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Effects of depression and stress on oral self-care among perinatal women in Appalachia: A longitudinal study 抑郁和压力对阿巴拉契亚围产期妇女口腔自我护理的影响:一项纵向研究。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-07-19 DOI: 10.1111/cdoe.12993
Jeongwi An, Christa Lilly, John R. Shaffer, Betsy Foxman, Mary L. Marazita, Daniel W. McNeil

Objectives

Oral health during the perinatal period and beyond affects the health and well-being of women and their offspring. Oral self-care behaviours can maintain or improve oral health; depression or stress during the perinatal period may compromise these behaviours. The aim of the study was to investigate the independent and combined effects of depression and stress on oral self-care behaviours of perinatal women in Appalachia, given the high burden of oral disease in this region.

Methods

A total of 1172 women in the first or second trimester of pregnancy were enrolled in the Center for Oral Health Research in Appalachia, cohort 2 (COHRA2) in West Virginia or Pittsburgh, Pennsylvania. Participants completed the Center for Epidemiological Studies Depression Scale, Perceived Stress Scale-10, and self-report items about oral self-care behaviours (i.e. toothbrushing and flossing) during pregnancy and five times in the 2+ years following birth. A Generalized Estimating Equation approach was used to analyse the longitudinal data.

Results

Maternal depression and stress were independently negatively related to toothbrushing and flossing frequency. These findings for toothbrushing were more pronounced in those with high levels of depression and high levels of stress, so there were both independent and combined effects. Frequency of toothbrushing and flossing stayed constant over time, so time was not associated with outcomes. About three-fourths of the sample reported toothbrushing levels that are consistent with established guidelines (i.e. two times daily), but almost half of the participants had very low levels of flossing (i.e. once or less a week).

Conclusion

Interventions targeting stress and depression throughout the perinatal period might be helpful in improving oral self-care behaviours and oral health among women in Appalachia, in addition to the benefit of decreasing emotional distress.

目标:围产期及以后的口腔健康影响着妇女及其后代的健康和幸福。口腔自我护理行为可以保持或改善口腔健康;围产期抑郁或压力可能会影响这些行为。鉴于阿巴拉契亚地区口腔疾病负担较重,本研究旨在调查抑郁和压力对该地区围产期妇女口腔自我护理行为的独立和综合影响:在西弗吉尼亚州或宾夕法尼亚州匹兹堡的阿巴拉契亚口腔健康研究中心队列 2(COHRA2)中,共招募了 1172 名怀孕前三个月或后三个月的妇女。参与者填写了流行病学研究中心抑郁量表、感知压力量表-10 和有关孕期口腔自我护理行为(即刷牙和使用牙线)的自我报告项目,并在产后 2 年多的时间里进行了 5 次自我报告。采用广义估计方程法对纵向数据进行了分析:结果:产妇抑郁和压力与刷牙和使用牙线的频率呈负相关。在高抑郁水平和高压力水平的人群中,刷牙的这些结果更为明显,因此存在独立效应和综合效应。随着时间的推移,刷牙和使用牙线的频率保持不变,因此时间与结果无关。约四分之三的样本报告的刷牙频率符合既定指南(即每天两次),但几乎一半的参与者使用牙线的频率很低(即每周一次或更少):结论:针对围产期压力和抑郁的干预措施可能有助于改善阿巴拉契亚妇女的口腔自我护理行为和口腔健康,此外还能减少情绪困扰。
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引用次数: 0
Prevalence and socioeconomic factors associated with non-utilization of dental care in Lebanon: A nationwide cross-sectional survey 黎巴嫩与不使用牙科保健相关的流行率和社会经济因素:一项全国性横断面调查。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-07-18 DOI: 10.1111/cdoe.12994
Dany Daou, Christiane Saliba, Loic Josseran

Objectives

To assess the prevalence of non-utilization of dental care in Lebanon and associated socioeconomic factors and self-care behaviours.

Methods

A nationwide, quantitative, survey-based study was conducted by trained interviewers with Lebanese residents aged ≥18 years between July and September 2019. Univariate analyses were performed using Pearson Chi Square test or the Fisher's exact test followed by a binary logistic regression using the SPSS Version 25.

