Objectives: To assess the association between dental insurance, dental care utilization and oral health-related impact on daily activities among patients visiting Health Resources and Services Administration (HRSA)-funded health centers in the United States.
Methods: This cross-sectional study examined the 2014 Health Center Patient Survey (HCPS), a survey of patients who received care at US health centers. Logistic regression analyses were conducted to explore the likelihood of the oral health-related impact on daily activities domains such as school/work performance, sleeping, eating/chewing, social and home activities considering sociodemographic, dental insurance, and dental care utilization.
Results: Among 7002 total participants, 6890 self-reported oral health-related impact on daily activities. Adults aged 18-44 were 2.6 times more likely to report an overall impact on everyday life activities compared to children and adolescents. After adjusting for sociodemographics, Hispanic patients were less likely to report any oral health-related impacts, while patients visiting rural centres reported higher odds of oral health related impairment. Patients who experienced delays in receiving dental care or were unable to access dental care when needed were 4.5 times more likely to encounter difficulties in their daily activities.
Conclusions: This study linked limited dental insurance and care to increased oral health issues impacting daily life, particularly among adults, rural populations, and those facing delay in dental care. This highlights the need for policy reforms and interventions aimed at improving dental care access to mitigate the detrimental effects of poor oral health on daily functions for vulnerable populations.
{"title":"Effects of dental insurance and dental care utilization on oral health-related daily life activities among federally qualified healthcare center patients in the United States.","authors":"Tejasvita Chandel, Muath Aldosari, Steffany Chamut","doi":"10.1111/cdoe.12986","DOIUrl":"https://doi.org/10.1111/cdoe.12986","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the association between dental insurance, dental care utilization and oral health-related impact on daily activities among patients visiting Health Resources and Services Administration (HRSA)-funded health centers in the United States.</p><p><strong>Methods: </strong>This cross-sectional study examined the 2014 Health Center Patient Survey (HCPS), a survey of patients who received care at US health centers. Logistic regression analyses were conducted to explore the likelihood of the oral health-related impact on daily activities domains such as school/work performance, sleeping, eating/chewing, social and home activities considering sociodemographic, dental insurance, and dental care utilization.</p><p><strong>Results: </strong>Among 7002 total participants, 6890 self-reported oral health-related impact on daily activities. Adults aged 18-44 were 2.6 times more likely to report an overall impact on everyday life activities compared to children and adolescents. After adjusting for sociodemographics, Hispanic patients were less likely to report any oral health-related impacts, while patients visiting rural centres reported higher odds of oral health related impairment. Patients who experienced delays in receiving dental care or were unable to access dental care when needed were 4.5 times more likely to encounter difficulties in their daily activities.</p><p><strong>Conclusions: </strong>This study linked limited dental insurance and care to increased oral health issues impacting daily life, particularly among adults, rural populations, and those facing delay in dental care. This highlights the need for policy reforms and interventions aimed at improving dental care access to mitigate the detrimental effects of poor oral health on daily functions for vulnerable populations.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141316905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francisca Verdugo-Paiva, Olivia Urquhart, Cleopatra N Matanhire-Zihanzu, Carolina Castro Martins-Pfeifer, Emmett Booth, H Austin Booth, Hind Aljarahi, John Button, Camila Pinto-Grunfeld, Julio Villanueva, Iliana V Kohler, Michael Glick, Alonso Carrasco-Labra
Objective: To advance oral health policies (OHPs) in the World Health Organization (WHO) African region, barriers to and facilitators for creating, disseminating, implementing, monitoring and evaluating OHPs in the region were examined.
Methods: Global Health, Embase, PubMed, Public Affairs Information Service Index, ABI/Inform, Web of Science, Academic Search Complete, Scopus, Dissertations Global, Google Scholar, WHO's Institutional Repository for Information Sharing (IRIS), the WHO Noncommunicable Diseases Document Repository and the Regional African Index Medicus and African Journals Online were searched. Technical officers at the WHO Regional Office for Africa were contacted. Research studies and policy documents reporting barriers to and facilitators for OHP in the 47 Member States in the WHO African region published between January 2002 and March 2024 in English, French or Portuguese were included. Frequencies were used to summarize quantitative data, and descriptive content analysis was used to code and classify barrier and facilitator statements.
Results: Eighty-eight reports, including 55 research articles and 33 policy documents, were included. The vast majority of the research articles and policy documents were country-specific, but they were lacking for most countries. Frequently mentioned barriers across policy at all stages included financial constraints, a limited and poorly organized workforce, deprioritization of oral health, the absence of health information systems, inadequate integration of oral health services within the overarching health system and limited oral health literacy. Facilitators included a renewed commitment to establishing national OHPs, recognition of a need to diversify the oral health workforce, and an increased understanding of the influence of social determinants of health among oral health care providers.
