointment more than 1 year ago: older adult, illiterate or incomplete primary school, and without private dental insurance. The outcome never had a dental appointment was significantly associated with illiterate (OR 26.65; 95% CI 17.63-40.29), male (OR 2.38; 95% CI 2.17-2.61), without private dental insurance (OR 5.20; 95% CI 3.48-7.76), self-rated oral health as bad or very bad (OR 2.67; 95% CI 2.31-3.09), household not enrolled in primary care teams (OR 1.29; 95% CI 1.11-1.49), household in a rural area (OR 1.86; 95% CI 1.69-2.05), high household crowding (OR 1.08; 95% CI 1.04-1.14) and low household income per capita (OR 0.99; 95% CI 0.99-0.99). This study showed that contextual and individual factors induce inequity in dental appointments. Moreover, Andersen's behavioural model demonstrated inequitable access for dental services in Brazil, in which social structure and enabling characteristics, rather than the need for the service, determine who receives health care. Living in a household enrolled in primary care teams favoured regular dental appointments. Thus, these findings may help policymakers improve health access by expanding coverage of dental services in primary health care.

Do changes in income and social networks influence self-rated oral health trajectories among civil servants in Brazil? Evidence from the longitudinal Pr\xf3-Sa\xfade study

BackgroundSocial factors are important determinants of health. However, evidence from longitudinal studies on the possible role of changes in socioeconomic circumstances on adult’s oral health is scarce. This study aimed to test whether changes in income and changes in social networks of family members and friends were associated with trajectories of self-rated oral health (SROH) among adults over a 13-year period.MethodsA prospective cohort study (Pro-Saude Study) was conducted involving non-faculty civil servants at university campi in Rio de Janeiro, Brazil. Individual data was collected through self-completed questionnaires in four waves (1999, 2001, 2007 and 2012). SROH trajectories between 2001 and 2012 were “Good-stable SROH”, “Changed SROH”, “Poor-stable SROH”. Per capita family income and social networks of family members and friends data obtained in 1999 and 2012 were grouped into “High stable”, “Increase”, “Decrease”, “Low stable”. Ordinal logistic regression using complete data of 2118 participants was used to estimate odds ratio (OR) and 95% CIs of changes in income and changes in social networks with SROH trajectories, adjusted for age, sex, skin colour and marital status.ResultsParticipants in the low income-stable and small social networks-stable groups showed 2.44 (95% CI 1.68–3.55) and 1.98 (95% CI 1.38–2.85) higher odds for worst trajectory of SRHO than those in the respective high-stable groups. Those in the decrease income group and decrease social networks group were 78% (95% CI 1.25–2.54) and 58% (95% CI 1.07–2.34) more likely to worst trajectory of SRHO than those in the high income-stable and high social networks-stable groups.ConclusionsAdults reporting low income and low social networks of family members and friends over 13 years and those with income and social networks decrease during the study period were at higher risk of having worsened their self-rated oral health.

Oral health problems and risk of incident disability in two studies of older adults in the United Kingdom and the United States.

BackgroundPreventing oral health problems can be crucial for maintaining physical independence in older adults. We aimed to examine the associations of a range of oral health problems with incidence of disability in older adults.MethodsWe used prospective data from the British Regional Health Study (BRHS) (N = 2147, 71–92 years), and the Health, Aging and Body Composition (HABC) study (USA) (N = 3075, 71–80 years). Oral health measures included tooth loss, periodontal disease, self‐rated oral health, and self‐reported dry mouth. Participants were followed for onset of disability over a follow‐up period of 3 years. Onset of disability was assessed through new cases of mobility limitations, activities of daily living (ADL), and instrumental activities of daily living (IADL). Logistic regression was performed to calculate the odds of incident disability.ResultsIn the BRHS, tooth loss was associated with greater odds of mobility limitations and ADL difficulties. Periodontal disease was associated with greater incidence of mobility limitations. Self‐report of ≥3 dry mouth symptoms was associated with increased odds of incident mobility limitations and ADL difficulties (OR = 2.08, 95% CI 1.27–3.42; OR = 1.73, 95% CI 1.03–2.90). Fair/poor self‐rated oral health was associated with greater incidence of IADL difficulties. In the HABC study, complete tooth loss was associated with greater incidence of mobility limitations (OR = 1.86, 95% CI 1.13–3.06), and fair/poor self‐rated oral health was associated with increased odds of incident ADL difficulties (OR = 1.42, 95% CI 1.04–1.94).ConclusionsOral health problems in older adults, particularly tooth loss, self‐reported dry mouth and self‐rated oral health were associated with greater incidence of disability. Poor oral health plays a potentially important role in the development of disability in older populations, which in turn is an essential part of quality of life and healthy aging.

