Self-reported Oral Health Research Articles

Self-Reported Oral Health Attitudes and Behaviors, and Gingival Status of Dental Students.

AimThe aim of this study was to assess self-reported oral health attitudes and behaviors of the Iraqi dental students and compare the variations in these attitudes and behaviors that linked to dental education level and gender.Materials and MethodsA self-administered questionnaire depended on the English version of the Hiroshima University Dental Behavioral Inventory (HU-DBI) was prepared, the questionnaire given to 198 dental students.ResultsAbout 91.4% of the dental students were worried about the teeth colour, and merely minor percentage of them (18.8%) thought it is not crucial to seek dental advice until they acquire a tooth pain; however, 26.3% of the students were disturbed because of their gum colour, and 75.3% of them examined their teeth after brushing. Besides, 72.2% of the students replied that gum disease could not be prevented by tooth brushing only, 60.1% of the students do not give visiting the dentist such concern, and 14.1% of dental students were smokers. The plaque and gingival indices were significantly higher in preclinical students than clinical students.ConclusionIraqi dental students had somewhat good oral health behavior and attitudes; however, extra concentrating is required on the anticipatory and behavioral aspects of oral self-care practices. Female dental students displayed better oral health behavior and attitudes than male colleagues on some issues.

Interdental Cleaning and Oral Health Status in an Adult Cohort, 2015 to 2018

Interdental cleaning is routinely recommended, despite limited evidence supporting efficacy to prevent advanced oral disease endpoints, such as caries and periodontal disease. We aimed to examine associations between interdental cleaning and oral health in a large, generalizable prospective cohort of adults in the United States. Data were drawn from wave 3 (2015 to 2016, n = 26,086 included in analysis) and wave 4 (2016 to 2018, n = 22,585) of the adult component (age ≥18 y) of the nationally representative Population Assessment of Tobacco and Health Study. Survey-weighted multivariable regression models estimated the associations between wave 3 weekly interdental cleaning frequency and 6 measures of self-reported oral health—overall rating, tooth extractions, gum bleeding, loose teeth, bone loss around teeth, and gum disease—cross-sectionally and prospectively, with adjustment for established periodontal disease risk factors. As compared with no interdental cleaning, interdental cleaning ≥7 times/wk was prospectively associated with greater odds of excellent self-rated oral health (adjusted odds ratio, 1.37; 95% CI, 1.17 to 1.62), lower odds of bleeding gums (adjusted odds ratio, 0.62; 95% CI, 0.54 to 0.70), but not statistically significantly lower odds of other oral health conditions in the following 12 mo. Older age, lower socioeconomic status, diabetes, and cigarette smoking were consistently associated with worse oral health across all outcome measures. Findings were largely robust to alternative model and variable specifications. Interdental cleaning is associated with better perceived oral health and less self-reported gingivitis. Prevention of more advanced disease states was not demonstrated. These findings should be interpreted cautiously given the self-reported nature of the measures and relatively short follow-up period.

Assessing Oral Health Status, Practices, and Access to Care among War-Affected Refugees Living in San Antonio, Texas.

Objectives Refugees encounter several health disparities including oral health problems. This study evaluated the self-reported oral health status, practices, and access to care of adult refugees living in San Antonio, Texas, United States. Materials and Methods Adult refugees ( n = 207) who accessed services from two centers in San Antonio, completed this survey. Multivariate logistic regression was used to examine the relationship of the refugees’ demographics with oral health status, practices, and access to care. Results Oral pain in the previous 12 months was common among refugees having been reported by almost 58.9% of the survey participants; 43% reported pain as the reason for their last dental visit. Approximately half of the participants reported both the condition to their teeth and gums as being good: 42.5 and 54.6%, respectively. Most participants (84%) reported brushing their teeth one or two times a day, and around 78% reported they never smoked. Fifty-two percent reported needing dental care in the past 12 months, but not being able to receive it; while 45.9% reported not having dental insurance, 41.5% reported not having money to pay a dentist. Fifteen percent reported never visiting a dentist. Arabic speakers, moving to the United States more recently, and lower level of education were associated with a poor oral health status and practices ( p < 0.05). Conclusion Refugees in this study encountered limited access to dental care. Their inability to seek dental care could affect their oral and general health, weaken efforts of preventing oral health diseases, and restrict their full inclusion into the community.