Conclusions: Most countries lack a country-specific body of evidence to assist policymakers in anticipating barriers to and facilitators for OHPs. The barriers and facilitators relevant to disparate subnational, national, and regional conditions and circumstances must be considered to advance the creation, dissemination, implementation, monitoring and evaluation of OHPs in the WHO African region.
{"title":"Barriers to and facilitators for creating, disseminating, implementing, monitoring and evaluating oral health policies in the WHO African region: A scoping review.","authors":"Francisca Verdugo-Paiva, Olivia Urquhart, Cleopatra N Matanhire-Zihanzu, Carolina Castro Martins-Pfeifer, Emmett Booth, H Austin Booth, Hind Aljarahi, John Button, Camila Pinto-Grunfeld, Julio Villanueva, Iliana V Kohler, Michael Glick, Alonso Carrasco-Labra","doi":"10.1111/cdoe.12984","DOIUrl":"https://doi.org/10.1111/cdoe.12984","url":null,"abstract":"<p><strong>Objective: </strong>To advance oral health policies (OHPs) in the World Health Organization (WHO) African region, barriers to and facilitators for creating, disseminating, implementing, monitoring and evaluating OHPs in the region were examined.</p><p><strong>Methods: </strong>Global Health, Embase, PubMed, Public Affairs Information Service Index, ABI/Inform, Web of Science, Academic Search Complete, Scopus, Dissertations Global, Google Scholar, WHO's Institutional Repository for Information Sharing (IRIS), the WHO Noncommunicable Diseases Document Repository and the Regional African Index Medicus and African Journals Online were searched. Technical officers at the WHO Regional Office for Africa were contacted. Research studies and policy documents reporting barriers to and facilitators for OHP in the 47 Member States in the WHO African region published between January 2002 and March 2024 in English, French or Portuguese were included. Frequencies were used to summarize quantitative data, and descriptive content analysis was used to code and classify barrier and facilitator statements.</p><p><strong>Results: </strong>Eighty-eight reports, including 55 research articles and 33 policy documents, were included. The vast majority of the research articles and policy documents were country-specific, but they were lacking for most countries. Frequently mentioned barriers across policy at all stages included financial constraints, a limited and poorly organized workforce, deprioritization of oral health, the absence of health information systems, inadequate integration of oral health services within the overarching health system and limited oral health literacy. Facilitators included a renewed commitment to establishing national OHPs, recognition of a need to diversify the oral health workforce, and an increased understanding of the influence of social determinants of health among oral health care providers.</p><p><strong>Conclusions: </strong>Most countries lack a country-specific body of evidence to assist policymakers in anticipating barriers to and facilitators for OHPs. The barriers and facilitators relevant to disparate subnational, national, and regional conditions and circumstances must be considered to advance the creation, dissemination, implementation, monitoring and evaluation of OHPs in the WHO African region.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Orthodontic treatment often involves four first premolar extractions. There is concern that the retraction of the anterior teeth due to extraction of first premolars may constrict tongue space and will reduce oral cavity and oropharynx space. Constricted airways are often associated with sleep disordered breathing (SDB) and sleep disruption. The aim of this study was to determine if there is an association of SDB factors with the absence of first premolars.
Methods: A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 data on participants, aged 18-65 years (n = 4742). Variables of interest included self-reports of SDB (symptoms of disrupted sleep such as snoring, snorting, daytime sleepiness, and inappropriate number of hours of sleep). Data for the presence/absence of first premolars were gathered from the oral examination section of NHANES. An assumption was made that absence of four first premolars in dentate participants indicated extractions for orthodontic treatment. Data analyses were conducted with Rao Scott chi squared test.
Results: There were no significant associations of SDB and symptoms of disrupted sleep associated with the absence of four first premolars in dentate participants.
Conclusion: Concerns of the impact of first premolar extractions on SDB were not supported with this study.
{"title":"Sleep disruption and premolar absence, NHANES, 2017-2020: A cross-sectional study.","authors":"R Constance Wiener, Michael Hnat, Peter Ngan","doi":"10.1111/cdoe.12983","DOIUrl":"https://doi.org/10.1111/cdoe.12983","url":null,"abstract":"<p><strong>Objective: </strong>Orthodontic treatment often involves four first premolar extractions. There is concern that the retraction of the anterior teeth due to extraction of first premolars may constrict tongue space and will reduce oral cavity and oropharynx space. Constricted airways are often associated with sleep disordered breathing (SDB) and sleep disruption. The aim of this study was to determine if there is an association of SDB factors with the absence of first premolars.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 data on participants, aged 18-65 years (n = 4742). Variables of interest included self-reports of SDB (symptoms of disrupted sleep such as snoring, snorting, daytime sleepiness, and inappropriate number of hours of sleep). Data for the presence/absence of first premolars were gathered from the oral examination section of NHANES. An assumption was made that absence of four first premolars in dentate participants indicated extractions for orthodontic treatment. Data analyses were conducted with Rao Scott chi squared test.</p><p><strong>Results: </strong>There were no significant associations of SDB and symptoms of disrupted sleep associated with the absence of four first premolars in dentate participants.</p><p><strong>Conclusion: </strong>Concerns of the impact of first premolar extractions on SDB were not supported with this study.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Doughty, C. Tran, A. J. Santella, R. Fitzgerald, F. Burns, Stephen Porter, Richard G. Watt
Objectives
Expanding HIV testing beyond specialized services has been a key strategic approach to eliminating the transmission of HIV. In recent years, dental settings have been identified as offering an opportunity for delivering point of care HIV testing (POCT) interventions. Intervention components and implementation strategies have varied across studies and there is uncertainty about the prevalence of undiagnosed HIV in the dental patient population. Therefore, this systematic review aimed to synthesize the HIV testing outcomes of intervention studies, identify the core components of POCT interventions implemented in dental settings; and understand the barriers and facilitators to intervention implementation.
