Self-rated Oral Health Research Articles

Self-rated oral and general health among Aboriginal adults in regional South Australia.

In Australia, Aboriginal adults experience higher levels of poor oral and general health than the non-Aboriginal population. This study compared self-rated oral and general health among Aboriginal adults in regional South Australia with participants in the National Survey of Adult Oral Health (NSAOH). Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Three sub-populations from the NSAOH were utilised for comparison: National Aboriginal, National non-Aboriginal and South Australian Regional Non-Aboriginal adults. All data were standardised by age group and sex, utilising Census data. Just over 70% of South Australian Regional Aboriginal participants gave a rating of 'excellent, very good or good' for general health, more than 17% lower than each of the other groups. Just over 50% rated their oral health highly, 20% fewer than the proportion for each other group. Stratifying by key socio-demographic factors did not account for all differences. Proportionally fewer South Australian Regional Aboriginal adults had high ratings of oral and general health than the Aboriginal and non-Aboriginal adults from the national survey, indicating that national-level data might underestimate the proportion of regional Aboriginal Australians with poor oral health.

Medo odontológico e saúde bucal: avaliação transversal do ciclo do medo entre universitários brasileiros

Aim: To evaluate the presence of dental fear among Brazilian undergraduate students and to observe whether the cycle of dental fear theory applies to this population. Materials and methods: A cross-sectional study were conducted with first year students of the Federal University of Pelotas, Brazil, in 2016. Sociodemographic data, dental fear, as well as the use of dental services and perception of caries and dental pain were collected through a self-administered questionnaire. The exposure was dental fear, and the outcomes included dental visit pattern, experience of dental caries and dental fear and self-rated oral health (SROH). Sociodemographic characteristics were included as aconfounding factor. To test the association between dental fear and the outcomes, Poisson regression models with robust variance were used, to estimate Prevalence Rations and Confidence Intervals. Results: 2,014 undergraduate students were evaluated and 22.4% of them reported dental fear. Those who reported dental fear had a higher prevalence of not visiting the dentist in the last year and, among those who visited, to have had only a pain/problem-oriented visit. Additionally, having fear increased the presence of dental caries, dental pain and negative SROH. Discussion: Our findings suggest the presence of the vicious cycle of dental fear in this population of undergraduate students in southern Brazil. Conclusion: This study provided evidence on the association between dental fear and the lower frequency of dental visit, dental caries, dental pain experience and negative SROH, corroborating with the cycle of dental fear theory.

Oral Health Impact Profile and Its Relationship with Their Oral Health Status of Beautician Cohorts in Porur, Chennai, India - A Cross Sectional Study

Aim: To evaluate the oral health impact profile and its relationship with their oral health status among beautician cohorts. Materials and Methods: A cross sectional study was conducted among 147 beauticians using a simple random sampling technique. The subjects would be taken from the Porur area those who were working in the beauty parlour as a beautician. An individual interview was held, and they got a dental check-up. Oral health status was measured by WHO Proforma 2013 modification. Oral health quality of life was assessed by oral health impact profile (OHIP-14) questionnaire. Sociodemographic data were collected and questions regarding oral hygiene measures and habits. As for data analysis, chi-square test was utilized. Results: All scores showed associations with self-rated oral health quality of life and dissatisfaction with oral health status .The dentition status and gingivitis showed statistically significant with oral health impact profile (OHIP-14) Conclusion: The study reveals that the impact of oral health does not have association with oral health problems, whereas perceived satisfaction with oral health has a better association with clinical indicators. We should motivate the oral hygiene practices among beautician cohorts. Keywords: Oral health impact profile, Oral health status, Oral health problems, dental diseases, gingivitis, periodontitis, dental caries, quality of life.