Results

Of the 1070 participants, 247 (23.1%) did not utilise any type of healthcare and 144/247 (58.3%) did not utilise dental care. The prevalence of non-utilization of dental care was estimated at 13.5%. Only 4.7% of the respondents consulted their dentist in the past year, among which 53% cited pain/emergencies as the reason for their consultation. Socioeconomic factors associated with the non-utilization of dental care were lack of social medical insurance (OR, 0.49 [95% CI, 0.31 to 0.79]) and long waiting time/patient time restriction (OR, 2.05 [95% CI, 1.26 to 3.35]). On the other hand, facilitators for utilization of dental care included ethical standards/personal qualities of the dentist (OR, 0.53 [95% CI, 0.32 to 0.88]) and convenient cost with respect to the individual's economic status (OR, 0.28 [95% CI, 0.18 to 0.43]).

Conclusion

This study suggests that dental care practices in Lebanon, including the non-utilization of dental care, are suboptimal. Measures such as reducing sugar and tobacco consumption, providing information on oral hygiene, and using fluoride products are inexpensive; however, implementing these measures may take substantial time and input by multiple stakeholders.

目的评估黎巴嫩不使用牙科护理的普遍程度以及相关的社会经济因素和自我护理行为:在2019年7月至9月期间,由训练有素的访问员对年龄≥18岁的黎巴嫩居民进行了一次全国范围的定量调查研究。使用 SPSS 25 版进行单变量分析,采用 Pearson Chi Square 检验或 Fisher's exact 检验,然后进行二元逻辑回归:在 1070 名参与者中,有 247 人(23.1%)未使用任何类型的医疗保健,144/247 人(58.3%)未使用牙科护理。据估计,不使用牙科保健服务的比例为 13.5%。只有 4.7% 的受访者在过去一年中看过牙医,其中 53% 的受访者认为疼痛/紧急情况是他们看牙医的原因。与不使用牙科护理相关的社会经济因素是缺乏社会医疗保险(OR,0.49 [95% CI,0.31 至 0.79])和等候时间长/患者时间限制(OR,2.05 [95% CI,1.26 至 3.35])。另一方面,使用牙科保健的促进因素包括牙医的道德标准/个人素质(OR,0.53 [95% CI,0.32 至 0.88])和与个人经济状况相关的便利费用(OR,0.28 [95% CI,0.18 至 0.43]):本研究表明,黎巴嫩的牙科保健做法(包括不使用牙科保健)并不理想。减少糖和烟草消费、提供口腔卫生信息、使用含氟产品等措施成本低廉;然而,实施这些措施可能需要大量时间和多方利益相关者的投入。
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引用次数: 0
Making the case for a new typology of dental care systems 为新的牙科保健系统分类提供依据。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-07-10 DOI: 10.1111/cdoe.12992
Carol C. Guarnizo-Herreño, Ankur Singh, Manu Raj Mathur, Shilpa Sarawagi, Marco A. Peres

Background and Rationale

Dental care systems have the potential to influence population oral health and patterns of socioeconomic inequalities. Therefore, understanding the impact of the ways in which countries fund, provide, and organize their dental care services is key in the analysis of determinants of oral health. In this commentary we offer a synopsis of recent typologies of healthcare systems, based on a rapid review, and highlight that none of them fit dental care services given the separation of dental care from general healthcare provision in many countries. The paper also summarizes evidence on dental care systems as determinants of population oral health and argues why a new typology of dental care systems is needed.

Challenges and Ways Forward

We argue that a typology must consider institutional arrangements, structures, and processes behind the provision of dental care, and that specific dimensions/variables that inform the typology should result from a process of discussion and consensus. Some methodological considerations for developing typologies are also discussed, including the challenges in the collection and analysis of data followed by an advanced cluster analysis. Despite their limitations, typologies have evolved into an essential tool for comparing the similarities and differences of healthcare systems across countries. Therefore, a dental specific typology for health systems will be useful for researchers, policymakers, and dental professionals to characterize the provision of dentalcare services in different countries. This will also enable examining their potential role as determinants of population oral health and inequalities.