Methods
A mixed-methods systematic review was undertaken. Two authors reviewed abstracts and full papers for inclusion and appraised the studies using the Mixed Methods Appraisal Tool. A convergent integrated mixed methods study design underpinned the synthesis. Outcomes were presented using descriptive statistics. Intervention components were mapped to the Template for Intervention Description and Replication (TIDieR) checklist. Barriers and facilitators were described using a narrative thematic analysis.
Results
POCT was offered to 22 146 dental patients, 62.5% accepted POCT. Intervention studies that reported higher uptake of testing utilized a dedicated dental or researcher staff member to provide testing, integrated testing and provided results within the routine dental appointment and adopted a provider-initiated universal approach to offering testing. Six themes emerged that were pertinent to the barriers and facilitators to HIV testing in dental setting.
Conclusions
POCT uptake in dental settings was comparable with other non-specialized health settings. Key to the operationalization of the intervention were perceptions about its value and relevance to the dental patient population, attitudes toward the intervention, logistical barriers to its implementation, the risk of HIV testing stigma to the patient-practitioner relationship and maximising the fit of the intervention within the constraints of the dental setting.
目标：将艾滋病检测扩展到专业服务之外一直是消除艾滋病传播的关键战略方法。近年来，牙科环境被认为是提供护理点 HIV 检测（POCT）干预的一个机会。不同研究中的干预内容和实施策略各不相同，而且在牙科患者人群中未确诊的 HIV 感染率也存在不确定性。因此，本系统综述旨在综合干预研究的艾滋病检测结果，确定在牙科环境中实施POCT干预的核心内容，并了解干预实施的障碍和促进因素：方法：采用混合方法进行了系统综述。两位作者对论文摘要和全文进行了审查，并使用混合方法评估工具对研究进行了评估。综合研究采用了聚合综合混合方法研究设计。研究结果采用描述性统计。干预措施的组成部分与干预措施描述和复制模板（TIDieR）核对表相对应。采用叙述性主题分析法对障碍和促进因素进行了描述：向 22 146 名牙科患者提供了 POCT，其中 62.5% 接受了 POCT。报告检测接受率较高的干预研究使用了专门的牙科或研究人员来提供检测，在常规牙科预约中整合检测并提供结果，以及采用由提供者发起的普遍方法来提供检测。在牙科环境中进行艾滋病检测的障碍和促进因素方面出现了六个相关主题：牙科机构的 POCT 使用率与其他非专业医疗机构相当。干预措施操作化的关键在于对其价值和与牙科患者群体相关性的看法、对干预措施的态度、实施干预措施的后勤障碍、HIV 检测对患者与执业医师关系造成污名化的风险以及在牙科环境的限制下最大限度地适应干预措施。
{"title":"Point of care HIV testing in dental settings in high-income countries: A mixed-methods systematic review","authors":"J. Doughty, C. Tran, A. J. Santella, R. Fitzgerald, F. Burns, Stephen Porter, Richard G. Watt","doi":"10.1111/cdoe.12963","DOIUrl":"10.1111/cdoe.12963","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Expanding HIV testing beyond specialized services has been a key strategic approach to eliminating the transmission of HIV. In recent years, dental settings have been identified as offering an opportunity for delivering point of care HIV testing (POCT) interventions. Intervention components and implementation strategies have varied across studies and there is uncertainty about the prevalence of undiagnosed HIV in the dental patient population. Therefore, this systematic review aimed to synthesize the HIV testing outcomes of intervention studies, identify the core components of POCT interventions implemented in dental settings; and understand the barriers and facilitators to intervention implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A mixed-methods systematic review was undertaken. Two authors reviewed abstracts and full papers for inclusion and appraised the studies using the Mixed Methods Appraisal Tool. A convergent integrated mixed methods study design underpinned the synthesis. Outcomes were presented using descriptive statistics. Intervention components were mapped to the Template for Intervention Description and Replication (TIDieR) checklist. Barriers and facilitators were described using a narrative thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>POCT was offered to 22 146 dental patients, 62.5% accepted POCT. Intervention studies that reported higher uptake of testing utilized a dedicated dental or researcher staff member to provide testing, integrated testing and provided results within the routine dental appointment and adopted a provider-initiated universal approach to offering testing. Six themes emerged that were pertinent to the barriers and facilitators to HIV testing in dental setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>POCT uptake in dental settings was comparable with other non-specialized health settings. Key to the operationalization of the intervention were perceptions about its value and relevance to the dental patient population, attitudes toward the intervention, logistical barriers to its implementation, the risk of HIV testing stigma to the patient-practitioner relationship and maximising the fit of the intervention within the constraints of the dental setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12963","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Arangurem Karam, Helena Silveira Schuch, Flávio Fernando Demarco, Bernardo L. Horta, Luisa N. Borrell, Roger Keller Celeste, Marcos Britto Correa
Objectives
To examine the association between social mobility and tooth loss in adults from the 1982 Pelotas Birth Cohort Study and whether race modifies this association.