Dental auxiliaries in tertiary hospitals in Nigeria; oral hygiene practices and dental service utilization


 
 
 
 Objective: This study was aimed at determining the oral self-care practices and dental service utilization among dental auxiliaries in teaching hospitals in Nigeria, and also to assess the dental utilization of their relatives.
 Methods: This was a descriptive, cross-sectional multicenter study conducted among dental auxiliaries from three teaching hospitals in Nigeria, namely; University of Port Harcourt Teaching Hospital (UPTH) Port Harcourt, Rivers State, Lagos University Teaching Hospital (LUTH) Idi-araba, Lagos State and University College Hospital, (UCH) Ibadan, Oyo State Nigeria. Self-administered questionnaires were used to obtain information on participants’ sociodemography, oral hygiene practices and dental service utilization. The self-rated oral health status was used to assess their oral health behavior (frequency of brushing, regular check-up and fluoride application). Statistical analysis was done using the IBM SPSS version 20.0. Statistical significance level was considered at p ≤ 0.05.
 Results: A total of 101 participants were enrolled into the study, consisting of dental nurses (16[15.8%]), dental technicians (21[20.8%]), dental technologists (46[45.5%]) and dental therapists (18[17.8%]). The mean age of the participants was 35.12 ± 8.89 years. Female: Male ratio was 2.26: 1. Most (90.1%) of the study participants rated their oral hygiene as excellent. Slightly over half (57.4%) brushed twice daily; 25% of the dental nurses, 52.4% of the dental technicians, 58.7% of the dental technologists and 88.9% of the dental therapists, this was statistically significant (p=0.002). Frequency of dental check-up for six months among the participants was low (31.7%). Only 31 (30.7%) of the participants had scaling and polishing done in the last 6 months. More of the dental nurses (93.8%) and technicians (71.4%) had invited their relatives for scaling and polishing compared to the other dental auxiliaries (p=0.0019).
 Conclusion: Even though the dental therapists had better tooth brushing practices in this study, the oral hygiene practices and utilization of dental services by the dental auxiliaries were generally less than optimal. There was a disparity between the self-rated oral health status and oral health practices of the dental auxiliaries. There is need for better motivation of dental auxiliaries towards optimal oral hygiene behavior.
 
 
 

Predictors of self-rated oral health in Canadian Indigenous adults

ObjectivesThe purpose of this study was to: (1) compare oral health indicators between Indigenous adults and the general population and (2) examine the predictors of poor self-rated oral health in the Indigenous population.MethodsData from the 2017–2018 cycle of the Canadian Community Health Survey was used and included 943 Indigenous and 20,011 non-Indigenous adults. Independent variables included demographic information, lifestyle behaviours, dental concerns and care utilization, and transportation access. The dependent variable was self-rated oral health. A logistic regression was performed to determine predictors of poor self-rated oral health.ResultsMore than half of the Indigenous sample were aged between 35 and 64 years (57.3%); 57.8% were female. Compared to the general population, the Indigenous group were significantly more likely to have no partner, have less post-secondary education, and have an income of less than $40,000. Almost a fifth of the Indigenous sample self-rated their oral health as poor (18.5%) compared to 11.5% in the general population. Indigenous participants reported significantly poorer general health, had poorer oral care practices, and lifestyle behaviours than the general population (all p < .001). Indigenous adults having poor self-rated oral health was predicted by poorer general health, being a smoker, male, bleeding gums, persistent pain, feeling uncomfortable eating food, avoiding foods, and not seeking regular dental care.ConclusionsThere are many predictors of poor self-rated oral health, many of which are preventable. Providing culturally adapted oral health care may improve the likelihood of Indigeneous adults visiting the dentist for preventative care.

Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA

Preventing deterioration of oral health in older age can be crucial for survival. We aimed to examine associations of oral health problems with all-cause, cardiovascular disease (CVD), and respiratory mortality in older people. We used cohort 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). Follow-up was 9 years (BRHS) and 15 years (HABC Study). Oral health comprised tooth loss, periodontal disease, dry mouth, and self-rated oral health. Cox regression was performed for all-cause mortality, competing risks for CVD mortality, and accelerated failure time models for respiratory mortality. In the BRHS, tooth loss was associated with all-cause mortality (hazard ratio (HR) = 1.59, 95% CI 1.09, 2.31). In the HABC Study, tooth loss, dry mouth, and having ≥ 3 oral problems were associated with all-cause mortality; periodontal disease was associated with increased CVD mortality (subdistribution hazard ratio (SHR) = 1.49, 95% CI 1.01, 2.20); tooth loss, and accumulation of oral problems were associated with high respiratory mortality (tooth loss, time ratio (TR) = 0.73, 95% CI 0.54, 0.98). Findings suggest that poor oral health is associated with mortality. Results highlight the importance of improving oral health to lengthen survival in older age.

