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Community and individual socioeconomic inequalities and dental caries from childhood to adolescence: A 10-year cohort study 社区和个人社会经济不平等与儿童至青少年时期的龋齿:一项为期 10 年的队列研究。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-25 DOI: 10.1111/cdoe.12950
Bruna Brondani, Jessica K. Knorst, Thiago M. Ardenghi, Fausto M. Mendes, Mário A. Brondani

Purpose

To evaluate the effect of individual and contextual socioeconomic inequalities in the occurrence of untreated dental caries during the transition from childhood to adolescence.

Methods

This 10-year prospective cohort study followed up an initial sample of 639 1–5 years old schoolchildren from southern Brazil. After 7 and 10 years from the baseline (T1), two other reassessments were conducted (T2 and T3), respectively. Untreated dental caries was measured through the International Caries Detection and Assessment System (ICDAS- scores 3, 5 and 6) at T1 and T3. Socioeconomic status (SES) at the contextual and individual level was assessed at T1. At T2, socioeconomic, behavioural and psychosocial characteristics were evaluated as possible pathways of explanation. Structural equation modelling was used to estimate the direct and indirect effects among the variables over 10 years.

Results

A total of 429 adolescents were reevaluated at 10-year follow-up (cohort retention rate of 67.1%). About 30.6% presented untreated dental caries at T3. Low individual SES at T1 directly impacted a higher occurrence of dental caries at T3. Non-white skin colour at T1 also indirectly impacted a higher occurrence of dental caries at T3 through low individual SES at T1 and lower household income at T2. Contextual SES did not predict, directly or indirectly, dental caries at T3.

Conclusion

There is strong evidence that socioeconomic inequalities at the individual level play an important role on the occurrence of dental caries from childhood to adolescence. On the other hand, there was no evidence that contextual SES influences the occurrence of dental caries over time.

目的:评估在从儿童期向青少年期过渡的过程中,个人和环境的社会经济不平等对未经治疗的龋齿发生率的影响:这项为期 10 年的前瞻性队列研究对巴西南部 639 名 1-5 岁学龄儿童的初始样本进行了跟踪调查。从基线(T1)开始的 7 年和 10 年后,分别进行了两次重新评估(T2 和 T3)。在 T1 和 T3 阶段,通过国际龋齿检测和评估系统(ICDAS--评分 3、5 和 6)对未经治疗的龋齿进行了测量。在 T1 阶段,对环境和个人层面的社会经济地位(SES)进行了评估。在 T2 阶段,对社会经济、行为和社会心理特征进行了评估,将其作为可能的解释途径。采用结构方程模型估算了 10 年间各变量之间的直接和间接影响:共有 429 名青少年在 10 年的随访中接受了重新评估(队列保留率为 67.1%)。约30.6%的青少年在T3时出现了未经治疗的龋齿。T1时个人社会经济地位较低直接影响了T3时龋齿发生率的升高。通过 T1 的低个人社会经济地位和 T2 的较低家庭收入,T1 的非白色肤色也间接影响了 T3 的较高龋齿发生率。环境社会经济地位并不能直接或间接地预测 T3 的龋齿情况:结论:有确凿证据表明,个人层面的社会经济不平等对儿童到青少年时期的龋齿发生率起着重要作用。另一方面,没有证据表明社会经济背景会随着时间的推移影响龋齿的发生。
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引用次数: 0
Functional oral status and oral health-related quality of life in community-dwelling older adults in Singapore 新加坡社区老年人的口腔功能状况和与口腔健康相关的生活质量。
IF 2.3 3区 医学 Q1 Dentistry Pub Date : 2024-02-20 DOI: 10.1111/cdoe.12948
Pei Yuan Chan, Zhi Hui Janice Tan, Seyed Ehsan Saffari, Yu Jie Soh, Khim Hean Teoh

Objectives

The objectives were to investigate the association between oral functional status (defined by the number of functional teeth and functional occluding units [FOUs]) on oral health-related quality of life (OHRQoL). It also aimed to determine if dentures could compensate for the loss of FOUs in terms of OHRQoL in community-dwelling older adults in Singapore.

Methods

Community-dwelling older adults, aged 60 years and above, were recruited from a community-based oral health functional screening programme from 1 May 2018 to 31 December 2019. During the screening, an Oral Health Impact Profile-14 (OHIP-14) questionnaire and oral examination were administered. Statistical analysis was performed using the chi-square test, univariate logistic regression and multivariate predictive modelling.