Immigrant Status and Oral Health Disparities among Asian Americans in the United States

OBJECTIVES: To explore the roles of household language, foreign-born status, and citizenship on disparities in dental care, and oral health status among Asians in the U.S.
 METHODS: Based on the National Health and Nutrition Examination Survey (NHANES) 2011-2018, the author applied weighted nested logistic regression to describe the effects of household language, foreign-born status, and citizenship on dentist visits and self-rated oral health. Weighted negative binomial regression was used to explore the effects of immigrant status on the number of missing teeth. Socioeconomic status and demographic characteristics were controlled for. 
 RESULTS: Asians who do not speak English at home present 1.428 times higher likelihood of irregular dentist visits, and 1.487 times higher self-rated fair/poor oral health. Respondents with no citizenship are more likely (OR=1.752) to present irregular dentist visits. Foreign-born Asians present more missing teeth (OR=1.361) than their U.S.-born counterparts.
 CONCLUSIONS: Despite the fact that Asians are often regarded as “model minorities” and/or “successful immigrants”, those with lower immigrant statuses illustrated higher risk for irregular dentist visits and disadvantaged oral health status.

Oral health promotion activities in the workplace: a scoping review.

There is limited literature and no reviews on oral health promotion activities in the workplace to guide planning and practice. This review summarizes evidence about oral health promotion activities in the workplace (nature and extent), its impact and the factors that facilitate or act as barriers to implementation. Using the PRISMA-ScR guidelines, scientific articles written in English and published in peer-reviewed journals up to April 2021, from six databases (Medline, PubMed, CINAHL, Scopus, EMBASE and Emcare) were screened and selected. The full texts of 95 articles were then considered; 21 articles met the inclusion criteria of using oral health status or oral health predisposing factors as primary outcome after an intervention in the workplace. Almost all included articles took a quantitative approach (n = 18), two used a qualitative design and another used a mixed-method approach. The most common activities were personalized or group oral health education interventions and oral health screenings conducted by a dental professional. Two studies reported the cost-benefit of workplace oral health promotion (WOHP). The literature indicated that WOHP interventions can be successful in achieving improvements in oral health, measured using a range of clinical (plaque accumulation, gingival inflammation, periodontal inflammation) and self-rated oral health indicators. Based on the limited literature available, WOHP may have benefits for employee oral health and employers, and the support of managers and organizations potentially improves the success of programmes. The workplace would appear to be an ideal setting to promote oral health. However, there is limited information to guide oral health promotion planning and implementation, and policy.