Dental trauma experience and oral-health-related quality of life among university students.

This study aimed to investigate the impact of self-reported dental trauma on oral-heath-related quality of life (OHRQoL) of young adults and determine whether personality characteristics influenced how it was reported. A cross-sectional study was carried out using a sample of 435 university students. A questionnaire sought data on previous dental trauma. OHRQoL was assessed using the short-form of the oral health impact profile (OHIP-14); the outcome being one or more impacts occurring 'fairly often'/'very often'. Personality was assessed using the Positive and Negative Affect Scale (PANAS). The participation rate was 87.2%. Dental trauma experience was reported by 110 participants (25.3%), and 242 (55.6 %) indicated previous dental caries experience. Among those with dental trauma history, one or more OHIP-14 impacts was reported by 29.1% (with 21.2% among those with no history). Impact prevalence was higher among those who had previous dental caries experience (29.8%) than among those who had not (14.7%; P<0.001). Higher PANAS negative affect scores were observed among those reporting one or more OHIP-14 impacts (P<0.001). While dental trauma does not appear to have a negative impact on OHRQoL in young adults, past dental caries experience does. Negative emotionality influences self-reported oral health.

A self-reported survey on oral health problems in patients with inflammatory bowel disease with a stoma

Patients with inflammatory bowel disease have an increased risk of developing oral health problems. The aim of this study was to investigate whether oral diseases in these patients are related to inflammation of the intestine and if there is a correlation between inflammatory bowel disease-specific health-related quality of life (IBD-HR-QOL) and oral health problems. The study was a cross-sectional survey and analysis of self-reported oral health of individuals with a stoma for Crohn's disease (CD), ulcerative colitis (UC), and treated colon cancer (CC). Validated international questionnaires were sent to members of the Stoma Federation of The Netherlands. Because there was an unequal distribution of male and female patients with CD and CC, data of 169 age-matched female patients with CD, UC, and CC with a stoma were analyzed. Patients with CD had significantly more oral health problems compared with those with UC or CC. Patients with CD and UC both had significantly more gingival-related problems compared with patients with CC. There was a significant negative correlation between IBD-HR-QOL and oral health problems. In the 3 distinguishable groups of patients with a stoma, patients with CD had an increased risk for oral health problems, independently from surgical removal of (a part of) the inflamed intestine, suggesting a general increased susceptibility of patients with CD for oral health problems.

Dental expenditure, progressivity and horizontal inequality in Chinese adults: based on the 4th National Oral Health Epidemiology Survey

BackgroundThe financial burden of oral diseases is a growing concern as the medical expenses rise worldwide. The aim of this study was to investigate the dental expenditure, analyze its progressivity and horizontal inequality under the general health finance and insurance system, and identify the key social determinants of the inequality for Chinese adults.MethodsA secondary analysis used the data of 13,464 adults from the 4th National Oral Health Epidemiological Survey (NOHES) in China was undertaken. The dental expenditure was collected and divided into out-of-pocket and health insurance payments. Horizontal inequality index and Kakwani index were used to analyze the horizontal inequality and progressivity, respectively. The decomposition model of the concentration index was set up to explore the associated socioeconomic determinants.ResultsThe results showed that a mean dental expenditure per capita of Chinese adults was $20.55 (95% Confidence Interval-CI: 18.83,22.26). Among those who actually used dental service, the cost was $100.95 (95%CI: 93.22,108.68). Over 90% of dental spending was due to out-of-pocket expenses. For self-reported oral health, the horizontal inequality index was − 0.1391 and for the decayed tooth (DT), it was − 0.2252. For out-of-pocket payment, the Kakwani index was − 0.3154 and for health insurance payment it was − 0.1598. Income, residential location, educational attainment, oral hygiene practice, self-reported oral health, age difference were the main contributors to the inequality of dental expenditure.ConclusionDental expenditure for Chinese adults was at a lower level due to underutilization. The ratio of payments of dental expenditure and utilization was disproportional, whether it was out-of-pocket or insurance payment. Individuals who were more in need of oral care showed less demand for service or not required service in time. For future policy making on oral health, it is worth the effort to further promote the awareness of the importance of oral health and utilization of dental service.

