Community dentistry and oral epidemiology最新文献

Objectives: Health literacy refers to an individual's ability to understand health information, navigate healthcare systems, make informed decisions and adopt health-promoting behaviours. The scoping review examined the available literature to explore adults' health literacy levels, health literacy measurements, and the role of health literacy in adults' dental service utilisation.

Methods: The scoping review used Arksey and O'Malley's framework, refined by Joanna Briggs Institute methodology. The inclusion criteria were peer-reviewed studies, published in English with adult participants in a dental setting. Four databases (MEDLINE via PubMed, Scopus, CINAHL and ASSIA) were searched for relevant studies from January 2000 to January 2025.

Results: Nineteen studies met the inclusion criteria, with 12 out of 19 conducted in the US. Health literacy was assessed by 11 different measures. Although most studies reported relatively inadequate health literacy levels, inconsistent findings persist due to a lack of consensus on measurement. Dental service utilisation, primarily assessed by dental visits, dental information seeking, and dentist-patient communication, demonstrated inconsistent associations with health literacy.

Conclusions: While some studies suggested a positive association between health literacy and dental service utilisation, the mechanisms through which health literacy influenced dental service utilisation remained unclear and required further investigation.

Objectives: Tooth loss was longitudinally associated with social isolation. The absence of dental prosthesis use was an additional risk factor. However, the mediating pathways for this association are unknown. The aim of this cohort study was to estimate the mediating effect of three oral functions: speaking, smiling and chewing observed at baseline on the association between oral health at baseline and social isolation after 6 years of follow-up.

Methods: The 2010-2016 panel data from 6103 functionally independent participants aged ≥ 65 years who were not socially isolated at baseline was used from the Japan Gerontological Evaluation Study (JAGES). Causal mediation analysis using parametric logistic regression models was used to calculate the natural direct effect (NDE), the natural indirect effect (NIE), and the total effect. Social isolation was derived from a 5-point index and dichotomised (0/3 = not isolated, 4/5 = isolated). The confounders observed at baseline were age, sex, educational attainment, income, activities of daily living, living area, and having depressive symptoms assessed using the geriatric depression scale (GDS-15).

Results: The mean age of the participants was 72.4 years (SD = ±5.1), and 44.7% were males. Social isolation was observed at follow-up among 3.6% of participants (n = 220). The cumulative incidence rate of socially isolated participants among those with ≥ 20 teeth was 2.9% increasing gradually to 3.2%, 3.5%, 3.7% and 7.2% among those with 10-19 teeth and used dental prosthesis, 10-19 teeth and did not use the dental prosthesis, 0-9 teeth and used dental prosthesis, and 0-9 teeth and did not use the dental prosthesis respectively. Compared with those with ≥ 20 teeth, having difficulty in speaking [NIE odds ratio (OR) = 1.02, 95% confidence interval (CI) = 0.93-1.11], problems in smiling (NIE OR = 1.02, 95% CI = 0.93-1.10) and difficulty in chewing (NIE OR = 1.04, 95% CI = 0.94-1.14) might have mediated the association for those with 10-19 teeth and used dental prosthesis as well as for those with 10-19 teeth without dental prosthesis (NIE OR = 1.02, 95% CI = 0.94-1.10), (NIE OR = 1.02, 95% CI = 0.93-1.11) and (NIE OR = 1.02, 95% CI = 0.93-1.11) respectively. While they might not have mediated the association for those with 0-9 teeth with and without dental prosthesis use.

Conclusion: With low precision and uncertain estimates, limited oral function might have mediated the association between tooth loss (10-19 with and without dental prosthesis use groups) and social isolation over 6 years. It was uncertain whether a mediation effect of oral functions was observed for those with 0-9 teeth with and without dental prosthesis use.

Objectives: This study examined country-level geo-temporal sentiment trends in community water fluoridation (CWF) discussions on 'X' from 2014 to 2023 and generated a five-year forecast to anticipate future shifts.