Methods
The Oral Health Study used data from 541 individuals who were followed up to 31 years of age. Social mobility, composed of the participants' socioeconomic position (SEP) at birth and at age 30, was categorized as never poor, upwardly mobile, downwardly mobile and always poor. The outcome was the prevalence of at least one tooth lost due to dental caries when the participants were examined at 31 years of age. The effect modifier was race (Black/Brown versus white people). Log-binomial regression models were used to estimate crude and sex-adjusted prevalence ratios (PR) and to determine whether the association varied with race. Statistical interactions were tested using an additive scale.
Results
The prevalence of any tooth loss was 50.8% (n = 274). In social mobility groups, the prevalence of at least one tooth lost in the never-poor group was about 31% points higher for Black/Brown (68.2%) than for white people (37.4%). Antagonistic findings were found for the interaction between race and social mobility (Sinergy Index = 0.48; 95% CI 0.24, 0.99; and relative excess of risk due to the interaction = −1.38; 95% CI −2.34, −0.42), suggesting that the observed joint effect of race and social mobility on tooth loss was lower than the expected sum of these factors. The estimates for Black/Brown people were smaller for those who were always poor during their lives, relative to their white counterparts.
Conclusions
The findings suggest a higher prevalence of at least one tooth lost among people in the downward mobile SEP group and Black/Brown people. Greater racial inequity was found among Black/Brown people who had never experienced episodes of poverty, with Black/Brown people having a greater prevalence of at least one tooth lost than their white counterparts.
{"title":"Differential effect of social mobility on tooth loss by race in adulthood: 1982 Pelotas Birth Cohort Study","authors":"Sarah Arangurem Karam, Helena Silveira Schuch, Flávio Fernando Demarco, Bernardo L. Horta, Luisa N. Borrell, Roger Keller Celeste, Marcos Britto Correa","doi":"10.1111/cdoe.12975","DOIUrl":"10.1111/cdoe.12975","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine the association between social mobility and tooth loss in adults from the 1982 Pelotas Birth Cohort Study and whether race modifies this association.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Oral Health Study used data from 541 individuals who were followed up to 31 years of age. Social mobility, composed of the participants' socioeconomic position (SEP) at birth and at age 30, was categorized as never poor, upwardly mobile, downwardly mobile and always poor. The outcome was the prevalence of at least one tooth lost due to dental caries when the participants were examined at 31 years of age. The effect modifier was race (Black/Brown versus white people). Log-binomial regression models were used to estimate crude and sex-adjusted prevalence ratios (PR) and to determine whether the association varied with race. Statistical interactions were tested using an additive scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of any tooth loss was 50.8% (<i>n</i> = 274). In social mobility groups, the prevalence of at least one tooth lost in the never-poor group was about 31% points higher for Black/Brown (68.2%) than for white people (37.4%). Antagonistic findings were found for the interaction between race and social mobility (Sinergy Index = 0.48; 95% CI 0.24, 0.99; and relative excess of risk due to the interaction = −1.38; 95% CI −2.34, −0.42), suggesting that the observed joint effect of race and social mobility on tooth loss was lower than the expected sum of these factors. The estimates for Black/Brown people were smaller for those who were always poor during their lives, relative to their white counterparts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest a higher prevalence of at least one tooth lost among people in the downward mobile SEP group and Black/Brown people. Greater racial inequity was found among Black/Brown people who had never experienced episodes of poverty, with Black/Brown people having a greater prevalence of at least one tooth lost than their white counterparts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eero Raittio, Vibeke Baelum, Gustavo G Nascimento, Rodrigo Lopez
Objectives: It is not clear if or how the incidence of systemic conditions like type 2 diabetes mellitus (DM2), rheumatoid arthritis (RA) or inflammatory bowel disease (IBD) affects dental service utilization. Using nationwide Danish register data, the aim of this study was to analyse the use of dental services 7 years before and after being diagnosed with DM2, RA or IBD between 1997 and 2011.