Oral health and its determinants among elderly immigrant Canadians

Objective: To compare the self-reported oral health status of elderly immigrant to Canadian-born (non-immigrant) seniors in Canada. Materials and Methods: This was a secondary data analysis of publicly available data from the 2008/09 Canadian Community Health Survey: Healthy Aging component (CCHS-HA). The sample consisted of 30,865 people aged 45 years and above. The outcome was self-reported oral health. We used predisposing (age, sex, marital status, immigrant status, time since immigration, smoking, alcohol use), enabling (education, household income, dental insurance, social support), need (self-reported health) and behavioural variables (brushing, physician and dentist visits) to compare the oral health status between immigrant and non-immigrant elders. Descriptive statistics and binary logistic regression were performed. Results: 16.9% of elderly immigrants reported fair to poor self-rated oral health compared to 10.5% non-immigrants. The predictors influencing fair to poor oral health among immigrant and non-immigrant elders varied. Significant predictors for immigrant elders included age, gender, marital status, education, income and physician visits. For non-immigrant seniors, last dental visit, income and education played a role in how oral health status was reported. Conclusion: An increasing influx of immigrants-coupled with an increasingly aging population, including elderly immigrants-has important public health policy implications. Policy approaches that incorporate oral health education, dental screening, awareness raising, and community-based initiatives in immigrant-concentrated areas would be beneficial when targeting the low-socio-economic status elderly immigrant population.

Impact on interprofessional collaboration and oral health-related quality of life from a prenatal care protocol: a mixed method study

Objective. The aim was to evaluate the potential impact on interprofessional collaboration and oral health-related quality of life from a prenatal care protocol. Method. We conducted an intervention study, with a post-test control group within a mixed-methods approach. The study population comprised 60 pregnant and health professionals enrolled in primary healthcare units. In the tested protocol, oral health technician was an important link with other members of multi-professional teams in the conversation wheels within which values, perceptions, behaviors and needs of pregnant women were shared about changes experienced during the pregnancy. Numerical data and narratives were used to assess self-rated oral health, oral health-related quality of life measured by OHIP-14, perception of pregnant women on interprofessional practices. Results. Patients were young and had incomplete or complete high school with no significant differences between the test and control groups. The perception of women in relation to interprofessional collaboration was greater in the intervention group than in control group. Self-rated oral health and oral health-related quality of life improved after intervention. Conclusions. The intervention encouraged the empowerment of the team to refocus the work process with greater involvement and collaborative professional interaction favored by oral health technician performance. The service organization protocol caused tensions and produced positive effects on interprofessional collaboration and on oral health-related quality of life. Clinical Relevance. The findings showed the relevance of the oral health technician’s performance integrating the activities between dental team and multidisciplinary professional team for quality of life related to oral health and interprofessional collaboration.

Differences in Determinants Influencing Self-Rated Oral Health in Korean and American Adults.

This study aims to identify the differences in the determinants that influence self-rated oral health (SROH) among Korean and American adults aged 20 years or older and the differences in objective oral health status between Korea and the United States. It included 13,068 Koreans and 5569 Americans who participated in the seventh Korea National Health and Nutrition Examination Survey and the 2017–2018 National Health and Nutrition Examination Survey. All analyses were conducted using the SPSS 25 program. The 39% of Koreans and 27.7% of Americans rated their oral health as “poor”. The mean SROH score was lower in Korea (2.66) than in the US (3.15). Conversely, objective oral health was better among Koreans. Further, an analysis of the differences in the predictors of SROH between the two countries confirmed that there were significant differences in age, household income, education level, insurance type (none), type of smoking, self-rated health, and decayed teeth index. Government-led projects or policy-based changes that can improve objective oral health status are needed to boost SROH in Korea, and subsequent studies should examine other objective oral health indices (e.g., periodontal disease) as well as differences in sociocultural backgrounds between countries.

Body mass index and self-rated oral health in Korean adults in 2017.