背景和基本原理:牙科保健系统具有影响人口口腔健康和社会经济不平等模式的潜力。因此,了解各国资助、提供和组织牙科保健服务的方式对口腔健康决定因素分析的影响至关重要。在这篇评论中,我们根据快速综述对最近的医疗保健系统类型学进行了概述,并强调,鉴于许多国家的牙科保健与普通医疗保健的提供是分离的,因此它们都不适合牙科保健服务。本文还总结了牙科保健系统作为人口口腔健康决定因素的证据,并论证了为什么需要对牙科保健系统进行新的分类:我们认为,类型学必须考虑提供牙科保健背后的制度安排、结构和过程,而类型学的具体维度/变量应该是讨论和共识的结果。此外,还讨论了制定类型学的一些方法上的考虑因素,包括在收集和分析数据后进行高级聚类分析所面临的挑战。尽管有其局限性,但类型学已发展成为比较各国医疗体系异同的重要工具。因此,一个针对牙科的医疗系统类型学对于研究人员、政策制定者和牙科专业人士来说是非常有用的,可以用来描述不同国家牙科保健服务的提供情况。这也将有助于研究其作为人口口腔健康和不平等决定因素的潜在作用。
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引用次数: 0
Correction to ‘the oral health landscape in Singapore: A commentary on key features, challenges and future policies’ 更正 "新加坡的口腔健康状况:关于主要特点、挑战和未来政策的评论"。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-07-01 DOI: 10.1111/cdoe.12991

Lee GKY, Wong KY, Lee WZ, Chng CK. The oral health landscape in Singapore: A commentary on key features, challenges and future policies. Community Dent Oral Epidemiol. 2024;52:259–264. doi:10.1111/cdoe.12927.

In the Abstract, the text ‘The findings reported 34.8% having untreated dental caries, and 15.7% and 41.2% experiencing moderate and severe periodontitis, respectively.’ was incorrect. This should have read: ‘The findings reported 34.8% having untreated dental caries, and 41.2% and 15.7% experiencing moderate and severe periodontitis, respectively.’

We apologise for this error.