Methods: Information about incident DM2 was obtained from the National Diabetes Register, and incident RA and IBD were defined based on diagnosis codes of hospital contacts identified through the National Patient Register. Separately, for each of the three conditions, each individual with the incident condition was matched to one control individual based on age, gender, country of origin, municipality of residence, highest completed education, the main source of income and income using coarsened exact matching in the year of incidence. The use of dental services and treatments received within each calendar year from 7 years before to 7 years after getting the condition were analysed with generalized estimating equations.
Results: People with incident DM2 were less likely (by seven percentage points) to be dental service users within a year than people without incident DM2 for a period extending from up to 7 years prior to 7 years after the diagnosis. This difference even slightly increased after the diagnosis. Those with incident IBD exhibited a consistently but modestly higher proportion of dental service use (three percentage points) than those without incident IBD before and after the diagnosis. Differences in the use of services between those with or without incident RA were minor. For all three systemic diseases, detected differences mainly mirrored differences in the provision of supragingival scaling and restorative treatment.
Conclusions: The findings suggest that the impact of these three systemic conditions on dental service use was minor.
{"title":"Dental service use among adults with incident type 2 diabetes, rheumatoid arthritis or inflammatory bowel disease.","authors":"Eero Raittio, Vibeke Baelum, Gustavo G Nascimento, Rodrigo Lopez","doi":"10.1111/cdoe.12976","DOIUrl":"https://doi.org/10.1111/cdoe.12976","url":null,"abstract":"<p><strong>Objectives: </strong>It is not clear if or how the incidence of systemic conditions like type 2 diabetes mellitus (DM<sub>2</sub>), rheumatoid arthritis (RA) or inflammatory bowel disease (IBD) affects dental service utilization. Using nationwide Danish register data, the aim of this study was to analyse the use of dental services 7 years before and after being diagnosed with DM<sub>2</sub>, RA or IBD between 1997 and 2011.</p><p><strong>Methods: </strong>Information about incident DM<sub>2</sub> was obtained from the National Diabetes Register, and incident RA and IBD were defined based on diagnosis codes of hospital contacts identified through the National Patient Register. Separately, for each of the three conditions, each individual with the incident condition was matched to one control individual based on age, gender, country of origin, municipality of residence, highest completed education, the main source of income and income using coarsened exact matching in the year of incidence. The use of dental services and treatments received within each calendar year from 7 years before to 7 years after getting the condition were analysed with generalized estimating equations.</p><p><strong>Results: </strong>People with incident DM<sub>2</sub> were less likely (by seven percentage points) to be dental service users within a year than people without incident DM<sub>2</sub> for a period extending from up to 7 years prior to 7 years after the diagnosis. This difference even slightly increased after the diagnosis. Those with incident IBD exhibited a consistently but modestly higher proportion of dental service use (three percentage points) than those without incident IBD before and after the diagnosis. Differences in the use of services between those with or without incident RA were minor. For all three systemic diseases, detected differences mainly mirrored differences in the provision of supragingival scaling and restorative treatment.</p><p><strong>Conclusions: </strong>The findings suggest that the impact of these three systemic conditions on dental service use was minor.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141080990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ivana Matic Girard, Paul Ward, Angela Durey, Caitlan McLean, Stephan Lund, Hanny Calache, Sarah R. Baker, Linda Slack-Smith
Objectives
This study comprises a synthesis of published qualitative studies from developed countries on the perspectives of carers regarding the oral hygiene toothbrushing practices of preschool children, through the lens of social practice theory.
Methods
A search of the following electronic databases was conducted for all available years: MEDLINE, EMBASE and Global Health using the Ovid platform; Dentistry & Oral Sciences Source (DOSS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Included qualitative studies reported primary caregivers' perceptions of oral hygiene practices (focusing on toothbrushing) in preschool children (0–5 years old) in developed countries. A thematic synthesis of the qualitative findings was undertaken for the results of each study.
Results
Eleven articles were included in this meta-synthesis. The focus of this paper was toothbrushing practices. A conceptual map of toothbrushing as a social practice was developed. Key findings included practice elements (meanings, competences, and materials), spatial and temporal aspects, and barriers and facilitators to performance.
Conclusions
The application of a social practice lens to published qualitative research on the oral hygiene of preschool children provided insights into the meanings and competences related to toothbrushing, as perceived by primary caregivers. However, it also revealed limited information on material, spatial and temporal aspects of toothbrushing practices, indicating the importance of considering social practice theory as a framework in future research to address this gap. Furthermore, exploring toothbrushing in connection with related social practices has the potential to increase understanding of factors influencing oral health in preschool children.