Health Literacy and Parental Oral Health Knowledge, Beliefs, Behavior, and Status Among Parents of American Indian Newborns.

To examine the relationship between health literacy (HL) and parental oral health knowledge, beliefs, behavior, and self-reported oral health status (OHS) among parents of American Indian (AI) children. This analysis used baseline data from a randomized controlled trial that tested an oral health intervention with parents of AI newborns. Participants were recruited in parent-child dyads (N = 579). Parents completed items assessing sociodemographic characteristics, HL, and parental oral health knowledge, beliefs, behavior, and self-reported OHS. We examined the correlation of HL with each oral health construct, controlling for parent age and income. On average, parents felt quite confident in their HL skills, performed well on questions assessing parental oral health knowledge, and endorsed beliefs likely to encourage positive parental oral health behaviors (e.g., confidence that one can successfully engage in such behaviors). Parents with more limited HL had significantly less knowledge, perceived cavities to be less severe, perceived more barriers and fewer benefits to recommended oral health behaviors, were less confident they could engage in these behaviors, and were more likely to believe their children's oral health was under the control of the dentist or a matter of chance (P values < 0.001). Limited HL was not associated with behavior (P > 0.05) but was linked to worse self-reported OHS (P = 0.040). HL was associated with parental oral health knowledge, beliefs, and self-reported OHS. Oral health education interventions targeting AI families should facilitate development of knowledge and positive oral health beliefs among parents with more limited HL skills.

Pre-treatment impairment of oral health-related quality of life is associated with variations in minimal clinically important differences among patients with removable partial denture treatment.

The minimal clinically important differences (MID) of the Oral Health-related Quality of Life (OHRQoL) are the benchmark to meaningfully interpret treatment outcomes. However, there is no available information regarding the factors impact the MID variations after removable partial denture (RPD) treatment. The purpose of this study was to determine the influence of the pre-treatment OHRQoL impairment on the MID in the oral health impact profile (OHIP) after RPD treatment. In this prospective study, OHIP and Self-reported Oral Health (SROH) questionnaires were administered to patients before and 3months after RPD treatment. The MID in each OHIP version (OHIP-49, OHIP-20, OHIP-14 and OHIP-5) was the mean score of patients who showed a minimum SROH improvement. Multiple linear regression analysis was conducted to determine the influence of the pre-treatment OHIP summary score on the MID score. Among 248 participants who completed both evaluations, 85 (34%) patients had minimum SROH improvements after RPD treatment. Multiple regression analysis indicated that each 10-point increase in the pre-treatment summary OHIP score was associated with an increase in the MID score of three points for OHIP-49 and four points for OHIP-20, OHIP-14 and OHIP-5 (P<.05), after controlling for age, sex and the number of missing teeth. Therefore, the MID increased as the pre-treatment OHRQoL was impaired. The MID was accounted for by approximately one-third of the pre-treatment summary score, independent of the OHIP version, in the interpretation of the effects of RPD treatment on patients' OHRQoL.