Results

Data from 1037 participants were analysed (52% female; mean age 71.5 (SD 7.15)). The mean OHIP-14 score was 4.5 ± 7.2. The OHIP-14 scores were significantly associated with the number of functional teeth and the number of FOUs (p < .001). Having at least 20 functional teeth or 10 FOUs was associated with a significantly lower OHIP-14 score. Those with no FOUs had higher OHIP-14 scores compared to those with at least 10 FOUs, even in the presence of a satisfactory denture.

Conclusion

Maintaining at least 20 functional teeth or 10 FOUs was associated with better OHRQoL among community-dwelling older adults in Singapore. Dentures may have limited compensatory ability in terms of replacing natural functional occlusal units and maintaining OHRQoL.

研究目的目的:研究口腔功能状态(以功能性牙齿和功能性咬合单位的数量定义)与口腔健康相关生活质量(OHRQoL)之间的关系。研究还旨在确定假牙是否能弥补新加坡社区老年人丧失功能性咬合单位后的口腔健康相关生活质量:方法:从 2018 年 5 月 1 日至 2019 年 12 月 31 日的社区口腔健康功能筛查计划中招募了 60 岁及以上的社区老年人。筛查期间,进行了口腔健康影响档案-14(OHIP-14)问卷调查和口腔检查。统计分析采用了卡方检验、单变量逻辑回归和多变量预测模型:分析了 1037 名参与者的数据(52% 为女性;平均年龄 71.5 岁(SD 7.15))。OHIP-14的平均得分是4.5 ± 7.2。OHIP-14得分与功能性牙齿数量和FOU数量有明显相关性(P 结论:OHIP-14得分与功能性牙齿数量和FOU数量有明显相关性:在新加坡社区居住的老年人中,保持至少 20 颗功能性牙齿或 10 颗 FOU 与更好的 OHRQoL 有关。假牙在替代天然功能性咬合单位和维持 OHRQoL 方面的补偿能力可能有限。
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引用次数: 0
Oral health knowledge, attitudes and behaviours of adults: Findings from a National Oral Health Survey in Singapore 成年人的口腔健康知识、态度和行为:新加坡全国口腔健康调查的结果。
IF 2.3 3区 医学 Q1 Dentistry Pub Date : 2024-02-13 DOI: 10.1111/cdoe.12947
Mun Loke Wong, Yun Hui Lee, Yu Fan Sim, Tzu-Jung Wong, Shean Han Soh, Bee Tin Goh, Choy Yoke Poon, Patrick Finbarr Allen, Kee Seng Chia, Christina P. C. Sim

Objectives

Prevention complements the curative management of oral diseases. Effective preventive interventions involve the adoption of oral health promoting behaviours. Little is known about the awareness of oral disease and its prevention among Singaporean adults as well as their prevailing oral health attitudes and behaviours. The aim of the study was to describe the oral health knowledge, attitudes and behaviours of adults in Singapore.

Methods

A random sample of adults (≥21 years old) in Singapore was selected to complete an interviewer-administered questionnaire. The questionnaire gathered information about their knowledge of the aetiology, signs and symptoms as well as prevention of dental caries and periodontal disease; attitudes about the value of teeth, locus of control in maintaining oral health and oral health behaviours including toothbrushing, flossing and dental attendance.

Results

A total of 1196 adults of weighted mean age 48 years old with almost equal proportions of males and females responded to the questionnaire. Participants were more unaware about the causes of periodontal disease (25.7%) than dental caries (4%). While more than 90% of participants felt that healthy teeth were important and could affect their overall health, many (67.0%) felt it was natural to lose their teeth with old age. Among the participants, 83.5% brushed their teeth twice a day; 41.9% flossed their teeth and 53.9% visited the dentist at least once a year.

Conclusions

The study findings showed good knowledge around dental caries but some gaps around periodontal disease. It also found that participants perceived having limited control over preventing tooth loss. Irregular dental attendance and poor denture wearing habits were also noted. The findings shed light on key areas to focus on through oral health promotion to improve overall oral health.