研究目的本研究通过社会实践理论的视角，对发达国家已发表的有关照顾者对学龄前儿童口腔卫生刷牙方法的看法的定性研究进行了综述：方法： 对以下电子数据库中所有可用年份的内容进行了检索：使用 Ovid 平台检索了 MEDLINE、EMBASE 和 Global Health；还检索了 Dentistry & Oral Sciences Source (DOSS)、Cumulative Index to Nursing and Allied Health Literature (CINAHL) 和 Scopus。纳入的定性研究报告了发达国家学龄前儿童（0-5 岁）的主要照顾者对口腔卫生做法（重点是刷牙）的看法。对每项研究的定性结果进行了专题综合：结果：共有 11 篇文章被纳入此次元综合研究。本文的重点是刷牙方法。研究人员绘制了一张刷牙这一社会实践的概念图。主要发现包括实践要素（意义、能力和材料）、空间和时间方面，以及执行的障碍和促进因素：将社会实践视角应用到已发表的学龄前儿童口腔卫生定性研究中，有助于深入了解主要照顾者眼中与刷牙有关的意义和能力。然而，它也揭示了刷牙实践的物质、空间和时间方面的信息有限，这表明在未来的研究中将社会实践理论作为一个框架以弥补这一不足的重要性。此外，将刷牙与相关社会实践联系起来进行探讨，有可能加深对影响学龄前儿童口腔健康因素的理解。
{"title":"A qualitative meta-synthesis of carers’ perceptions of factors influencing preschool children’s oral hygiene practices—A social practices perspective","authors":"Ivana Matic Girard, Paul Ward, Angela Durey, Caitlan McLean, Stephan Lund, Hanny Calache, Sarah R. Baker, Linda Slack-Smith","doi":"10.1111/cdoe.12973","DOIUrl":"10.1111/cdoe.12973","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study comprises a synthesis of published qualitative studies from developed countries on the perspectives of carers regarding the oral hygiene toothbrushing practices of preschool children, through the lens of social practice theory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A search of the following electronic databases was conducted for all available years: MEDLINE, EMBASE and Global Health using the Ovid platform; Dentistry & Oral Sciences Source (DOSS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Included qualitative studies reported primary caregivers' perceptions of oral hygiene practices (focusing on toothbrushing) in preschool children (0–5 years old) in developed countries. A thematic synthesis of the qualitative findings was undertaken for the results of each study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven articles were included in this meta-synthesis. The focus of this paper was toothbrushing practices. A conceptual map of toothbrushing as a social practice was developed. Key findings included practice elements (meanings, competences, and materials), spatial and temporal aspects, and barriers and facilitators to performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The application of a social practice lens to published qualitative research on the oral hygiene of preschool children provided insights into the meanings and competences related to toothbrushing, as perceived by primary caregivers. However, it also revealed limited information on material, spatial and temporal aspects of toothbrushing practices, indicating the importance of considering social practice theory as a framework in future research to address this gap. Furthermore, exploring toothbrushing in connection with related social practices has the potential to increase understanding of factors influencing oral health in preschool children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12973","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141070918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michaela Goodwin, Tanya Walsh, William Whittaker, Richard Emsley, Michael P. Kelly, Matt Sutton, Martin Tickle, Iain A. Pretty
Objectives
The objective was to assess the effectiveness of a Water Fluoridation program on a contemporary population of children.
Methods
The study used a longitudinal prospective cohort design.
In Cumbria, England, two groups of children were recruited and observed over a period of 5–6 years. The Birth Cohort consisted of families recruited from two hospitals in Cumbria where children were conceived after water fluoridation was reintroduced. The systemic and topical effects of community water fluoridation were evaluated in the Birth Cohort. The Older Cohort were approximately 5 years old and recruited from primary schools in Cumbria, shortly after water fluoridation was reintroduced. The predominantly topical effects of fluoridated water were evaluated in the Older Cohort.
The primary outcome was the proportion of children with clinical evidence of caries experience in their primary (Birth Cohort) or permanent teeth (Older Cohort). Unadjusted and adjusted regression models were used for analysis.
Results
The final clinical examinations for the Birth Cohort involved 1444 participants (mean age 4.8 years), where 17.4% of children in the intervention group were found to have caries experience, compared to 21.4% in the control group. A beneficial effect of water fluoridation was observed adjusting for deprivation (a socioeconomic measure), sex, and age, (adjusted odds ratio 0.74 95% CI 0.55 to 0.98). The final Older Cohort clinical examinations involved 1192 participants (mean age 10.8 years) where 19.1% of children in the intervention group were found to have caries experience compared to 21.9% in the control group (adjusted odds ratio 0.80, 95% CI 0.58 to 1.09). For both the Birth Cohort and Older Cohort there was evidence of a beneficial effect on dmft/DMFT count (IRR 0.61, 95% CI 0.44, 0.86) and (IRR 0.69, 95% CI 0.52, 0.93) respectively. No conclusive proof was found to indicate that the effectiveness of water fluoridation differed across area deprivation quintiles.