To investigate the association between obesity and self-rated oral health (SROH). This study examined the cross-sectional associations between body mass index (BMI) and SROH in Korean adults. This study used data from 217304 adults (100110 men and 117194 women aged>19years) from the 2017 Korean Community Health Survey. Participants were categorised into six ordinal groups based on BMI: underweight (<18.5kg/m2 ), normal weight (18.5-22.9kg/m2 ), overweight (23.0-24.9kg/m2 ), obese-I (25.0-27.4kg/m2 ), obese-II (27.5-29.9kg/m2 ) or obese-III (≥30.0kg/m2 ). SROH was assessed using responses to the question, "How do you rate your oral health, including your teeth and gums?" rated on a 5-point scale. SROH was categorised as "good" (reported as "fair," "good" or "very good") or "poor" or "very poor." Age- and sex-stratified associations between BMI categories and poor SROH were assessed using ordinal logistic regression analysis with sampling weights. The age-adjusted odds ratio (OR) for poor SROH according to BMI levels was lowest in the overweight group in both men and women. In men, the OR for poor SROH was 2.03 (99% confidence interval [CI], 1.72-2.39) in the underweight group, 1.17 (99% CI, 1.17-1.25) in the normal group, 1.05 (99% CI, 0.98-1.13) in the obese-I group, 1.08 (99% CI, 0.98-1.18) in the obese-II group and 1.36 (99% CI, 1.20-1.55) in the obese-III group. In women, the OR was 1.18 (99% CI, 1.07-1.31) in the underweight group, 1.01 (99% CI, 0.95-1.07) in the normal group, 1.07(99% CI, 0.99-1.16) in the obese-I group, 1.16 (99% CI, 1.04-1.30) in the obese-II group and 1.39 (99% CI, 1.20-1.62) in the obese-III group. From the restricted cubic spline models in both sexes, BMI showed a J-shaped association with poor and very poor SROH in men and women. In a stratified analysis by age group and sex, men and older women in the underweight group had poorer SROH than those in overweight group. In a nationally representative sample of Korean adults, there was a J-shaped association between BMI and poor SROH, with the highest risk in the underweight group amongst men and in the obese-III group amongst women. Furthermore, in men and women over 65years of age, underweight and obesity were associated with poorer SROH.

Oral health inequality among Indonesian workers in South Korea: role of health insurance and discrimination factors

BackgroundThe health of migrant workers is becoming an important public health issue. Although there are an increasing number of migrant workers in Korea, the health status in migrant populations remains unknown. The aims of this study were (1) to evaluate the association between income and self-rated oral health (SROH), and (2) to assess the role of health insurance and self-perceived discrimination in the association between income and SROH among Indonesian migrant workers in Korea.MethodsInformation about self-reported income, SROH, coverage/utilization of health insurance (HI), living difficulties related to oral health (LDROH), oral health literacy (OHL), and discrimination were obtained from Indonesian migrant workers in Korea (n = 248). The main explanatory variable was income, and SROH was an outcome variable. Logistic regression analyses were performed controlling for age, gender, HI, LDROH, OHL, and discrimination. The paths from income to SROH were analyzed using the Partial Least Square-Structural Equation Model (PLS-SEM).ResultsAmong Indonesian migrant workers, the lower income group had the highest probability of a poor SROH compared to the higher income group. The variables showing a high explanatory power were discrimination among the low income group and HI among the middle income group. In PLS-SEM, the variables such as HI, LDROH, OHL, and discrimination contributed 11% to explaining the association between income and SROH.ConclusionA monotonic gradient was revealed among migrant workers according to the association between income and SROH. Discrimination and HI contributed to oral health inequalities.

Is social origin, destination or mobility what matters to adult self-rated oral health?

To evaluate the independent contributions of parental socioeconomic position (SEP), own SEP and social mobility to explain adult self-rated oral health. Data from 6633 participants in the 1970 British Cohort Study were analysed. Parental SEP at the age of 10years (social origin) and own SEP at the age of 46years (social destination) were indicated by the 7-class National Statistics Socioeconomic Classification (NS-SEC). The study outcome was self-rated oral health (SROH) at the age of 46years. Diagonal reference models (DRMs) were used to parse out the effects of parental SEP, own SEP and intergenerational mobility from childhood to middle adulthood, after adjusting for demographic characteristics (sex, ethnicity, country and area of residence). Overall, 23.1% of participants reported poor SROH. A baseline DRM, with no indicators of social mobility, showed that the contribution of own SEP to explain variations in SROH was higher than that of parental SEP. However, they became almost equal after indicators of social mobility were introduced. Downward mobility was associated with poor SROH (odds ratio: 1.24, 95% CI: 1.01-1.51), but upward mobility was not (1.01, 95% CI: 0.83-1.23). Also, short-range downward mobility and long-range downward mobility (moving 1 and 2+ social classes down in NS-SEC, respectively) were associated with poor SROH (1.26, 95% CI: 1.01-1.58 and 1.39, 95% CI: 1.06-1.83, respectively) whilst short-range upward mobility (1.04, 95% CI: 0.84-1.28) and long-range upward mobility (0.88, 95% CI: 0.67-1.14) were not. The contributions of parental and own SEP were similar once social mobility was accounted for. Only downward mobility was associated with poor SROH, with new evidence that long-range mobility was more strongly associated with poor SROH than short-range mobility.