目的:预防是口腔疾病治疗的补充。有效的预防干预措施包括采取促进口腔健康的行为。人们对新加坡成年人对口腔疾病及其预防的认识,以及他们普遍存在的口腔健康态度和行为知之甚少。本研究旨在描述新加坡成年人的口腔健康知识、态度和行为:方法:随机抽取新加坡成年人(≥21 岁)填写由访问者主持的调查问卷。问卷收集的信息包括:对龋齿和牙周病的病因、症状和体征以及预防的了解;对牙齿价值的态度;保持口腔健康的控制力;口腔健康行为,包括刷牙、使用牙线和看牙医:共有 1196 名成年人回答了问卷,加权平均年龄为 48 岁,男女比例几乎相等。与龋齿(4%)相比,参与者更不了解牙周病的病因(25.7%)。虽然超过 90% 的参与者认为健康的牙齿很重要,会影响他们的整体健康,但许多人(67.0%)认为随着年龄的增长,牙齿脱落是很自然的事情。在参与者中,83.5%的人每天刷牙两次;41.9%的人使用牙线清洁牙齿;53.9%的人每年至少看一次牙医:研究结果表明,参加者对龋齿的了解程度较高,但对牙周病的了解存在一定差距。研究还发现,参与者认为自己对预防牙齿脱落的控制能力有限。此外,还发现了看牙不规律和佩戴假牙习惯不良等问题。研究结果揭示了通过口腔健康宣传改善整体口腔健康需要关注的关键领域。
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引用次数: 0
Towards the integration of prevention and control of oral diseases within child primary healthcare: The case of Peru 将预防和控制口腔疾病纳入儿童初级保健:秘鲁案例。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-28 DOI: 10.1111/cdoe.12945
Ximena Concha Melgar, Diego Azañedo, Fernando Neves Hugo

Objectives

The Peruvian public health norm of primary healthcare (PHC) for growth and development medical check-ups (CRED, Spanish acronym) of children under 5 years of age was updated in 2017 with the inclusion of interdisciplinary prevention and control actions for oral diseases, such as dentist referral. The aim of this study was to explore the association between CRED and oral health services utilization (OHSU), throughout the heterogeneous Peruvian territory.

Methods

A population-based cross sectional study was conducted using the 2021 Demographic and Family Health Survey of Peru and included data from 15 836 children aged 12–59 months. Poisson generalized linear models were used to evaluate the association between any CRED and OHSU, in the 6 months prior to the survey, including sociodemographic characteristics of the children and their mothers as confounding variables. A possible effect modification by natural region of residence (Metropolitan Lima/rest of the Coast/Highlands/Jungle) was evaluated. To examine the robustness of the regression model, a sensitivity analysis was performed using the cumulative number of CRED.

Results

Children who had at least one CRED were almost twice as likely to report OHSU (aPR: 1.95; 95% CI: 1.73–2.21), which was greater in the regions of rest of the Coast (aPR: 2.56; 95% CI: 2.00–3.17) and Jungle (aPR: 2.03; 95% CI: 1.64–2.56). The sensitivity analysis showed consistent results for the association CRED-OHSU. Nevertheless, within the last 6 months, attendance at CRED and OHSU were only achieved by 43.7% and 13.7% of the children respectively.

Conclusions

Integrating oral health into Peruvian Child PHC seems to be a promising public health intervention to increase children's OHSU. For a greater scope, it is crucial to drive greater attendance at CRED and continuous monitoring and strengthening of CRED-based oral health promotion in all Peruvian natural regions with an equity-focused approach.