Lee GKY, Wong KY, Lee WZ, Chng CK.新加坡的口腔健康状况:关于主要特征、挑战和未来政策的评论。Community Dent Oral Epidemiol.2024;52:259-264. doi:10.1111/cdoe.12927.In the Abstract, the text 'The findings reported 34.8% having untreated dental caries, and 15.7% and 41.2% experiencing moderate and severe periodontitis, respectively.'有误。我们对此错误表示歉意。
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引用次数: 0
Oral health literacy, knowledge, practice and beliefs among Asian Americans: A scoping review 亚裔美国人的口腔健康素养、知识、实践和信仰:范围综述。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-23 DOI: 10.1111/cdoe.12988
Rohit Baal Balasundaram, Sarpong Boateng, R. Andrew Yockey, Hayley Yording, Duong Tran, Uyen-Sa D. T. Nguyen
<div> <section> <h3> Objectives</h3> <p>The Asian American (AsA) population is at high risk for poor oral health outcomes and remains an underserved and understudied community. Low oral health literacy could explain poor oral health behaviours, practices and outcomes in this population. The aims were as follows: (i) provide a scoping review of oral health literacy, knowledge, practice and beliefs among AsA individuals residing in the United States; (ii) identify any instruments or tools translated into participants' language and (iii) determine whether the translated instruments had been assessed for validity and reliability.</p> </section> <section> <h3> Methods</h3> <p>The current study used a scoping review framework based on PRISMA-ScR that included rigorous eligibility criteria, search strategy, independent selection process with adjudication, and standardized reporting of outcomes. The search was conducted on March 14, 2022, and updated on February 25, 2023 and February 13, 2024, in the following databases: Ovid MEDLINE, Embase, Web of Science and CINAHL.</p> <p>Peer-reviewed original research on oral health literacy, knowledge, awareness, practice, and beliefs related to oral health care in AsA subgroups published in English were included.</p> <p>Two reviewers independently assessed whether titles and abstracts should be included for review, with discrepancies adjudicated by a third reviewer. Data extracted from articles used a standard template that included study design, and measurement tools of oral health, knowledge, awareness, practice and beliefs, as well as results and conclusions of the publication. In addition, the template captured whether the translated and original measurement tools were assessed for reliability and validity.</p> </section> <section> <h3> Results</h3> <p>Of the 367 papers identified, 10 studies that met eligibility criteria were included in the final review. Of these, four studies used previously validated tools to assess oral health measurements in AsA. Only five of the studies translated the tools into the participants' native language. Although AsA exhibited lower oral health literacy than Whites but higher than Hispanics and African Americans, none of the translated tools were assessed for reliability and validity. Acculturation and country of birth were factors influencing oral health behaviours related to good oral health practice and utilization, with AsA born in the United States exhibiting higher oral health utilization than those born in their country of origin. Oral health beliefs played a significant role in dental care utilization among As
目标:亚裔美国人(AsA)是口腔健康不良后果的高风险人群,但仍然是一个服务不足和研究不足的社区。较低的口腔健康素养可以解释该人群不良的口腔健康行为、做法和结果。研究目的如下(i)对居住在美国的亚裔口腔健康素养、知识、实践和信仰进行范围性回顾;(ii)确定任何翻译成参与者语言的工具或手段;(iii)确定翻译后的工具是否经过有效性和可靠性评估:本研究采用了基于 PRISMA-ScR 的范围界定审查框架,其中包括严格的资格标准、检索策略、带裁定的独立筛选过程以及结果的标准化报告。检索于 2022 年 3 月 14 日进行,并于 2023 年 2 月 25 日和 2024 年 2 月 13 日在以下数据库中进行了更新:Ovid MEDLINE、Embase、Web of Science 和 CINAHL。纳入经同行评审的、以英语发表的关于AsA亚群口腔健康素养、知识、意识、实践和口腔保健相关信念的原创研究。两位审稿人独立评估是否应纳入标题和摘要进行审阅,不一致之处由第三位审稿人裁定。从文章中提取的数据采用标准模板,包括研究设计、口腔健康测量工具、知识、意识、实践和信仰,以及结果和出版物结论。此外,该模板还记录了翻译工具和原始测量工具是否经过可靠性和有效性评估:在确定的 367 篇论文中,有 10 项符合资格标准的研究被纳入最终审查。其中,四项研究使用了以前验证过的工具来评估 AsA 的口腔健康测量结果。只有五项研究将工具翻译成了参与者的母语。虽然亚裔口腔健康知识水平低于白人,但高于西班牙裔和非裔美国人,但没有一项翻译工具经过可靠性和有效性评估。文化程度和出生国是影响与良好口腔卫生实践和利用相关的口腔卫生行为的因素,在美国出生的亚裔比在其原籍国出生的亚裔表现出更高的口腔卫生利用率。口腔健康信仰在亚裔人口的牙科保健利用率中发挥着重要作用:关于亚裔美国人社区口腔健康的范围界定综述指出了一个重大的研究缺口,特别是缺乏有效的工具来评估口腔健康素养,而不同种族群体的口腔健康素养各不相同。综述指出,亚裔美国人的口腔健康素养普遍低于白人,但高于西班牙裔美国人和非裔美国人。在美国出生的亚裔口腔健康状况较好,这受到文化适应和出生国的影响。研究结果强调,有必要采用更全面、更适合文化背景的研究方法来解决这一多元化群体的口腔健康差异问题。
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引用次数: 0
Dental caries status and related factors among 12-year-old Somali school children in Hargeisa 哈尔格萨 12 岁索马里学龄儿童的龋齿状况及相关因素。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-23 DOI: 10.1111/cdoe.12990
Abdelrahman Eid Dahroug, Espen Kolstad Heen, Mohamed A. Hussein, Ahmed Ali Madar

Objectives

There is little data on the oral health conditions of Somali children. The aim was to assess the dental caries status and related risk factors of 12-aged children in primary schools in Hargeisa, Somaliland.

Methods

A school-based survey was conducted in Hargeisa in December 2022. Using 2-stage cluster sampling, 405 children (12-aged) were randomly selected from 16 primary schools. Data collection involved WHO structured interviewer-administered questionnaire and clinical examinations. The DMFT index was measured according to WHO criteria, and accordingly, the mean for the significant caries index (SiC) was calculated. The association between the DMFT and the relevant variables was analysed using negative binomial regression in STATA.

Results

The overall prevalence of dental caries was found to be 62.7%, with a mean DMFT of 1.7 and a SiC score of 3.7. Non-public school pupils showed significantly higher prevalence of dental caries and mean DMFT compared to public school counterparts (68.5% vs. 58.6%) and (1.91 vs. 1.48), respectively. Merely 14.7% of the participants utilized dental care services in the previous year. The multivariable analysis showed a significant positive association of the DMFT outcome with attending a non-public school (95% CI 1.16–2.12) and having many previous dental visits (95% CI 1.22–2.83). In the adjusted model, fathers of low education had children with better dental caries status (lower mean DMFT) than their well-educated counterparts. The mean DMFT was not significantly influenced by the factors sex, location, educational attainment (school class of the participants) and frequency of teeth cleaning.