Sociodemographic Disparities and Self-reported Oral Health Problems Associated with Pregnancy: A Case-control Study in Morocco

Background: Dental and periodontal diseases are a public health problem over the world, however little is known about individual characteristics or behaviors associated with self-reported oral status during pregnancy. This cross-sectional study examines the relationships between pregnancy and Dental and Periodontal Health (DPH), socio-demographic factors and DPH, and health behavioral factors and DPH. Study design: This study adopted a cross-sectional, descriptive and correlational research design to investigate the current oral health related health behavior, and socio-demographic disparities in pregnant and non-pregnant women in the MARRAKESH region in Morocco. Methods: Participants (n=539, 251 pregnant, and 288 non-pregnant women), recruited from two health centers in the Marrakesh region (urban and rural), completed questionnaires addressing: Education, economic status, dental insurance, self-reported DPH, oral hygiene practices, and dental care utilization. Results: 162 women were urban and 87 were rural in the pregnant group, while 226 women were urban vs 62 in the non-pregnant group. Also, 181 women were educated and 68 were illiterate in the pregnant group while 238 women were educated and 50 were illiterate in the non-pregnant women group. Moreover, pregnant women brush less frequently than non-pregnant women, dental visits were more important amongst non-pregnant women than pregnant women, and only 37 pregnant women visited a dentist while 82 pregnant women visited a dental quack. Conclusion: This study highlights the effect of pregnancy and sociodemographic disparities on self-reported DPH, and provides useful findings for preventive and therapeutic interventions.

History of Inflammatory Bowel Disease and Self-Reported Oral Health: Women's Health Initiative Observational Study.

Background and Objective: Both periodontal disease and inflammatory bowel disease (IBD), are chronic inflammatory conditions, which are mediated by a complex interplay among a dysbiotic microbiota, dysregulated host immune-inflammatory responses, and lifestyle factors. Despite substantial differences in physical and chemical environments, rather strong correlations have been detected between microbial compositions of the oral cavity and stool. In this study, we tested the hypothesis that oral health conditions are affected by the presence of IBD. Materials and Methods: We analyzed the data from 73,621 women who were enrolled in the Women's Health Initiative observational cohort study and completed a follow-up questionnaire that surveyed oral health status specifically at year 5. Among these, 880 reported IBD at the baseline, including 47% who were symptomatic cases and 27% who were on immunosuppressive treatment. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for the association of IBD and medication status for self-reported oral health outcomes, using logistic regression models, adjusted for selected covariates. Results: IBD was not associated with periodontal disease history itself in a multivariable model; however, poorer self-rated oral health was modestly associated with the presence of IBD (OR = 1.15, 95% CI: 1.01-1.30). Likewise, more frequent eating limitations due to teeth were associated with the presence of IBD history (OR = 1.22, 95% CI: 1.07-1.39). When IBD cases were limited to those who were symptomatic, the associations with these two self-rated oral health outcomes were more pronounced with ORs of 1.28 (95% CI: 1.07-1.54) and 1.36 (95% CI: 1.07-1.54), respectively. Immunosuppressive treatment had little effect on these risk estimates. Conclusions: Among this nation-wide cohort of women 50-79 years of age, history of IBD was associated with poorer perceived oral health status.

Clinical Consequences of Untreated Dental Caries, Individual Characteristics, and Environmental Factors on Self-Reported Oral Health Measures in Adolescents: A Follow-Up Prevalence Study

Background/Aims: This study evaluated the relationships of clinical consequences of untreated dental caries, individual characteristics, and environmental factors on self-reported oral health measures in adolescents. Methods: A follow-up prevalence study was conducted involving 406 twelve-year-old adolescents selected from public schools in the eastern area of the city of Manaus, Brazil. Baseline data included clinical consequences of untreated caries (PUFA/pufa index), DMFT, sociodemographic characteristics (sex, parental schooling, and family income), psychosocial factors (sense of coherence [SOC-13 scale], oral health beliefs and self-esteem [Rosenberg Self-Esteem Scale]), and social support (SSA questionnaire). Oral health-related quality of life (OHRQoL [CPQ_11–14]) and self-rated oral health were assessed at the 6-month follow-up. Structural equation modelling was used to explore the relationships between variables according to the Wilson and Cleary model. Results: The prevalence of PUFA/pufa was 17.8% and mean DMFT was 1.5. The number of teeth with clinical consequences of untreated caries predicted poor self-rated oral health at the 6-month follow-up. Low parental schooling predicted low family income and clinical consequences of untreated dental caries. Psychosocial factors predicted OHRQoL directly and self-rated oral health indirectly. OHRQoL was linked to self-rated oral health. Clinical consequences of untreated dental caries mediated the relationship of parental schooling with OHRQoL and self-rated oral health. OHRQoL mediated the relationship of psychosocial factors and sex with self-rated oral health. Clinical consequences of untreated dental caries was associated with adolescents’ self-rated oral health. Furthermore, the former was an important mediator on the link between low parental education and adolescents’ self-reported oral health measures. Conclusions: Socioeconomic status, psychosocial factors, and social support were related to OHRQoL and self-rated oral health via direct and indirect pathways.