Assessment of Oral Health-Related Quality of Life and Its Associated Factors among the Young Adults of Saudi Arabia: A Multicenter Study.

Oral health-related quality of life (OHRQoL) is an essential indicator of people's overall health and health-related quality of life. Poor oral health and OHRQoL among young adults lead to numerous negative consequences and an increased burden on the healthcare system. The present study is aimed at assessing the OHRQoL among the young adults of Saudi Arabia, identifying self-rated oral health, and determining the relationship between sociodemographic and lifestyle factors with the OHRQoL. The present analytical cross-sectional survey was conducted among 1152 health and non-health-related college university students from three randomly selected universities. The OHRQoL was evaluated using the validated Arabic version of the oral health impact profile-14 questionnaire (OHIP-14). Of the population studied, one-fourth of the participants (24.9%) reported poor or fair oral health, and the highest OHIP-14 score was found in the domains of physical pain (4.14), followed by psychological discomfort (4.07). Logistic regression analysis revealed that the poor oral health category was significantly associated with male gender (ref: female: adjusted OR (AOR) = 1.89, 95%CI = 1.23–2.94, p = 0.004), daily smokers (ref: nonsmokers: AOR = 3.47, 95%CI = 1.97–4.82, p < 0.001), chocolate and candies intake more than once a day (ref: never; AOR = 1.54, 95%CI = 1.10–2.19, p = 0.034), and did not seek periodical dental care (ref: periodic dental care received: AOR = 2.23, 95%CI = 1.53‐2.86, p = 0.002). The present study revealed the factors associated with poor OHRQoL. The concerned authorities should consider the implementation of periodic dental checkups for university students, especially for the high-risk group. Furthermore, it is recommended to have regular health education programs that will help to change the student's lifestyle and poor oral health behaviors.

Is the association between social support and oral health modified by household income? Findings from a national study of adults in Australia.

To investigate whether the association between social support and oral health outcomes is modified by levels of household income. Data were from the National Study of Adults Oral Health (NSAOH 2004-06), a nationally representative study comprising n=3619 adults in Australia. Effect measure modification (EMM) analysis was adopted to verify whether the association between social support and poor/fair self-rated oral health, lack of a functional dentition (<21 teeth) and low Oral Health Related Quality of Life (OHRQoL; measured using OHIP-14) varies according to levels of income. Poisson regressions adjusted for age, sex, education, country of birth, main language spoken at home and remoteness were used to estimate prevalence ratios (PR) for oral health outcomes for each stratum of social support (overall, family, friends and significant other) and income (effect modifier). We then computed the Relative Excess Risk due to Interaction (RERI), which represents the risk that is over what would be expected if the combination of low social support and low income was entirely additive. Sensitivity analyses for different cut-offs of household income were performed. Adults with lower levels of social support had a 2.1, 1.2 and 1.9 times higher prevalence of fair/poor self-rated oral health, <21 teeth and poor OHRQoL respectively. The RERIs observed were 0.98 (95% CI -0.01; 1.96) for poor/fair self-rated oral health; 0.52 (95% CI -0.06; 1.10) for lack of a functional dentition and 0.50 (95% CI -0.16; 1.15) for poor OHRQoL. For all outcomes and all individual domains of social support, the positive RERIs indicated that the joint association of low social support and low household income surpassed the sum of their separate associations with objective and subjective oral health indicators. Individuals with lower levels of social support had poorer oral health than those with high levels of social support, although this association was small for the outcome <21 teeth. The association between social support and poor oral health indicators is modified by levels of household income. Hence, the provision of social support had a stronger association with the oral health of low-income participants, suggesting that socioeconomically disadvantaged individuals would mostly benefit from a social support intervention.