Conclusion

Although the overall mean DMFT of school children in Hargeisa could be regarded low, the high levels of untreated caries especially in the one-third most affected are a cause for concern. Children enrolled in non-public schools formed the high-risk group. Preventive oral public health programs targeting Somali school children are recommended.

目的:有关索马里儿童口腔健康状况的数据很少。目的是评估索马里兰哈尔格萨小学 12 岁儿童的龋齿状况和相关风险因素:方法:2022 年 12 月,在哈尔格萨开展了一项以学校为基础的调查。采用两阶段群组抽样法,从 16 所小学随机抽取了 405 名儿童(12 岁)。数据收集包括世界卫生组织结构化访谈问卷和临床检查。根据世卫组织的标准测量了 DMFT 指数,并据此计算了重要龋齿指数(SiC)的平均值。在 STATA 中使用负二项回归分析了 DMFT 与相关变量之间的关联:龋齿总患病率为 62.7%,DMFT 平均值为 1.7,SiC 平均值为 3.7。与公立学校学生相比,非公立学校学生的龋齿患病率和平均 DMFT 分别为(68.5% 对 58.6%)和(1.91 对 1.48)。只有 14.7% 的参与者在过去一年中使用过牙科保健服务。多变量分析表明,DMFT结果与就读非公立学校(95% CI 1.16-2.12)和曾多次看牙医(95% CI 1.22-2.83)有显著正相关。在调整模型中,与受过良好教育的父亲相比,受教育程度低的父亲的子女龋齿状况较好(平均DMFT较低)。性别、地点、教育程度(参与者的学校班级)和洗牙频率等因素对平均 DMFT 没有明显影响:虽然哈尔格萨学龄儿童的平均龋齿指数总体上较低,但未经治疗的龋齿水平较高,尤其是在三分之一的高发人群中,这一点令人担忧。在非公立学校就读的儿童是高危人群。建议针对索马里学龄儿童开展口腔公共卫生预防计划。
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引用次数: 0
Assessing motivational interviewing integrity in the Toddler Oral Health Intervention study 评估幼儿口腔健康干预研究中动机访谈的完整性
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-21 DOI: 10.1111/cdoe.12987
Peggy C. J. M. van Spreuwel, Esther Voets, Janna Bruijning, Cor van Loveren, Geert J. M. G. van der Heijden, Katarina Jerković-Ćosić

Objectives

The Toddler Oral Health Intervention (TOHI) was launched in 2017 to promote oral health prevention at well-baby clinics, with a focus on parents with children aged 6–48 months. This study aims to evaluate the integrity of motivational interviewing (MI) as one of the core intervention pillars in the TOHI study.

Methods

The TOHI study was conducted at nine well-baby clinics in the central and southern regions of the Netherlands, with 11 trained oral health coaches (OHCs) delivering a tailored individual counselling programme. Audio recordings of counselling sessions were uploaded by the OHCs into an online portal for feedback and integrity evaluation purposes. A trained independent assessor evaluated MI integrity using the MITI 4.2.1 coding scale. IBM SPSS Statistics was used to analyse the data, with ratings on technical and relational components and behavior counts computed by adding up the scores and categorizing them into six key MI skills. Descriptive statistics, including frequencies, percentages and median scores with interquartile ranges, were calculated.

Results

The median ratings on the technical and relational components were 2.5 (IQR 2.0–3.5) and 3.5 (IQR 3.0–4.0) out of a maximum of 5, with 45% and 58% of recordings showing fair or good MI integrity, respectively. A median of 38% (IQR 25–55%) of complex reflections and a reflection-to-question ratio of 0.7 (IQR 0.4–1.0), with 47% and 24% of recordings showing fair or good MI integrity, respectively. Median counts of MI-adherent and non-adherent statements were 3.0 (IQR 2.0–5.0) and 0.0 (IQR 0.0–1.0), respectively. The duration of recordings and MI integrity varied among oral health coaches.