Self-Reported Oral Health Knowledge and Practices During Pregnancy and Their Social Determinants in Poland.

To determine the effects of sociodemographic and pregnancy-related factors on oral health attitudes during pregnancy, as well as the main predictors of proper oral practices. An electronic survey consisting of 47 (single or multiple-choice) questions was conducted in women up to 3 years after childbirth in 2017. Sociodemographic data, as well as information on the course of pregnancy and delivery, oral knowledge and basic behaviours during pregnancy were collected. The Chi-square test and Spearman's rank correlation coefficient were used for statistical analysis. Odds ratios were determined. A statistical significance level of 0.05 was used. A total of 2480 questionnaires completed by women aged between 13 and 45 years who were up to 3 years after delivery, were analysed. Correct answers to all questions regarding basic oral health and oral practices were obtained by 20.8% and 19.6% of respondents, respectively. Proper health behaviours were more strongly correlated with the level of knowledge (r = 0.155; odds ratio (OR) = 2.44; CI:1.93-3.07; p <0.001) and the use of dental care before pregnancy (r = 0.187; OR = 2.88; CI:2.29-3.63; p <0.001) rather than age (r = 0.144), good or very good financial status (r = 0.110), high level of education (r = 0.081), urban residence (r = 0.058) or occupational activity (r = 0.049). Attending dental visits depended on the conviction about their safety (r = 0.195; OR = 2.47; CI: 2.09-2.93; p <0.001) as well as gynaecologist's referral in the case of general conditions in pregnancy (r = 0.052) and the risk of premature birth (r = 0.053). No effects of other parameters associated with pregnancy or delivery were confirmed. Health attitudes during pregnancy are modified by sociodemographic factors. The main predictors of proper health behaviours include high level of knowledge on oral health and the use of dental care before conception. Furthermore, dental attendance among pregnant women depends on the awareness of the safety of dental visits and a gynaecologist referral in case of general condition and risk of premature birth.

Acute and chronic diabetes complications associated with self-reported oral health: a retrospective cohort study

BackgroundOral health is associated with diabetes, but the chances of experiencing acute or chronic diabetes complications as per this association is unknown in Canada’s most populous province, Ontario. This study assesses the impact of self-reported oral health on the likelihood of experiencing acute and chronic complications among a cohort of previously diagnosed diabetics.MethodsA retrospective cohort study was conducted of diabetics (n = 5183) who participated in the Canadian Community Health Survey 2003 and 2007–08. Self-reported oral health status was linked to health encounters in electronic medical records until March 31, 2016. Multinomial regression models determined the odds of the first acute or chronic complication after self-report of oral health status.ResultsThirty-eight percent of diabetics reporting “poor to fair” oral health experienced a diabetes complication, in comparison to 34% of those reporting “good to excellent” oral health. The odds of an acute or chronic complication among participants reporting “poor to fair” oral health status was 10% (OR 1.10; 95% CI 0.81, 1.51) and 34% (OR 1.34; 95% CI 1.11, 1.61) greater respectively, than among participants experiencing no complications and reporting “good to excellent” oral health.ConclusionSelf-reporting “poor to fair” oral health status is associated with a greater likelihood of chronic complications than acute complications. Further research regarding the underlying causal mechanisms linking oral health and diabetes complications is needed.