Methods: Sentiment analysis was conducted using the VADER 'SentimentIntensityAnalyzer', with polarity thresholds defined as negative (< -0.05), neutral (-0.05 to +0.05) and positive (> +0.05). Data were collected via the 'X' API and examined for sentiment distribution, country-level geo-temporal patterns based on user location information, and engagement metrics (likes, retweets, replies). Ethical approval was obtained, and only publicly available data were analysed in compliance with the platform's terms of service. Limitations include restriction to English-language tweets and the non-representativeness and demographic biases of 'X' users compared with national populations.

Results: Of 72 309 original tweets analysed, 37.4% were negative, 34.4% positive and 28.2% neutral. Countries with low tweet volumes (e.g., Venezuela, Cyprus, Croatia, Pakistan, Vietnam) showed predominantly positive sentiment. In contrast, high-volume countries (the US, Canada, Australia, Brazil and the United Kingdom) displayed mixed sentiment without a clear majority. Predictive modelling indicated a modest shift toward less positive sentiment polarity over the next 5 years, with average polarity projected to decrease from 0.43 in 2024 to 0.38 in 2028. Supplementary analysis of more recent tweets (Jan 2024-Aug 2025) provided further insight into emerging patterns, broadly consistent with the projected trends.

Conclusions: CWF discourse on 'X' is polarised and varies across countries and time. The expected decline in positivity underscores the need for tailored country-specific public health communication strategies to strengthen engagement and counter misinformation.

Objective: To investigate whether a stronger Sense of Coherence (SOC) modifies the association between low household income and poor self-rated dental and general health measures (SRDH and SRGH, respectively).

Methods: Cross-sectional analyses were performed using data from the Dental Care and Oral Health Study (DCOHS, 2015-2016) in South Australia (n = 3664). In multivariate Poisson regression models, the main effects, interactions and effect modifications of SOC in the association between income and SRDH and SRGH were estimated using prevalence ratios (PRs) for poor self-rated health.

Results: In the low-income group, among those with stronger SOC, the prevalence of poor SRDH (16.0%) and SRGH (8.1%) was lower than that of those with weaker SOC (25.0% and 18.9%). Lower coherence (weak SOC) was associated with poor SRGH (PR = 4.8, 95% CI [1.8-13.1]). The interaction between lower coherence and low- and middle-income strata was not associated with the prevalence of poor SRDH and SRGH.

Conclusions: Although interactions between SOC and income were not statistically significant, findings suggest a potential modifying role of strong SOC on the association between low income and poor health. These results should be interpreted with caution, as they are exploratory.

Objectives: To describe the landscape of dental care provided by specialised centres for children and adolescents with rare diseases (RDs) in the state of Minas Gerais, southeastern Brazil.

Methods: A retrospective cross-sectional study was conducted involving individuals aged 0-18 years with a confirmed diagnosis of a RD who received care at five specialised dental centres. Data on the diagnosis, age at first dental appointment, frequency of annual visits and travel distance from home to treatment centre were analysed using descriptive and inferential statistics.

Results: A total of 1057 individuals with 244 different RDs were identified. Most were boys (54.9%). The average age at the first dental appointment was 8.52 years. Haematological diseases were the most prevalent (38.9%). The average travel distance for treatment was 99.1 km, with individuals from the Jequitinhonha region traveling the farthest (526.3 km). The average number of annual dental visits was 2.4. Patients with craniofacial syndromes accessed care earlier (average: 3.6 years) and had more frequent follow-up appointments (average: 4.8 visits/year). Significant regional disparities were found in age at first appointment (p < 0.001), travel distance (p < 0.001) and frequency of visits (p = 0.002).

Conclusions: Children and adolescents with RDs had delayed initiation of dental care, low follow-up rates and substantial travel burdens. The concentration of specialised centres in the state capital underscores the need for policy reforms to improve equitable access, particularly for patients in remote areas.