Conclusion

Overall, this study revealed that, while intensive training was provided, not all OHCs in the TOHI study met fair thresholds for MI integrity. These findings emphasize the necessity of ongoing training, reflection and support to achieve and maintain a fair or good level of MI integrity in clinical practice.

目的幼儿口腔健康干预(TOHI)于 2017 年启动,旨在促进健康婴儿诊所的口腔健康预防工作,重点关注有 6-48 个月大婴儿的父母。本研究旨在评估动机访谈法(MI)作为 TOHI 研究核心干预支柱之一的完整性。方法 TOHI 研究在荷兰中部和南部地区的九家婴儿健康诊所开展,由 11 名经过培训的口腔健康指导员(OHC)提供量身定制的个人咨询项目。口腔健康辅导员将辅导课的录音上传到一个在线门户网站,用于反馈和完整性评估。一名训练有素的独立评估员使用 MITI 4.2.1 编码量表对口腔信息管理的完整性进行评估。数据分析使用了 IBM SPSS 统计软件,通过将分数相加并归类为六种关键的多元智能技能,计算出技术和关系部分的评分以及行为计数。结果技术和关系部分的评分中位数分别为 2.5(IQR 2.0-3.5)和 3.5(IQR 3.0-4.0)(满分 5 分),分别有 45% 和 58% 的录音显示出一般或良好的管理信息系统完整性。复杂反射的中位数为 38%(IQR 25-55%),反射与问题的比率为 0.7(IQR 0.4-1.0),分别有 47% 和 24% 的记录显示出一般或良好的 MI 完整性。符合 MI 和不符合 MI 的中位数分别为 3.0(IQR 2.0-5.0)和 0.0(IQR 0.0-1.0)。总之,本研究表明,虽然提供了强化培训,但并非 TOHI 研究中的所有口腔保健教练都达到了口腔健康指导完整性的公平阈值。这些发现强调了持续培训、反思和支持的必要性,以便在临床实践中达到并保持管理信息系统完整性的一般或良好水平。
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引用次数: 0
Prevalence and severity of periodontal disease in the host community and Rohingya refugees living in camps in Bangladesh 孟加拉国难民营中收容社区和罗兴亚难民的牙周病患病率和严重程度。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-19 DOI: 10.1111/cdoe.12985
Khaleda Zaheer, Mohammad Jonayed Hossain, Israt Isha, Elsa Delgado-Angulo, Luigi Nibali

Objectives

To assess the prevalence and severity of periodontal disease of the Rohingya refugees and host community in Bangladesh.

Methods

An unpublished pilot was conducted for the sample size calculation. Two-stage cluster sampling method was used to select 50 participants from refugee camps and 50 from the host community. Structured questionnaire and periodontal examination were completed. Composite measures of periodontal disease were based on the World Workshop (WW) and Centers for Disease Control and Prevention-American Academy of Periodontology. Linear regression models, for clinical attachment level and periodontal pocket depth (PPD) and ordered logistic regression models, for composite measures, were fitted to test the association of periodontal measures and refugee status.

Results

Compared to the host community, a smaller percentage of refugees reported good oral health-related behaviours. Refugees exhibited lower levels of bleeding on probing but higher PPD, hence a higher proportion had severe stages of periodontitis.

As per the WW, prevalence of periodontal disease was 88% and 100% in the host and refugee groups, respectively. In the unadjusted models, refugees were three times more likely to have severe stages of periodontitis; this association was attenuated when adjusted for confounders (sociodemographic variables and oral health-related behaviours).

Conclusions

Prevalence of periodontitis was high both in the host community and refugees. The refugees exhibited a more severe disease profile. The oral health of both groups is under-researched impacting the response of the health system. Large-scale research systematically exploring the oral health of both groups will inform the design and delivery of community-based interventions.