Bidirectional relations between cognitive function and oral health in ageing persons: a longitudinal cohort study.

evidence suggests a reciprocal relationship between cognitive function (CF) and oral health (OH), but no study has demonstrated this inter-relationship in a longitudinal population. to investigate the bidirectional relationship between CF and OH in an ageing cohort. cohort study. general community. participants from the English Longitudinal Study of Ageing. OH, measured by teeth status, self-reported OH and OH-related quality of life (OHRQoL), and CFs were collected at three time points in 2006/07, 2010/11 and 2014/15. Cross-lagged structural equation models were used to investigate the association between CF and OH, adjusted for potential confounding factors. 5477 individuals (56.4% women) were included (mean age = 63.1years at 2006/07, 67.2 at 2010/11 and 70.4 at 2014/15, SD = 8.9) in analyses. The average CF score was 46.5(SD = 12.3) at baseline and 41.2 (SD = 13.4) at follow-up. 3350 (61.2%) participants had natural teeth only and 622 (11.2%) were edentulous. In the fully adjusted model, better cognition at baseline was associated with better OH at follow-up (beta coefficient = 0.02, 95% CI: 0.01-0.03); conversely better OH at baseline predicted better cognition (beta coefficient = 0.12, 95% CI: 0.06-0.18). Similar magnitude and direction of the reciprocal association was evident between cognition and OHRQoL. This is the first longitudinal study to demonstrate the positive reciprocal association between CF and OH. The findings suggest the importance of maintaining both good CF and OH in old age.

Associations between self-reported physical activity and oral health: a cross-sectional analysis in 17,777 Spanish adults.

Background The aim of this study was to assess the association between levels of physical activity and oral health in adults residing in Spain.Methods Cross-sectional data from the Spanish National Health Survey 2017 were analysed (n = 17,777 adults aged ≥15 years; 52.0% females). The International Physical Activity Questionnaire (IPAQ) short form was used to measure physical activity. Oral health was self-reported through eight variables. Covariates included were sex, age, marital status, education, obesity, smoking and alcohol consumption.Results Dental caries (19.8% vs 27.8%), dental extraction (72.7% vs 75.4%), gingival bleeding (15.5% vs 19.1%), tooth movement (4.3% vs 5.9%) and missing tooth (57.9% vs 62.5%) were statistically significantly less frequent in the sufficient than insufficient physical activity group, whereas dental filling (74.2% vs 70.9%), dental material (36.6% vs 34.8%) and no missing tooth and no material (28.2% vs 25.1%) were statistically significantly more common. After adjustment, there was a negative relationship between physical activity and dental caries (OR = 0.72; 95%CI = 0.66-0.78), gingival bleeding (OR = 0.79; 95%CI = 0.72-0.86), tooth movement (OR = 0.83; 95%CI = 0.71-0.96) and missing tooth (OR = 0.91; 95%CI = 0.85-0.98). In contrast, physical activity was positively associated with dental material (OR = 1.16; 95%CI = 1.07-1.25).Conclusions Participation in physical activity is favourably associated with some but not all self-reported oral health correlates.