目标:秘鲁于2017年更新了5岁以下儿童生长发育体检(CRED,西班牙语缩写)的初级医疗保健(PHC)公共卫生规范,纳入了口腔疾病的跨学科预防和控制行动,如牙医转诊。本研究的目的是在秘鲁各地探索 CRED 与口腔健康服务利用率(OHSU)之间的关联:这项基于人口的横断面研究使用了 2021 年秘鲁人口与家庭健康调查的数据,包括 15 836 名 12-59 个月大的儿童的数据。研究采用泊松广义线性模型来评估调查前 6 个月内任何 CRED 与 OHSU 之间的关联,其中包括作为混杂变量的儿童及其母亲的社会人口特征。此外,还评估了自然居住区域(利马大都会区/沿海地区/高地/丛林)可能产生的影响。为了检验回归模型的稳健性,我们使用 CRED 的累积次数进行了敏感性分析:至少有一次 CRED 的儿童报告 OHSU 的可能性几乎是其他儿童的两倍(aPR:1.95;95% CI:1.73-2.21),在沿海其他地区(aPR:2.56;95% CI:2.00-3.17)和丛林地区(aPR:2.03;95% CI:1.64-2.56)报告 OHSU 的可能性更大。敏感性分析表明,CRED-OHSU 的关联结果是一致的。然而,在过去 6 个月中,分别只有 43.7% 和 13.7% 的儿童参加了 CRED 和 OHSU:将口腔健康纳入秘鲁儿童初级保健似乎是一项很有前景的公共卫生干预措施,可以提高儿童的 OHSU 率。为了扩大范围,必须推动更多的儿童参加儿童口腔保健中心,并以公平为重点,在秘鲁所有自然区持续监测和加强以儿童口腔保健中心为基础的口腔保健推广工作。
{"title":"Towards the integration of prevention and control of oral diseases within child primary healthcare: The case of Peru","authors":"Ximena Concha Melgar,&nbsp;Diego Azañedo,&nbsp;Fernando Neves Hugo","doi":"10.1111/cdoe.12945","DOIUrl":"10.1111/cdoe.12945","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The Peruvian public health norm of primary healthcare (PHC) for growth and development medical check-ups (CRED, Spanish acronym) of children under 5 years of age was updated in 2017 with the inclusion of interdisciplinary prevention and control actions for oral diseases, such as dentist referral. The aim of this study was to explore the association between CRED and oral health services utilization (OHSU), throughout the heterogeneous Peruvian territory.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A population-based cross sectional study was conducted using the 2021 Demographic and Family Health Survey of Peru and included data from 15 836 children aged 12–59 months. Poisson generalized linear models were used to evaluate the association between any CRED and OHSU, in the 6 months prior to the survey, including sociodemographic characteristics of the children and their mothers as confounding variables. A possible effect modification by natural region of residence (Metropolitan Lima/rest of the Coast/Highlands/Jungle) was evaluated. To examine the robustness of the regression model, a sensitivity analysis was performed using the cumulative number of CRED.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Children who had at least one CRED were almost twice as likely to report OHSU (aPR: 1.95; 95% CI: 1.73–2.21), which was greater in the regions of rest of the Coast (aPR: 2.56; 95% CI: 2.00–3.17) and Jungle (aPR: 2.03; 95% CI: 1.64–2.56). The sensitivity analysis showed consistent results for the association CRED-OHSU. Nevertheless, within the last 6 months, attendance at CRED and OHSU were only achieved by 43.7% and 13.7% of the children respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Integrating oral health into Peruvian Child PHC seems to be a promising public health intervention to increase children's OHSU. For a greater scope, it is crucial to drive greater attendance at CRED and continuous monitoring and strengthening of CRED-based oral health promotion in all Peruvian natural regions with an equity-focused approach.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569897","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}
引用次数: 0
Recalled body silhouette trajectories over the lifespan and oral conditions in adulthood: A cross-sectional analysis of the Paris Prospective Study 3 回顾人一生的身体轮廓轨迹与成年后的口腔状况:巴黎前瞻性研究 3》的横断面分析。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-25 DOI: 10.1111/cdoe.12946
Yara Saade, Omar Deraz, Eirini Chatzopoulou, Hélène Rangé, Pierre Boutouyrie, Marie-Cécile Perier, Catherine Guibout, Frédérique Thomas, Nicolas Danchin, Xavier Jouven, Philippe Bouchard, Jean-Philippe Empana

Objectives

To examine the association between life-course body silhouette changes and oral conditions in adulthood.

Methods

At study recruitment (2008–2012), 5430 adults underwent a full-mouth clinical examination and recalled their body silhouettes at ages 8, 15, 25, 35 and 45. Life-course trajectories of body silhouettes were computed using group-based trajectory modelling. Gingival inflammation, dental plaque, masticatory units, numbers of healthy, missing, decayed and filled teeth at study recruitment were clustered. The associations between body silhouette trajectories and clusters of oral conditions were assessed by multinomial logistic regression.

Results

The final analysis included 4472 participants. Five body silhouette trajectories were established: lean-stable (30.0%), lean-increased (19.3%), moderate stable (18.1%), lean-marked increased (25.8%) and heavy stable (6.7%). Three clusters of oral conditions were identified: optimal oral health and preserved masticatory capacity (70.0%, cluster 1), moderate oral health and moderately impaired masticatory capacity (25.4%, cluster 2) and poor oral health and severely impaired masticatory capacity (4.7%, cluster 3). Participants with a lean-increased trajectory were 58% more likely than those with a lean-stable trajectory to be in cluster 3 (aOR 1.58 [95% CI 1.07; 2.35]) relative to cluster 1, independently of covariates measured at study recruitment and including age, sex, smoking, socioeconomic status, BMI, hypertension, type 2 diabetes, cholesterol and triglycerides.