Conclusions
In the contemporary context of lower caries levels and widespread use of fluoride toothpaste, the impact of water fluoridation on the prevalence of caries was smaller than previous studies have reported. It is important to consider the clinical importance of the absolute reduction in caries prevalence against the use of other dental caries preventive measur
目标目的是评估水氟化计划对当代儿童群体的有效性：研究采用纵向前瞻性队列设计。研究采用纵向前瞻性队列设计，在英格兰坎布里亚招募了两组儿童，并对他们进行了为期 5-6 年的观察。出生队列由坎布里亚两家医院招募的家庭组成，这些家庭的孩子都是在重新实施水氟化之后出生的。出生组群对社区水氟化的全身和局部影响进行了评估。年长组群约 5 岁，在重新实施水氟化后不久从坎布里亚的小学中招募。老年队列主要评估氟化水的局部效果。主要结果是有临床证据表明乳牙（出生队列）或恒牙（老年队列）有龋齿的儿童比例。分析采用未调整和调整回归模型：出生队列中有1444名参与者（平均年龄为4.8岁）接受了最终临床检查，其中干预组有17.4%的儿童被发现患有龋齿，而对照组的这一比例为21.4%。在对贫困程度（一种社会经济衡量标准）、性别和年龄进行调整后，观察到水氟化的有益效果（调整后的几率比 0.74 95% CI 0.55 至 0.98）。最终的老年队列临床检查涉及 1192 名参与者（平均年龄为 10.8 岁），干预组中有 19.1% 的儿童被发现患有龋齿，而对照组中只有 21.9% 的儿童被发现患有龋齿（调整后的几率比为 0.80，95% CI 为 0.58 至 1.09）。有证据表明，出生队列和年长队列的 dmft/DMFT 计数（IRR 分别为 0.61，95% CI 0.44，0.86）和（IRR 分别为 0.69，95% CI 0.52，0.93）均有益处。没有发现确凿证据表明氟化水的效果因地区贫困程度的不同而不同：结论：在龋齿水平较低、含氟牙膏广泛使用的当代背景下，水氟化对龋齿流行率的影响比以往研究报告的要小。在使用其他龋齿预防措施的情况下，考虑龋齿发病率绝对值下降的临床重要性非常重要。
{"title":"The CATFISH study: An evaluation of a water fluoridation program in Cumbria, UK","authors":"Michaela Goodwin, Tanya Walsh, William Whittaker, Richard Emsley, Michael P. Kelly, Matt Sutton, Martin Tickle, Iain A. Pretty","doi":"10.1111/cdoe.12967","DOIUrl":"10.1111/cdoe.12967","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The objective was to assess the effectiveness of a Water Fluoridation program on a contemporary population of children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used a longitudinal prospective cohort design.</p>\u0000 \u0000 <p>In Cumbria, England, two groups of children were recruited and observed over a period of 5–6 years. The Birth Cohort consisted of families recruited from two hospitals in Cumbria where children were conceived after water fluoridation was reintroduced. The systemic and topical effects of community water fluoridation were evaluated in the Birth Cohort. The Older Cohort were approximately 5 years old and recruited from primary schools in Cumbria, shortly after water fluoridation was reintroduced. The predominantly topical effects of fluoridated water were evaluated in the Older Cohort.</p>\u0000 \u0000 <p>The primary outcome was the proportion of children with clinical evidence of caries experience in their primary (Birth Cohort) or permanent teeth (Older Cohort). Unadjusted and adjusted regression models were used for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The final clinical examinations for the Birth Cohort involved 1444 participants (mean age 4.8 years), where 17.4% of children in the intervention group were found to have caries experience, compared to 21.4% in the control group. A beneficial effect of water fluoridation was observed adjusting for deprivation (a socioeconomic measure), sex, and age, (adjusted odds ratio 0.74 95% CI 0.55 to 0.98). The final Older Cohort clinical examinations involved 1192 participants (mean age 10.8 years) where 19.1% of children in the intervention group were found to have caries experience compared to 21.9% in the control group (adjusted odds ratio 0.80, 95% CI 0.58 to 1.09). For both the Birth Cohort and Older Cohort there was evidence of a beneficial effect on dmft/DMFT count (IRR 0.61, 95% CI 0.44, 0.86) and (IRR 0.69, 95% CI 0.52, 0.93) respectively. No conclusive proof was found to indicate that the effectiveness of water fluoridation differed across area deprivation quintiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In the contemporary context of lower caries levels and widespread use of fluoride toothpaste, the impact of water fluoridation on the prevalence of caries was smaller than previous studies have reported. It is important to consider the clinical importance of the absolute reduction in caries prevalence against the use of other dental caries preventive measur","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christina P. C. Sim, Yun Hui Lee, Yu Fan Sim, Jennifer Wong, Shean Han Soh, Bee Tin Goh, Choy Yoke Poon, Patrick Finbarr Allen, Kee Seng Chia, Mun Loke Wong
Objectives
The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS).
Methods
A multi-stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face-to-face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC-AAP classifications. Weighted analysis was performed to adjust for oversampling, non-response and post-stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries.
Results
Six hundred and sixty-three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1–2-room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC-AAP classification, the prevalence of moderate–severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease.
Conclusions
Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio-economic gradient in the distribution of tooth loss, untreated dental caries and moderate-to-severe periodontitis was observed.