Socioeconomic Life Course Models and Oral Health: A Longitudinal Analysis

We compared socioeconomic life course models to decompose the direct and mediated effects of socioeconomic status (SES) in different periods of life on late-life oral health. We used data from 2 longitudinal Swedish studies: the Level of Living Survey and the Swedish Panel Study of Living Conditions of the Oldest Old. Two birth cohorts (older, 1925 to 1934; younger, 1944 to 1953) were followed between 1968 and 2011 with 6 waves. SES was measured with 4 indicators of SES and modeled as a latent variable. Self-reported oral health was based on a tooth conditions question. Variables in the younger and older cohorts were grouped into 4 periods: childhood, young/mid-adulthood, mid /late adulthood, late adulthood/life. We used structural equation modeling to fit the following into lagged-effects life course models: 1) chain of risk, 2) sensitive period with late-life effect, 3) sensitive period with early- and late-life effects, 4) accumulation of risks with cross-sectional effects, and 5) accumulation of risks. Chain of risk was incorporated into all models and combined with accumulation, with cross-sectional effects yielding the best fit (older cohort: comparative fit index = 0.98, Tucker-Lewis index = 0.98, root mean square error of approximation = 0.04, weighted root mean square residual = 1.51). For the older cohort, the chain of SES from childhood → mid-adulthood → late adulthood → late life showed the following respective standardized coefficients: 053, 0.92, and 0.97. The total effect of childhood SES on late-life tooth loss (standardized coefficient: –0.23 for older cohort, –0.17 for younger cohort) was mediated by previous tooth loss and SES. Cross-sectional effects of SES on tooth loss were observed throughout the life course, but the strongest coefficients were at young/mid-adulthood (standardized coefficient: –0.41 for older cohort, –0.45 for younger cohort). SES affects oral health cumulatively over the life course and through a chain of risks. Actions to improve socioeconomic conditions in early life might have long-lasting effects on health if they help prevent people from becoming trapped in a chain of risks.

Understanding the association between self-reported poor oral health and exposure to adverse childhood experiences: a retrospective study

BackgroundAdverse childhood experiences, including physical, sexual or emotional abuse, can have detrimental impacts on child and adult health. However, little research has explored the impact that such early life experiences have on oral health. This study examines whether experiencing adverse childhood experiences before the age of 18 years is associated with self-reported poor dental health in later life.MethodsUsing stratified random probability sampling, a household survey (N = 5307; age range 18–69 years) was conducted in the South of England (Hertfordshire, Luton and Northamptonshire). Data were collected at participants’ homes using face-to-face interviews. Measures included exposure to nine adverse childhood experiences, and two dental outcomes: tooth loss (> 8 teeth lost due to dental caries or damage) and missing or filled teeth (direct or indirect restorations; > 12 missing or filled teeth).ResultsStrong associations were found between exposure to childhood adversity and poor dental health. The prevalence of tooth loss was significantly higher (8.3%) in those with 4+ adverse childhood experiences compared to those who had experienced none (5.0%; p < 0.05). A similar relationship was found for levels of missing or filled teeth (13.4%, 4+ adverse childhood experiences; 8.1%, none; p < 0.001). Exposure to 4+ adverse childhood experiences was associated with a higher level of tooth loss and restorations at any age, compared to individuals who had not experienced adversity. Demographically adjusted means for tooth loss increased with adverse childhood experience count in all age groups, rising from 1.0% (18–29 years) and 13.0% (60–69 years) in those with none, to 3.0% and 26.0%, respectively in those reporting 4+.ConclusionsExposure to childhood adversity could be an important predictive factor for poor dental health. As oral health is an important part of a child’s overall health status, approaches that seek to improve dental health across the life-course should start with safe and nurturing childhoods free from abuse and neglect. Given the growing role that dental professionals have in identifying violence and abuse, it seems appropriate to raise awareness in the field of dentistry of the potential for individuals to have suffered adverse childhood experiences, and the mechanisms linking childhood adversity to poor dental health.

Oral health status among Spanish adults with diabetes: National Health Survey, 2017

AimsWe aim i) to describe self-reported oral health among patients with diabetes in Spain; ii) to recognize which variables (socio-demographic, lifestyle and health-related), were related to poor self-reported oral health in patients with diabetes. MethodsWe used data from subjects of the National Health Interview Survey performed in 2017. Diabetes status was self-reported. One non-diabetes patient was matched by gender and age for each diabetes case. Poor self-reported oral health was defined using the answers “I have dental caries” to the following question: "What is the state of your teeth and molars?". Socieconomic, demographic, comorbidities, health status, health care-related were independent variables. ResultsWe found that the prevalence of dental caries was higher among subjects with diabetes than their matched controls (23.8% vs. 16.5%; P < 0.001). The OR of dental caries for people with diabetes was 1.45 (95% CI 1.12–1.30). Older age, having lower monthly income, obesity, periodontal disease, very poor/poor/ fair self-rated health and having public dental health insurance increased the probability of suffering caries. ConclusionsPoor self-reported oral health was higher among people with diabetes compared to non-diabetes controls. Physicians and dentists should increase their awareness with their patients with diabetes, especially those with obesity, younger and with lower education.