Conclusions

A life-course lean-increased body silhouette trajectory is associated with higher likelihood of poor oral health and severely impaired masticatory capacity in adulthood.

目的研究成年后身体轮廓变化与口腔状况之间的关系:在研究招募时(2008-2012 年),5430 名成年人接受了全口临床检查,并回忆了他们在 8、15、25、35 和 45 岁时的身体轮廓。采用基于群体的轨迹模型计算了身体轮廓的生命历程轨迹。对研究招募时的牙龈炎症、牙菌斑、咀嚼单位、健康牙齿数量、缺失牙齿数量、蛀牙数量和补牙数量进行了分组。通过多项式逻辑回归评估身体轮廓轨迹与口腔状况群组之间的关联:最终分析包括 4472 名参与者。确定了五种身体轮廓轨迹:瘦削稳定型(30.0%)、瘦削增加型(19.3%)、中度稳定型(18.1%)、瘦削明显增加型(25.8%)和重度稳定型(6.7%)。口腔状况分为三组:口腔健康状况最佳,咀嚼能力保持良好(70.0%,第 1 组);口腔健康状况中等,咀嚼能力中度受损(25.4%,第 2 组);口腔健康状况差,咀嚼能力严重受损(4.7%,第 3 组)。相对于第 1 组,精益增加轨迹的参与者进入第 3 组的可能性比精益稳定轨迹的参与者高 58%(aOR 1.58 [95% CI 1.07; 2.35]),不受研究招募时测量的协变量(包括年龄、性别、吸烟、社会经济地位、体重指数、高血压、2 型糖尿病、胆固醇和甘油三酯)的影响:终生瘦身-身体轮廓增加的轨迹与成年后口腔健康状况不佳和咀嚼能力严重受损的可能性较高有关。
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引用次数: 0
Dentists' perspectives on structural and system barriers hindering oral healthcare provision in residential care facilities 牙科医生对阻碍在住宿护理设施中提供口腔保健服务的结构性和系统性障碍的看法。
IF 2.3 3区 医学 Q1 Dentistry Pub Date : 2024-01-22 DOI: 10.1111/cdoe.12944
Sarah Mun Yee Koh, Sayaka Tada, Gabriel Keng Yan Lee, Mun Loke Wong

Objectives

Oral healthcare service is not well integrated with existing healthcare policy in nursing homes (NHs) globally. This qualitative study aimed to identify dentists' perspectives on structural and system barriers that hinder oral healthcare (OHC) provision to seniors in NHs in Singapore and to understand the consequences of these barriers.

Methods

Nineteen dentists (8 males and 11 females, 36.0 [IQR: 32.0–48.5] years old) were recruited through combination of purposive and snowball sampling. Four focus group discussions were conducted via teleconferencing, and each discussion had 4–5 anonymised participants. Sessions lasted 90–120 min and were audio-recorded and transcribed verbatim. Thematic analysis was conducted on data collected using NVivo software (Version12, QRS International).

Results

Participants agreed that the current OHC system for seniors in NHs is not well developed. The challenges dentists faced were categorised in three themes: [1] general oral healthcare system level; [2] local nursing home setting level; and [3] geriatric oral healthcare education level. These challenges are complexly intertwined and have contributed to several consequences such as a shortage of dentists in NHs and their diminished motivation to serve. It has also limited the quality of dental service they are able to provide in NHs, contributing to the current poor access of dental services for seniors in NHs.

Conclusions

Dentists in Singapore face many structural and systemic barriers in providing OHC to seniors in NHs, some of which are unique to the local context. Newfound understanding of these barriers and its consequences will be helpful in developing strategic approaches to overcome these challenges.