目的:评估孟加拉国罗辛亚难民和收容社区牙周病的患病率和严重程度:评估孟加拉国罗辛亚难民和收容社区牙周病的患病率和严重程度:为计算样本量,进行了一次未发表的试验。采用两阶段聚类抽样法从难民营和收容社区各抽取 50 名参与者。完成结构化问卷调查和牙周检查。牙周病的综合测量以世界研讨会(WW)和美国疾病控制和预防中心-美国牙周病学会为基础。对临床附着水平和牙周袋深度(PPD)采用线性回归模型,对综合指标采用有序逻辑回归模型,以检验牙周指标与难民身份之间的关联:与东道社区相比,报告有良好口腔健康相关行为的难民比例较低。难民的探诊出血量较低,但PPD较高,因此患有严重牙周炎的比例较高。根据世界卫生组织的调查,东道主群体和难民群体的牙周病患病率分别为 88%和 100%。在未经调整的模型中,难民患有严重阶段性牙周炎的几率是普通人的三倍;在对混杂因素(社会人口变量和口腔健康相关行为)进行调整后,这种关联有所减弱:结论:东道国社区和难民的牙周炎患病率都很高。难民的病情更为严重。对这两个群体的口腔健康研究不足,影响了卫生系统的应对措施。对这两个群体的口腔健康进行系统的大规模研究将为设计和实施基于社区的干预措施提供信息。
{"title":"Prevalence and severity of periodontal disease in the host community and Rohingya refugees living in camps in Bangladesh","authors":"Khaleda Zaheer,&nbsp;Mohammad Jonayed Hossain,&nbsp;Israt Isha,&nbsp;Elsa Delgado-Angulo,&nbsp;Luigi Nibali","doi":"10.1111/cdoe.12985","DOIUrl":"10.1111/cdoe.12985","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the prevalence and severity of periodontal disease of the Rohingya refugees and host community in Bangladesh.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An unpublished pilot was conducted for the sample size calculation. Two-stage cluster sampling method was used to select 50 participants from refugee camps and 50 from the host community. Structured questionnaire and periodontal examination were completed. Composite measures of periodontal disease were based on the World Workshop (WW) and Centers for Disease Control and Prevention-American Academy of Periodontology. Linear regression models, for clinical attachment level and periodontal pocket depth (PPD) and ordered logistic regression models, for composite measures, were fitted to test the association of periodontal measures and refugee status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to the host community, a smaller percentage of refugees reported good oral health-related behaviours. Refugees exhibited lower levels of bleeding on probing but higher PPD, hence a higher proportion had severe stages of periodontitis.</p>\u0000 \u0000 <p>As per the WW, prevalence of periodontal disease was 88% and 100% in the host and refugee groups, respectively. In the unadjusted models, refugees were three times more likely to have severe stages of periodontitis; this association was attenuated when adjusted for confounders (sociodemographic variables and oral health-related behaviours).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Prevalence of periodontitis was high both in the host community and refugees. The refugees exhibited a more severe disease profile. The oral health of both groups is under-researched impacting the response of the health system. Large-scale research systematically exploring the oral health of both groups will inform the design and delivery of community-based interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 6","pages":"817-823"},"PeriodicalIF":1.8,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12985","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426542","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}
引用次数: 0
Dental antibiotic policies, stewardship, and implementation in India: A policy document analysis 印度的牙科抗生素政策、管理和实施:政策文件分析。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-18 DOI: 10.1111/cdoe.12989
Aarthi Bhuvaraghan, Rebecca King, John Walley, Badri Thiruvenkatachari, Vishal R. Aggarwal

Objectives

Dental antibiotic stewardship is crucial in low- and middle-income countries where the burden of antimicrobial resistance (AMR) is high and antibiotic misuse is common. Given that India is the most populous country, the largest antibiotic consumer and has a large dental prescriber population, this study investigated the extent to which current Indian policy and practice for dental antibiotic prescribing and stewardship aligns with the global policy and best practice.

Methods

The READ approach was used to identify and extract data and synthesize the findings. Policy documents on dental antimicrobial stewardship were identified using a systematic search strategy involving nine medical and grey literature databases (Medline, Global Health, Web of Science, Cochrane, CINAHL, Eldis, Global Index Medicus, Proquest and Opengrey), targeted websites (government organizations and dental regulatory bodies) and contact with experts. Framework analysis was used to code extracted data into themes related to dental antimicrobial stewardship.

Results

Of the 3039 records screened, 25 documents were included in the final analysis. The analysis showed a lack of guidelines or toolkits for appropriate antibiotic prescribing in dentistry in India. The treatment guidelines for antimicrobial use in common syndromes published by the Indian Council of Medical Research had no section or content for dental practitioners. Furthermore, the undergraduate dental curriculum developed by the Dental Council of India (DCI), included little content on appropriate antibiotic prescribing and no mention of AMR or stewardship. There were no educational resources either for dental practitioners or patients in the documents.