{"title":"Findings from the 2019 nationally representative oral health survey for adults in Singapore","authors":"Christina P. C. Sim, Yun Hui Lee, Yu Fan Sim, Jennifer Wong, Shean Han Soh, Bee Tin Goh, Choy Yoke Poon, Patrick Finbarr Allen, Kee Seng Chia, Mun Loke Wong","doi":"10.1111/cdoe.12961","DOIUrl":"10.1111/cdoe.12961","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multi-stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face-to-face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC-AAP classifications. Weighted analysis was performed to adjust for oversampling, non-response and post-stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six hundred and sixty-three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1–2-room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC-AAP classification, the prevalence of moderate–severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio-economic gradient in the distribution of tooth loss, untreated dental caries and moderate-to-severe periodontitis was observed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naichuan Su, Denise Duijster, Geert J. M. G. van der Heijden, Joost Oude Groeniger, Mariëlle A. Beenackers
Objectives
The study aimed to assess whether psychological distress mediates the association between financial strain and oral health and dental attendance in the Dutch adult population.
Methods
The study followed a cross-sectional design based on 2812 participants from the 2014 wave of the Dutch population-based GLOBE study. Financial strain was considered the exposure, while psychological distress measured with the Mental Health Inventory-5 (MHI-5) was the mediator. The outcomes included self-reported number of teeth, self-rated oral health, and self-reported dental attendance. Generalized regression analyses were used for the mediation analysis adjusted for several covariables.
Results
Greater financial strain was significantly associated with poorer self-rated oral health (total effect: 0.09, 95%CI: 0.05; 0.14) and restorative or no dental attendance (i.e. participants never visiting a dentist or only visiting a dentist for regular treatments or when they have complaints with their mouth, teeth, or prosthesis) (total effect: 0.05, 95%CI: 0.02; 0.09). Greater financial strain was not significantly associated with self-reported number of teeth (total effect: −0.14, 95%CI: −0.91; 0.64). Psychological distress significantly mediated the association of financial strain with self-rated oral health (average causal mediation effect [ACME]: 0.02, 95%CI: 0.01; 0.03) and self-reported dental attendance (ACME: 0.01, 95%CI: 0.00; 0.02), respectively. However, it did not significantly mediate the association of financial strain with self-reported number of teeth (ACME: −0.11, 95%CI: −0.25; 0.02). The estimated proportion of the total effect of financial strain on self-rated oral health and self-reported dental attendance that could be explained by psychological distress was respectively 24% (95%CI: 14%; 48%) and 19% (95%CI: 6%; 62%).
Conclusions
Psychological distress partly explains the association of financial strain with self-rated oral health and dental attendance, but not with self-reported number of teeth. Future studies using longitudinal data are necessary to confirm the results.
{"title":"The role of psychological distress in the relationship of financial strain with oral health and dental attendance in Dutch adults: A mediation analysis based on cross-sectional data","authors":"Naichuan Su, Denise Duijster, Geert J. M. G. van der Heijden, Joost Oude Groeniger, Mariëlle A. Beenackers","doi":"10.1111/cdoe.12974","DOIUrl":"10.1111/cdoe.12974","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The study aimed to assess whether psychological distress mediates the association between financial strain and oral health and dental attendance in the Dutch adult population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study followed a cross-sectional design based on 2812 participants from the 2014 wave of the Dutch population-based GLOBE study. Financial strain was considered the exposure, while psychological distress measured with the Mental Health Inventory-5 (MHI-5) was the mediator. The outcomes included self-reported number of teeth, self-rated oral health, and self-reported dental attendance. Generalized regression analyses were used for the mediation analysis adjusted for several covariables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Greater financial strain was significantly associated with poorer self-rated oral health (total effect: 0.09, 95%CI: 0.05; 0.14) and restorative or no dental attendance (i.e. participants never visiting a dentist or only visiting a dentist for regular treatments or when they have complaints with their mouth, teeth, or prosthesis) (total effect: 0.05, 95%CI: 0.02; 0.09). Greater financial strain was not significantly associated with self-reported number of teeth (total effect: −0.14, 95%CI: −0.91; 0.64). Psychological distress significantly mediated the association of financial strain with self-rated oral health (average causal mediation effect [ACME]: 0.02, 95%CI: 0.01; 0.03) and self-reported dental attendance (ACME: 0.01, 95%CI: 0.00; 0.02), respectively. However, it did not significantly mediate the association of financial strain with self-reported number of teeth (ACME: −0.11, 95%CI: −0.25; 0.02). The estimated proportion of the total effect of financial strain on self-rated oral health and self-reported dental attendance that could be explained by psychological distress was respectively 24% (95%CI: 14%; 48%) and 19% (95%CI: 6%; 62%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Psychological distress partly explains the association of financial strain with self-rated oral health and dental attendance, but not with self-reported number of teeth. Future studies using longitudinal data are necessary to confirm the results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12974","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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