What factors contribute to the self-reported oral health status of Arab adolescents? An assessment using a validated Arabic-WHO tool for child oral health (A-OHAT)

BackgroundThe current study was performed; to validate the Arabic version of WHO child oral health assessment tool (A-OHAT), to assess the oral health status of Arab school children and finally to identify the important risk factors associated with the poor teeth and gum conditions of school children.MethodsA cross-sectional study with two-staged simple random sampling technique was implemented. A-OHAT, a self-assessment tool was subjected to psychometric analyses with the respondents being high school children. The Cronbach’s alpha and the Intra class correlation values were computed. Paired t-test was performed to identify the differences between the readings after repeated administration, followed by the analysis for convergent validity. This tested Arabic-WHO Child-OHAT was administered to collect the data. Univariate, bivariate and logistic regression analyses were performed to report on the potential risk factors associated with poor teeth and poor gum conditions of school children.ResultsPsychometric analyses revealed that the Arabic Child Oral Health Assessment Tool (A-OHAT) was reliable and valid. A total of 478 (N) high school children were subjected to the tested tool, of which 66.5% were male and 33.5% were female with a mean age of 16.28 + 1.04 years. 80.3% of school children had poor teeth condition and 36.2% of school children had often experienced toothache. Children had 1.5 times higher odds of having poor teeth condition if they had increased frequency of sweet and candy consumption. It was also seen that increased frequency of sweets and candy consumption by school children had put them at nearly 20% higher risk of having poor gum condition. Finally, children with the habit of using toothbrush had nearly 50% lower chance of having poor gum condition in contrast to the school children who do not use toothbrush.ConclusionTo conclude, the study provides a reliable and valid tool to assess the oral health status of Arab adolescents. Improper oral hygiene habits and diet were identified as the plausible risk factors for poor teeth and gum condition.

Oral health status and oral health care use among formerly incarcerated people

BackgroundIncarceration carries adverse consequences for health, yet there is limited research on the association between incarceration and oral health outcomes. The authors examined the relationship between former incarceration and 2 self-reported oral health outcomes—periodontal disease and oral health care use—and assessed the degree to which postrelease factors mediate the relationship between former incarceration and oral health outcomes. MethodsThe authors analyzed nationally representative observational data from the National Longitudinal Study of Adolescent to Adult Health by using multivariate logistic regression. Karlson-Holm-Breen mediation analysis was used to assess how much former incarceration and oral health outcomes are confounded by material hardship, health insurance coverage, and poor health behaviors. ResultsIncarceration history is associated with periodontal disease (odds ratio [OR], 1.454; 95% confidence interval [CI], 1.042 to 2.029) and oral health care use (OR, 1.433; 95% CI, 1.248 to 1.646) after control variables are taken into account. However, the confounding variables fully mediate the association between incarceration and periodontal disease (OR, 1.143; 95% CI, 0.815 to 1.605) and oral health care use (OR, 1.133; 95% CI, 0.980 to 1.309). ConclusionsFormerly incarcerated people in the United States have worse oral health outcomes than their never-incarcerated counterparts, and much of this relationship can be explained by socioeconomic status and health behaviors. Practical ImplicationsFormerly incarcerated people have scarce resources and lack knowledge about oral health care. Health care professionals should encourage formerly incarcerated people to focus on oral health care. Because modifiable risk behaviors confound much of this relationship, targeted interventions may provide benefits for improving oral health care among this vulnerable population.