Social, Clinical and Psychometric Factors Affecting Self-Rated Oral Health, Self-Rated Health and Wellbeing in Adults: A Cross-Sectional Survey

Background: Many studies examined and reported oral and general health inequalities in clinical health, SROH and SRH. Objectives: The study aims to explore the social influences, gradients and predictors of self-rated oral health (SROH) and self-rated health (SRH) and wellbeing in Greek adults. Methods: Cross-sectional study, of men and women, aged 65 years and over (N = 743) in Greece. Descriptive and statistical analyses were performed for dentate and edentulous participants. For the association between socioeconomic exposures and binary outcomes, logistic regression was performed to estimate Odds Ratios and 95% Confidence Intervals (OR, 95% CI); levels of association and Cramer’s V were applied to calculate associations and p-values. Results: The objective socioeconomic measures, such as household income, education level and last main occupation were significant predictors and determinants of both SROH and self-rated health (SRH). For Satisfaction with life (SWL), there was a diversity in the results analogous to the dental status of the participants. Household income and SSS were predictors of SWL in dentate participants. In the total sample Household income, occupation and SSS, were predictors of SWL, while in edentulous participants only occupation and SSS were statistically significant (p p p < 0.05). Conclusion: There are socioeconomic gradient inequalities in SROH and SRH in Greek adults living in Attica area. Subjective social status is a predictor of SROH, SRH and SWL. The need to prioritize interventions to eliminate disparities and inequalities in oral and general health and wellbeing of elders is evident.

Social and racial inequity in self-rated oral health in adults in Southern Brazil.

This study aimed to estimate social and racial inequalities in self-rated oral health in adults from the Brazilian birth cohort study. This study belongs to 1982 Pelotas (Brazil) birth cohort study. Data from this study was collected for oral health conditions 31 years old (Oral Health Study). The outcome was self-rated oral health, dichotomized into positive (good/very good) and negative (regular/bad/very bad). Analyses were stratified by gender, racial/skin color groups, schooling level and income. For statistical analysis, the slope index of inequality (SII) and the concentration index (CIX) were used. The prevalence of negative self-rated oral health was 36.1%. Social inequalities were observed in self-rated oral health in both absolute and relative terms. A SII of -30.0 (95%CI: -43.6; -16.4) was observed for income, and -27.7 (95%CI: -41.9; -13.4) for schooling level. Both the individuals' income and the schooling level had negative CIX (CIXincome -14.6 [95%CI: -21.2; -8.0] and CIXschooling level -14.1 [95%CI: -20.7; -7.5]). Furthermore, the prevalence of negative self-rated oral health in black/brown/indigenous individuals from the highest income/schooling level was comparable to prevalence of the outcome in the white individuals belonging to the lowest income/schooling levels. This study results demonstrate racial disparities in oral health regardless of income and schooling levels. Furthermore, a higher concentration of negative self-rated oral health was identified among the most socioeconomically vulnerable individuals. Our findings reinforce the presence of racial and socioeconomic inequalities in oral health.

Association between oral health literacy and dental outcomes among users of primary healthcare services.