目的:在全球范围内,口腔保健服务并没有很好地与养老院(NHs)的现有医疗保健政策相结合。这项定性研究旨在确定牙医对阻碍新加坡养老院为老年人提供口腔保健服务的结构性和系统性障碍的看法,并了解这些障碍的后果:19名牙医(8男11女,36.0 [IQR:32.0-48.5]岁)通过有目的抽样和滚雪球抽样相结合的方式被招募。通过远程会议进行了四次焦点小组讨论,每次讨论有 4-5 名匿名参与者。讨论持续了 90-120 分钟,并进行了录音和逐字记录。使用 NVivo 软件(第 12 版,QRS International)对收集到的数据进行了主题分析:结果:参与者一致认为,目前在非营利性医疗机构中为长者提供的老年保健服务体系并不完善。牙医面临的挑战分为三个主题:[1] 一般口腔医疗保健系统层面;[2] 当地养老院环境层面;[3] 老年口腔医疗保健教育层面。这些挑战错综复杂地交织在一起,造成了一些后果,如养老院牙医短缺,服务积极性降低。这也限制了他们在非营利性医疗机构所能提供的牙科服务质量,导致目前非营利性医疗机构中的老年人难以获得牙科服务:新加坡的牙医在为养老院的老年人提供口腔保健服务时面临着许多结构性和系统性的障碍,其中一些是当地特有的。对这些障碍及其后果的新认识将有助于制定克服这些挑战的战略方法。
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引用次数: 0
Oral cancer epidemiology in relation to inter-country disparities in human development in south and Southeast Asia 口腔癌流行病学与南亚和东南亚国家间人类发展差距的关系。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-19 DOI: 10.1111/cdoe.12941
Muhammad Usman Amanat, Hutcha Sriplung, Duangporn Kerdpon

Objectives

South Asia (SA) and Southeast Asia (SEA) are geographically close; however, discrepancies in oral cancer (OC) epidemiology exist between the two regions. Socioeconomic disparities may influence the OC burden. The aim of this study was to assess the epidemiology of OC and its relationship with the Inequality Adjusted Human Development Index (IHDI) and its components in SA and SEA.

Methods

Cancer data for this ecological study was obtained from GLOBOCAN 2020, while the IHDI was obtained from the Human Development Report 2020. Based on data availability, 14 SA and SEA countries were chosen. Poisson log-weighted regression models were employed to examine IHDI and its components in relation to incidence and mortality. Univariate linear regression models were utilized to determine the association between the mortality-to-incidence ratio (MIR) and the IHDI.

Results

Mortality and MIR of OC were negatively correlated with all sub-indices of the IHDI, including education, health and income. However, incidence and mortality of OC were influenced by region and sex.

Conclusions

Higher IHDI countries tended to have lower MIR. SA and males showed higher incidence and mortality. Reducing intra-country inequalities in development may be a pragmatic approach to enhancing the OC burden and prognosis.

目的:南亚(SA)和东南亚(SEA)地理位置相近,但两个地区在口腔癌(OC)流行病学方面存在差异。社会经济差异可能会影响口腔癌的负担。本研究旨在评估南亚和东南亚地区口腔癌的流行病学及其与不平等调整后人类发展指数(IHDI)及其组成部分之间的关系:这项生态学研究的癌症数据来自《2020 年全球癌症数据》(GLOBOCAN 2020),而人类发展指数则来自《2020 年人类发展报告》(Human Development Report 2020)。根据数据可用性,选择了 14 个南澳和东南亚国家。研究采用泊松对数加权回归模型来检验 IHDI 及其组成部分与发病率和死亡率的关系。利用单变量线性回归模型确定死亡率与发病率之比(MIR)与 IHDI 之间的关联:结果:OC 的死亡率和 MIR 与 IHDI 的所有分指数(包括教育、健康和收入)均呈负相关。然而,OC 的发病率和死亡率受地区和性别的影响:结论:IHDI较高的国家往往具有较低的MIR。南澳大利亚和男性的发病率和死亡率较高。减少国家内部的发展不平等可能是减轻 OC 负担和改善预后的务实方法。
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引用次数: 0
Contesting the conventional wisdom of periodontal risk assessment 质疑牙周风险评估的传统智慧。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-19 DOI: 10.1111/cdoe.12942
Eero Raittio, Rodrigo Lopez, Vibeke Baelum

Over the years, several reviews of periodontal risk assessment tools have been published. However, major misunderstandings still prevail in repeated attempts to use these tools for prognostic risk prediction. Here we review the principles of risk prediction and discuss the value and the challenges of using prediction models in periodontology. Most periodontal risk prediction models have not been properly developed according to guidance given for the risk prediction model development. This shortcoming has led to several problems, including the creation of arbitrary risk scores. These scores are often labelled as ‘high risk’ without explicit boundaries or thresholds for the underlying continuous risk estimates of patient-important outcomes. Moreover, it is apparent that prediction models are often misinterpreted as causal models by clinicians and researchers although they cannot be used as such. Additional challenges like the critical assessment of transportability and applicability of these prediction models, as well as their impact on clinical practice and patient outcomes, are not considered in the literature. Nevertheless, these instruments are promoted with claims regarding their ability to deliver more individualized and precise periodontitis treatment and prevention, purportedly resulting in improved patient outcomes. However, people with or without periodontitis deserve proper information about their risk of developing patient-important outcomes such as tooth loss or pain. The primary objective of disseminating such information should not be to emphasize assumed treatment efficacy, hype individualization of care, or promote business interests. Instead, the focus should be on providing individuals with locally validated and regularly updated predictions of specific risks based on readily accessible and valid key predictors (e.g. age and smoking).