Effect of interdental cleaning devices on proximal caries.

To estimate the association between the use of interdental cleaning devices and proximal caries experience. This study used a cross-sectional data from the Sixth Korea National Health and Nutrition Examination Survey (2013-2015). A total of 13525 adults aged 19-64years who participated in both the nutrition survey and the health examination survey were included. Data on sociodemographic factors (age and sex), socioeconomic factors (level of education and household income) and personal health practices (frequency of toothbrushing, visits to dental clinic, frequency of snacking and self-rated oral health status), and number of proximal caries were collected. Prevalence ratios (PRs) and 95% confidence intervals (95% CI) were calculated using the multivariable Poisson generalized linear model according to use of dental floss or an interdental brush. The risk of proximal caries for dental floss following the stratification of participants into various subgroups related to oral health was assessed. While nonflossers had 1.46 times (PR 1.46, 95% CI: 1.16-1.84) higher risk for proximal caries than flossers, the use of an interdental brush was not associated with proximal caries. In the nonflossers, the association for proximal caries was the strongest in those in their 40s (PR 2.28, 95% CI: 1.29-4.03), followed by those in their 30s (PR 1.85, 95% CI: 1.18-2.90). Although nonflossers with middle-low household income had a 59% higher risk (PR 1.59, 95% CI: 1.24-2.03) for proximal caries than those with high household income, there were no significant differences in household income in flossers. The findings of the study suggest that flossing at home along with toothbrushing is one of the easiest ways to prevent proximal caries. Therefore, dental floss should not be excluded from oral healthcare products.

Cannabis Use and Oral Health in a National Cohort of Adults

Cannabis use is common and increasing among adults. Evidence connects cannabis use to poor periodontal health, but few prospective studies exist of adults in the United States. This investigation examined associations between cannabis use and self-reported adverse oral health conditions among participants (N = 18,872) in the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative cohort. Survey-weighted regression modeling estimated associations between cannabis use and seven self-reported measures of oral health status, adjusted for tobacco use and other disease risk factors. Reporting past-30-days cannabis use in any of PATH Waves 1-3 was positively and statistically significantly associated at Wave 4 with multiple periodontal disease sequalae and with self-rated fair or poor overall oral health (adjusted odds ratio versus never-users: 1.75; 95% confidence interval: 1.52, 2.01). These findings provide further evidence that cannabis use is an independent risk factor for poor oral health, although study limitations (self-reported outcomes, limited information on cannabis use frequency and modality) must be considered. Dental professionals should engage patients in clear, nonjudgmental dialogue about cannabis use to address oral health risks and avoid potential patient safety issues in care delivery. General recommendations for addressing cannabis use in dental practice are presented.

Oral health and oral health behavior in young adults with caries disease

ObjectiveThe aim of this study was to describe and analyze oral health, oral health behaviors, and oral health-related quality of life (OHRQoL) in relation to the level of caries disease among caries-active young adults.Material and methodsThis study presents data from a sample of young adults (n = 135) with active caries disease who were enrolled in a clinical, randomized controlled trial. The independent variables of sociodemographics, oral health (gingivitis, plaque), oral health behaviors (such as toothbrushing, dental attendance, sugar-containing sweets and drinks), dental anxiety, self-rated oral health, and OHRQoL were collected. Multinomial logistic regression was used to simultaneously evaluate the associations between the independent variables and caries severity.ResultsMultinominal logistic regression showed that poor OHRQoL and gingivitis were associated with caries severity in a gradient fashion in accordance with caries disease activity. Also, irregular dental care and frequent consumption of sugary soda were significantly associated with very high caries severity.ConclusionsThe risk factors related to caries severity among young adults were poor OHRQoL, gingivitis, consumption of sugary soda and irregular dental care attendance, indicating the need for a combination of different interventions specifically health behavior change. Furthermore, these findings may contribute to identifying high caries-risk individuals.