Conclusion

This document analysis showed that there was little or no mention of dental antibiotic prescribing guidelines in key policy documents such as the National Action Plan on AMR. In addition, contradictory and subjective information provided in some policy documents could encourage dentists and other health professionals such as general practitioners to prescribe antibiotics for common dental conditions for which they are contra-indicated. There is an urgent need to develop relevant guidelines and include these in Indian policy documents on AMR particularly the National Action Plan on AMR.

目的:在中低收入国家,牙科抗生素管理至关重要,因为这些国家的抗菌药耐药性(AMR)很高,滥用抗生素的现象也很普遍。鉴于印度是人口最多的国家,也是最大的抗生素消费国,同时拥有大量的牙科处方医生,本研究调查了印度目前的牙科抗生素处方和监管政策与实践在多大程度上与全球政策和最佳实践保持一致:方法:采用 "READ "方法识别和提取数据,并对研究结果进行综合。采用系统性检索策略,包括九个医学和灰色文献数据库(Medline、Global Health、Web of Science、Cochrane、CINAHL、Eldis、Global Index Medicus、Proquest 和 Opengrey)、目标网站(政府组织和牙科监管机构)以及与专家的联系,确定了有关牙科抗菌药物管理的政策文件。采用框架分析法将提取的数据编码为与牙科抗菌药物管理相关的主题:结果:在筛选出的 3039 份记录中,有 25 份文件被纳入最终分析。分析结果表明,印度牙科缺乏适当的抗生素处方指南或工具包。印度医学研究委员会发布的常见综合症抗菌药使用治疗指南中没有针对牙科医生的章节或内容。此外,印度牙科委员会(DCI)制定的牙科本科课程中几乎没有关于合理使用抗生素的内容,也没有提及AMR或管理。文件中也没有针对牙科医生或患者的教育资源:文件分析表明,在诸如《国家 AMR 行动计划》等重要政策文件中,很少或根本没有提及牙科抗生素处方指南。此外,一些政策文件中提供的自相矛盾和主观臆断的信息可能会鼓励牙医和其他医疗专业人员(如全科医生)为常见的牙科疾病开具抗生素处方,而这些疾病是不适合使用抗生素的。目前迫切需要制定相关的指导方针,并将其纳入印度的 AMR 政策文件,特别是《国家 AMR 行动计划》。
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引用次数: 0
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 牙科保险和牙科保健使用对美国联邦医疗保健中心患者口腔健康相关日常生活活动的影响。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-06-14 DOI: 10.1111/cdoe.12986
Tejasvita Chandel, Muath Aldosari, Steffany Chamut

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.

目的评估在美国卫生资源与服务管理局(HRSA)资助的健康中心就诊的患者中,牙科保险、牙科保健利用率和口腔健康对日常活动的影响之间的关联:这项横断面研究研究了 2014 年健康中心患者调查(HCPS),这是一项针对在美国健康中心接受治疗的患者的调查。考虑到社会人口学、牙科保险和牙科保健使用情况,研究人员进行了逻辑回归分析,以探讨口腔健康对日常活动领域(如学习/工作表现、睡眠、饮食/咀嚼、社交和家庭活动)产生影响的可能性:在 7002 名参与者中,有 6890 人自我报告了口腔健康对日常活动的影响。与儿童和青少年相比,18-44 岁的成年人报告对日常生活活动造成总体影响的可能性要高出 2.6 倍。在对社会人口统计学进行调整后,西班牙裔患者报告任何口腔健康相关影响的可能性较低,而到农村中心就诊的患者报告口腔健康相关损害的几率较高。延迟接受牙科治疗或在需要时无法获得牙科治疗的患者在日常活动中遇到困难的几率是其他患者的 4.5 倍:这项研究将有限的牙科保险和护理与影响日常生活的更多口腔健康问题联系在一起,尤其是在成年人、农村人口和那些面临牙科护理延误的人群中。这突出表明,有必要进行政策改革和干预,以改善牙科保健的可及性,从而减轻口腔健康状况不佳对弱势群体日常功能的不利影响。
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引用次数: 0
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Community dentistry and oral epidemiology
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