This study aimed to investigate the association between Oral Health Literacy (OHL) and dental outcomes. A sample of 920 adults above 18 years of age living in areas covered by 10 Family Health Units (FHUs) in a large city in São Paulo state, Brazil, was included. OHL was assessed using the short-form Health Literacy in Dentistry Scale (HeLD-14). Data on sociodemographic factors, oral health, and general health were obtained through a structured questionnaire. The investigated outcomes "tooth loss" and "reason for the last dental appointment" were evaluated using self-reported data. Simple logistic regression models were used to analyze the associations between each independent factor and outcomes. Factors that presented a significance level of ≤0.20 in the bivariate analysis were included in the hierarchical multiple logistic regression models. Participants with an education level up to high school, low OHL, and poor/fair self-rated oral health had 1.35 (95%CI, 1.01-1.80), 1.48 (95%CI, 1.12-1.95), and 1.46 (95%CI, 1.11-1.92) times more probability to report missing teeth, respectively. Adults from families with lower monthly income, low OHL, and poor/fair self-rated oral health had 1.70 (95%CI, 1.29-2.26), 1.89 (95%CI, 1.42-2.51), and 1.73 (95%CI, 1.30-2.30) times more chance, respectively, to have gone to the last dental appointment due to pain or caries. Adults with low OHL levels are more likely to have missing teeth and have gone to the last dental visit for pain, reinforcing the importance of OHL as an important determinant for promoting oral health.

Social capital and oral health in children and adolescents: Asystematic review and meta-analysis.

To systematically evaluate the association of individual and contextual social capital with oral health outcomes in children and adolescents. Electronic searches were performed in PubMed/Medline, Embase, Web of Science and Scopus databases for articles published from 1966 up to June 2021. Two calibrated reviewers screened and critically appraised the identified papers. Observational studies that evaluated the relationship of individual or/and contextual social capital or their proxies with oral health outcomes in children and adolescents using validated methods were included. Quality assessment was conducted using the Newcastle-Ottawa Scale. Data were extracted for narrative synthesis and meta-analysis followed by a meta-regression model. Meta-analysis using random effects method was used to estimate pooled prevalence ratio (PR) and 95% confidence intervals (CI). Of the 3060 studies initially retrieved, 31 were included in the systematic review and 21 in the meta-analysis, totalling 81241 individuals. The clinical outcomes included dental caries and gingival bleeding and subjective outcomes were oral health-related quality of life (OHRQoL) and self-rated oral health (SROH). Individuals with lower levels of individual social capital had a higher prevalence of poor clinical (PR 1.11; 95%CI 1.02-1.22) and subjective (PR 1.25; 95%CI 1.09-1.45) oral health conditions. The prevalence of worse clinical (PR 1.34; 95%CI 1.11-1.61) and subjective (PR 1.56; 95%CI 1.13-2.16) oral health outcomes were also associated with lower levels of contextual social capital. In general, the contextual level of social capital exerted more impact, and the subjective oral health outcomes were the more affected. Contextual and individual social capital were positively related to oral health outcomes, such as dental caries, gingival bleeding, SROH and OHRQoL in children and adolescents.

Socioeconomic Classes among Oldest-Old Women in South Korea: A Latent Class Analysis.

Oldest-old women are known to live at the intersection of multiple socioeconomic disadvantages in South Korean society. This study classified oldest-old Korean women into several socioeconomically homogeneous classes based on various socioeconomic status (SES) risks and compared health characteristics among the identified classes. This cross-sectional study utilized the 2019 Korean Community Health Survey, including data from 11,053 women (≥80 years). Latent class analysis determined the number of underlying socioeconomic classes based on nine selected SES variables. Four distinct socioeconomic classes were identified: “Urban, living alone, recipient of NBLSS, moderate education, leisure activity” (Class 1), “Rural, traditional house, living with others, not financially deprived, low education, employed” (Class 2), “Urban, living with family, financially affluent, not employed, no barriers to healthcare” (Class 3), “Rural, traditional house, living alone, financially deprived, uneducated, employed, barriers to healthcare” (Class 4). Depressive symptoms, subjective stress, and the prevalence of sleep disorder and diabetes were higher in Class 1 compared to other classes. Health-related quality of life, perceived health, and self-rated oral health were the poorest in Class 4. Class 3 reported the best health status. Understanding the intersecting SES risk factors in this group can aid in developing targeted interventions.