Inequality and Inequity in the Use of Oral Health Services in Australian Adults.

Social determinants drive disparities in dental visiting. This study aimed to measure inequality and inequity in dental visiting among Australian adults. Data were obtained from the National Study of Adult Oral Health (2017 to 2018). Participants were Australian adults aged ≥30 y. The outcome of interest was dental visiting in the last 12 mo. Disparity indicators included education and income. Other sociodemographic characteristics included age, gender, Indigenous status, main language, place of birth, residential location, health card and dental insurance status, and individual's self-rated and impaired oral health. To characterize inequality in dental service use, we examined bivariate relationships using indices of inequality: the absolute and relative concentration indexes and the slope and relative indexes of inequality. Inequalities were depicted through concentration curves. Indirect standardization with a nonlinear model was used to measure inequity. A total of 9,919 Australian adults were included. Bivariate analysis showed a gradient by education and income on dental visiting, with 48% of those with lowest educational attainment/income having not visited a dentist in the last 12 mo. The concentration curves showed pro-low education and pro-poor income inequalities. All measures of absolute and relative indices were negative, indicating that from the bottom to the top of the socioeconomic ladder (education and income), the prevalence of no dental visiting decreased: absolute and relative concentration index estimates were approximately 2.5% and 5.0%, while the slope and relative indexes of inequality estimates were 14% to 18% and 0.4%, respectively. After need standardization, the group with the highest education or income had almost 1.5-times less probability of not having a dental visit in the previous year than those with the lowest education or income. The use of oral health services exhibited socioeconomic inequalities and inequities, disproportionately burdening disadvantaged Australian adults. The results of this study can be used by policy makers when planning a dental labor force in relation to the capacity of supply dental services to 1) reduce the inequality and inequity in the use of oral health services and 2) meet identified oral health needs across the Australian population, which is important for preventive dental care.

Prevalence and Associated Factors of Self-rated Oral Health among a National Population-based Sample of Adults in Sudan: Results of the 2016 STEPS Survey.

To estimate the prevalence and correlates of self-rated oral health (SROH) among adults in a national population-based survey in Sudan. Nationally representative data were analysed from the cross-sectional 2016 Sudan STEPS survey. In all, 7722 18- to 69-year-old individuals (median age 31 years) were assessed with questions on SROH, physical measurements, and medical conditions. The prevalence of poor SROH was 8.0%, with 12.4% among females and 4.4% among males. In multivariable logistic regression analysis, ages 50-69 years, higher household income, urban residence, pain in the teeth/mouth, impaired Oral Health Related Quality of Life, dental visit, having overweight or obesity and elevated total cholesterol were positively associated with poor SROH, and male sex, primary or less education and having 20 or more natural teeth were negatively associated with poor SROH. In addition, in the unadjusted analysis, having dentures, hypertension, diabetes, stroke, or heart attack were positively associated with SROH, and engaging in moderate or high physical activity were negatively associated with poor SROH. Almost one in ten participants reported poor SROH. Several factors associated with poor SROH were found that can aid in designing programmes to improve SROH in Sudan.

Self-Rated Oral Health and Associated Factors among an Adult Population in Rural India-An Epidemiological Study.

Background: To determine the perception of oral health status and its associated factors among adults living in rural areas in Karnataka state, India. Methods: A cross-sectional study was conducted among adults in the age group of 35–54 years old residing in villages in a southern state in India. The main outcome measure was poor self-rated oral health (SROH) among adults in rural India. Results: About 873 adults participated in the study. The prevalence of poor SROH was 15.2%. Adults of age 40–44 years, females, those in lower socioeconomic conditions, and those with high caries experience (DMFT ≥ 4) and periodontal disease were associated with poor SROH. Those who had visited a dentist in the previous one year were 1.9 times more likely to report poor oral health. Conclusions: Nearly 15% of rural people reported poor oral health. Socioeconomic conditions, sex, age, smoking, and dental visiting were associated with poor SROH. People’s perception of poor oral health was associated with severe periodontitis and DMFT ≥ 4. A dose–response relationship was observed between experience with dental caries and poor SROH.