多年来,已经发表了多篇关于牙周风险评估工具的综述。然而,在反复尝试使用这些工具进行预后风险预测的过程中,仍然存在着很大的误区。在此,我们回顾了风险预测的原理,并讨论了在牙周病学中使用预测模型的价值和挑战。大多数牙周风险预测模型都没有根据风险预测模型开发指南进行正确开发。这一缺陷导致了一些问题,包括任意创建风险评分。这些分数往往被贴上 "高风险 "的标签,而对患者重要结果的基本连续风险估计却没有明确的界限或阈值。此外,尽管预测模型不能作为因果模型使用,但临床医生和研究人员显然经常将其误解为因果模型。文献中没有考虑到其他挑战,如对这些预测模型的可移植性和适用性进行严格评估,以及它们对临床实践和患者预后的影响。尽管如此,这些工具在推广时都声称能够提供更个性化、更精确的牙周炎治疗和预防,从而改善患者的治疗效果。然而,无论是否患有牙周炎,人们都应该获得有关其发生诸如牙齿脱落或疼痛等对患者至关重要的后果的风险的正确信息。传播此类信息的主要目的不应是强调假定的治疗效果、炒作个性化护理或促进商业利益。相反,传播的重点应该是根据容易获得的有效关键预测因素(如年龄和吸烟),为个人提供经过当地验证并定期更新的特定风险预测。
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引用次数: 0
Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey 土耳其儿童和成人的龋齿及相关因素:第三次全国口腔健康调查的结果。
IF 1.8 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-01-18 DOI: 10.1111/cdoe.12943
Ayse Isil Orhan, Afra Alkan, Kaan Orhan, Adnan Tezel, Serpil Karaoglanoglu, Dilek Oztas

Background

Information on the current status of oral health and related risk factors is lacking in Turkiye. This study aimed to evaluate dental caries and associated factors among the Turkish population using the findings of the third national oral health survey.

Methods

This cross-sectional epidemiological survey was carried out between March and September in 2018 including five index ages and age groups (5-, 12-, 15-year-olds, 35–44 and 65–74 age groups). A multistage cluster sampling design was used to obtain a national representative sample of these age groups. Participants were interviewed face-to-face using a structured questionnaire, and oral examinations were performed based on the methods and criteria suggested by the World Health Organization. The adjusted prevalence ratio for dental caries was estimated considering sociodemographic and behavioural characteristics by using log-binomial and robust Poisson regression analysis in R and SAS software.

Results

After data cleaning, a total of 11 091 participants remained. The prevalence of dental caries was 76.5% (95% confidence interval: 75.4%–77.7%) and determined to be associated with age, dental visit, and pain or discomfort history during the previous year among the Turkish population. Prevalence was also associated with the mother's education level among 5-, 12- and 15-year-olds. For the 35–44 age group, individuals living in urban areas had lower dental caries than those living in rural areas. For 65–74 age group, none of the factors were significantly associated with dental caries.

Conclusion

A high prevalence of dental caries was observed in Turkish children and adults. Therefore, it is necessary to strengthen current preventive oral health programs. Regular disease surveillance should be maintained. National oral health targets should be formulated in accordance with Turkiye's needs, resources and structure.