Parental socioeconomic status and adolescent health in Japan

There is no consensus on which parental socioeconomic indicators should be used to define adolescents’ socioeconomic status (SES). Utilising the data for 3154 parent-adolescent pairs obtained from the sample of the Survey of Lifestyle Value of Parents and Children 2011 conducted by the Cabinet Office in Japan, the associations between adolescent’s subjective economic status, parental SES (i.e. education, occupation, and household income), and child health-related outcomes (i.e. self-rated health, dietary and oral health behaviours) were analysed using multilevel mixed-effects ordered logistic regression to investigate heterogeneity in these relationships across SES indicators and health outcome measures. Results demonstrated that income was the strongest predictor of adolescent health outcomes, suggesting that adolescents in the middle- or high-income groups tended to report better health status compared to the low-income group, have a higher frequency of having breakfast, and more likely to regularly brush their teeth by 24% (OR 1.24, 95% CI [1.06–1.46]) to 66% (OR 1.66, 95% CI [1.30–2.12]). Parental education was also related to child health-related behaviours, with higher levels of habitual healthy behaviours being observed in the middle- and high-education groups than in the low-education group by 15% (OR 1.15, 95% CI [1.01–1.32]) to 63% (OR 1.63, 95% CI [1.31–2.03]). Future studies regarding health disparities among children/adolescents should carefully choose an SES indicator, taking multiple pathways between each SES indicator and health/health behaviours into consideration.

Oral hygiene and periodontal condition of 12- and 15-year-old Greek adolescents. Socio-behavioural risk indicators, self- rated oral health and changes in 10 years.

To investigate oral hygiene and periodontal status of 12- and 15-year-old Greek adolescents in relation to socio- demographic and behavioural indicators and identify national trends. In a stratified cluster sample of 2,478 participants, the Simplified Debris Index (DI-S) and the Community Periodontal Index (CPI) were calculated. Socio- demographic/behavioural data were collected through structured questionnaires. Multivariate ordinary regression examined the effect of socio-behavioural indicators on oral hygiene and periodontal conditions. 51.7% of the 12-year-olds and 56.9% of the 15- year-olds had fair and good oral hygiene, respectively. Approximately 30% of the adolescents had healthy periodontium. Bleeding on probing was detected in 23.6% and 21.6% of the 12- and the 15-year-olds, accordingly. Calculus was found in 46.2% and 44.3% of the 12- and the 15-year-old groups, correspondingly. The prevalence of periodontal pockets ?4mm was 3.2%. Significantly higher DI-S scores were found among 12-year-olds who were males, had lower educated mothers or did not use dental floss and among adolescents who brushed their teeth <twice/day. Inferior periodontal status was found among 15-year-olds who were males, 12-year- olds with lower educated mothers, who did not brush or brushed infrequently, and among subjects who did not floss. Poor self-rated oral health was significantly related to adverse oral hygiene and periodontal health outcomes. Oral hygiene and periodontal status of Greek adolescents improved moderately in ten years. Periodontal health promotion strategies should target vulnerable sub- groups of adolescents to reduce future periodontal burden. Self-rated oral health may be useful for identifying unmet periodontal treatment needs.

Prevalence and correlates of physical health conditions in Jamaica and Guyana

The increasing prevalence of non-communicable diseases remains an important source of concern in the Caribbean and Latin American regions. This study examines rates and the associated socio-demographic correlates of physical health indicators in Jamaica and Guyana. Area probability cross-sectional data were collected on 1,218 Jamaicans and 2,068 Guyanese participants in 2005. Physician- diagnosed hypertension, diabetes mellitus, arthritis, and self-rated oral and general physical health were assessed using descriptive statistics, chi-square, and hierarchical logistic regression analytic procedures. Jamaicans generally reported poorer physical health, including diabetes mellitus, arthritis, and overall perceived oral and physical health compared to Guyanese; Guyanese reported higher rates of hypertension. Generally, lower social and economic standing was associated with poorer health conditions but made different contributions across countries. The study highlights the need for greater awareness and access to health care services for individuals who are especially vulnerable to poorer health. The results of this study suggest the need for additional studies on factors associated with physical health conditions, including a better understanding of the role of race/ethnicity in the Caribbean. Key words: prevalence, physical health, Guyana, Jamaica.

Associations between oral health and general health: a surveywide association study of the NHANES.

This proof of concept study uses data from the National Health and Nutrition Examination Survey (NHANES) to explore potential associations between oral and systemic health in a survey-wide association study (SWAS). Data from n=9,971 records in the 2015-2016 NHANES survey were used to evaluate associations between self-rated oral health and the various systemic health conditions that are included in the survey. Associations were estimated using survey-weighted linear regression models adjusted for age, sex, race, and smoking status. Substantial associations with self-rated oral health were evident after correction for multiple comparisons. The study revealed associations in categories of mental health, cardiovascular disease, and diabetes adding to the body of evidence. The study also suggested associations with physical functioning, vision, hearing, genitourinary symptoms, and the prevalence of hepatitis. The SWAS method demonstrated the ability to identify associations between oral health and systemic health. Suggested associations should be investigated further investigated with emphasis on both biologic and societal mechanisms. The noteworthy associations with mental health, physical activity, and cardiovascular disease in this study inform clinicians from each of these disciplines that they may benefit from collaborations with oral health care providers to promote whole-person health.

Dynamics in oral health-related factors of Indigenous Australian children: A network analysis of a randomized controlled trial.

Network analysis is an innovative, analytic approach that enables visual representation of variables as nodes and their corresponding statistical associations as edges. It also provides a new way of framing oral health-related questions as complex systems of variables. We aimed to generate networks of oral health variables using epidemiological data of Indigenous children, and to compare network structures of oral health variables among participants who received immediate or delayed delivery of an oral health intervention. Epidemiological data from 448 mother-child dyads enrolled in a randomized controlled trial of dental caries prevention in South Australia, Australia, were obtained. Networks were estimated with nodes representing study variables and edges representing partial correlation coefficients between variables. Data included dental caries, impact on quality of life, self-rated general health, self-rated oral health, dental service utilization, knowledge of oral health, fatalism and self-efficacy in three time points. Communities of nodes, centrality, clustering coefficient and network stability were estimated. The oral health intervention interacted with the network through self-rated general health and knowledge of oral health. Networks depicting groups shortly after receiving the intervention presented higher clustering coefficients and a similar arrangement of nodes. Networks tended to return to a preintervention state. The intervention resulted in increased connectivity and changes in the structure of communities of variables in both intervention groups. Our findings contribute to elucidating dynamics between variables depicting oral health networks over time.

Perceived social support and discrimination and oral health behaviors in adolescents.

ObjectivesThe aims of this study were to examine the associations between perceived social support and oral health behaviors among adolescents and if this perception had a protective effect against the influence of perceived racial discrimination on oral health behaviors in this population.Material and methodsParticipants of this cross‐sectional study were adolescents aged 12–18 years recruited from University dental clinic. They completed a questionnaire comprising three sections: demographics (14 items), oral health behaviors (6 items), and validated Personal Resource Questionnaire (25 items). Perceived discrimination was evaluated by a question asking if the adolescent had ever experienced discrimination based on their race.ResultsOf 252 participants, mean (SD) age of 14 (1.8) years, 60% were girls, 56% were self‐identified as White, and 81% were born in Canada. Discrimination was reported by 21%. Frequency of toothbrushing and self‐rated oral health were significantly associated with increased levels of perceived social support. Sugar consumption was significantly different for participants with and without perceived racial discrimination (p‐value = 0.002). Perceived social support did not act as a buffer against perceived racial discrimination for sugar consumption (OR = 1.00; 95% CI: 0.98–1.01).ConclusionsAdolescents' perceived social support affected some aspects of their oral health but did not moderate the influence of perceived racial discrimination.

Food Insecurity Is Prevalent in Iowa’s Medicaid Expansion Population

BackgroundFood insecurity has been identified as an important social determinant of health and is associated with many health issues prevalent in Medicaid members. Despite this, little research has been done around food insecurity within Medicaid populations. ObjectiveOur objective was to estimate the prevalence of household food insecurity and identify factors associated with experiencing food insecurity in Iowa’s Medicaid expansion population. DesignWe conducted a cross-sectional telephone survey between March and May of 2019. ParticipantsOur sample was drawn from Medicaid members enrolled in Iowa’s expansion program at least 14 months, stratified by Federal Poverty Level (FPL) category. Members who did not have valid contact information were excluded. We selected one individual per household to reduce the interrelatedness of responses. We sampled 6,000 individuals and had 1,349 respondents in the analytic sample. Main outcome measureOur main outcome was whether a respondent’s household experienced food insecurity in the previous year, using the Hunger Vital Sign screening tool. Statistical analyses performedWe weighted responses to account for the sampling design and differential nonresponse between strata. We estimated the prevalence of food insecurity and used logistic regression to model food insecurity as a function of demographic (age, FPL category, gender, employment, education, race, rurality, and Supplemental Nutrition Assistance Program [SNAP] participation) and health-related (self-rated health, self-rated oral health, health literacy) factors. ResultsThe estimated prevalence of experiencing food insecurity was 51.3%. Race, gender, education, employment, health literacy, and self-rated health were all significantly associated with food insecurity. ConclusionsOur findings show that food insecurity is prevalent in Iowa’s Medicaid expansion population. Food insecurity should be more widely measured as a critical social determinant of health in Medicaid populations. Policymakers and clinicians should consider interventions that connect households experiencing food insecurity to food resources (eg, produce prescriptions and food pantry referrals) and policies that increase food access. AbbreviationsIowa Wellness Plan (IWP); Federal Poverty Level (FPL); Healthy Behavior Program (HBP); Supplemental Nutrition Assistance Program (SNAP)

An Indonesian Version of Child Oral Health Impact Profile-Short Form 19 (COHIP-SF19): Assessing Validity and Reliability

Previous surveys have indicated that the majority of Indonesian children have poor oral health. However, scant information is available on children’s oral health related quality of life (OHRQoL). The purpose of this study was to assess reliability as well as discriminant and convergent validity of Child Oral Health Impact Profile-Short Form 19 (COHIP-SF 19) Indonesian version. Methods: The Indonesian version of COHIP-SF 19 was developed according to the guidelines for the cross-cultural adaptation process. The instrument was tested among 529 children between 12 – 15 years old who were randomly selected from six junior high schools in Jakarta. The psychometric testing included internal consistency reliability, test-retest reliability, discriminant validity, and convergent validity. Results: Mean age of the participants was 13.3±0.9 years and 54% of the participants were female. The mean COHIP-SF 19 score was 57.8±8.8 and the median was 58 (range 27 – 75). The internal consistency and test-retest reliability was excellent for COHIP-SF 19 score with Chronbach’s alpha 0.83 and intra-class correlation coefficient 0.81. Children with active decay, untreated caries with pulpal involvement, and gingivitis had significantly lower COHIP-SF 19 scores (p-value ≤ 0.030). Correlation between COHIP-SF 19 score, subscale scores and clinical severity as well as self-rated general or oral health were very low to low (rs = 0.04 – 0.27, p-value ≤ 0.028), after adjustment for children’s age and gender. Conclusions: The Indonesian version of COHIP-SF 19 was successfully developed to be used as an OHRQoL instrument for Indonesian school-age children. The internal consistency, test-retest reliability, discriminant validity, and convergent validity of COHIP-SF 19 Indonesian version were confirmed