背景:土耳其缺乏有关口腔健康现状及相关风险因素的信息。本研究旨在利用第三次全国口腔健康调查的结果,评估土耳其人口中的龋齿及相关因素:这项横断面流行病学调查于 2018 年 3 月至 9 月间进行,包括五个指标年龄和年龄组(5 岁、12 岁、15 岁、35-44 岁和 65-74 岁年龄组)。调查采用多阶段聚类抽样设计,以获得这些年龄组的全国代表性样本。采用结构化问卷对参与者进行了面对面访谈,并根据世界卫生组织建议的方法和标准进行了口腔检查。在 R 和 SAS 软件中使用对数二项式和稳健泊松回归分析法估算了龋齿的调整患病率,并考虑了社会人口学和行为学特征:数据清理后,共有 11 091 名参与者。在土耳其人口中,龋齿患病率为 76.5%(95% 置信区间:75.4%-77.7%),并确定与年龄、牙科就诊、前一年的疼痛或不适病史有关。在 5 岁、12 岁和 15 岁的儿童中,患病率还与母亲的教育水平有关。在 35-44 岁年龄组中,城市居民的龋齿率低于农村居民。在 65-74 岁年龄组中,所有因素都与龋齿无明显关系:结论:据观察,土耳其儿童和成人的龋齿发病率很高。因此,有必要加强当前的口腔预防保健计划。应保持定期的疾病监测。应根据土耳其的需求、资源和结构制定国家口腔健康目标。
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引用次数: 0
Cultural diversity of traditions for the disposal of exfoliated teeth: Implications for researchers 处理脱落牙齿传统的文化多样性:对研究人员的启示。
IF 2.3 3区 医学 Q1 Dentistry Pub Date : 2024-01-12 DOI: 10.1111/cdoe.12928
Clara L. B. Parsons, Rebecca V. Mountain, Kristina Jacobsson, Felicitas B. Bidlack, Lisa Soleymani Lehmann, Erin C. Dunn

Objectives

For decades, researchers in anthropology and archaeology have used teeth, including exfoliated primary teeth, as fossil records of people's physical life experiences. Recently, researchers in psychiatry, epidemiology, environmental health and other fields have recognized the potential for teeth to serve as biomarkers of other early-life experiences, including trauma exposure and other types of psychosocial stress, which are potent determinants of later mental and physical health problems. Despite the emerging appreciation and value of teeth as biospecimens, little is understood about cultural beliefs and practices surrounding exfoliated teeth. If known, such insights could inform culturally appropriate practices for paediatric dental care and improve protocols for the ethical acquisition of teeth as biospecimens in research studies. To address this gap, a qualitative systematic review was performed to summarize the variety of traditions performed worldwide for disposing of primary exfoliated teeth.

Methods

PubMed, Google Scholar, AnthroSource, Anthropological Literature, EHRAF World Cultures and Anthropology Plus were searched with a systematic search strategy to identify articles published from inception through December 2, 2021. Citations of relevant papers were also forward and backward searched.

Results

There were 3289 articles that met the initial inclusion criteria, of which 37 were included after individual screening and applying exclusion criteria. Thematic analysis was used to identify 74 distinct traditions related to the disposal of exfoliated teeth, which were organized into seven general themes: (1) giving teeth to a tooth fairy, (2) giving teeth to mouse figures, (3) throwing teeth, (4) hiding/keeping teeth, (5) burying teeth, (6) giving teeth to animals and (7) eating the tooth.

Conclusions

The results of this study elucidate the diversity within—yet universality of—exfoliated tooth disposal traditions and underscore the importance of tooth exfoliation as a major milestone during child development. Special attention must be paid to these traditions and related ethical concerns when designing research protocols related to their collection. With a greater understanding of beliefs and practices related to exfoliated teeth, researchers will be better equipped to engage children and families in studies that include analyses of exfoliated teeth, collect teeth as biospecimens, and broaden the use of teeth in research.

研究目的数十年来,人类学和考古学研究人员一直使用牙齿(包括脱落的基牙)作为人们实际生活经历的化石记录。最近,精神病学、流行病学、环境健康和其他领域的研究人员认识到,牙齿有可能成为其他早期生活经历的生物标志物,包括创伤暴露和其他类型的社会心理压力,这些都是日后心理和身体健康问题的有力决定因素。尽管人们开始重视牙齿作为生物样本的价值,但对围绕脱落牙齿的文化信仰和习俗却知之甚少。如果了解了这些情况,就能为儿科牙科护理提供文化上适当的做法,并改进研究中以合乎道德的方式获取牙齿作为生物样本的规程。为了填补这一空白,我们进行了一项定性系统综述,总结了世界各地处理原生脱落牙齿的各种传统:方法:采用系统性检索策略对 PubMed、谷歌学术、AnthroSource、人类学文献、ERHRAF 世界文化和 Anthropology Plus 进行检索,以确定从开始到 2021 年 12 月 2 日发表的文章。此外,还对相关论文的引文进行了正向和反向检索:共有 3289 篇文章符合最初的纳入标准,其中 37 篇在经过单独筛选并应用排除标准后被纳入。通过主题分析,确定了 74 种与处理脱落牙齿有关的不同传统,并将其归纳为 7 个一般主题:(1) 将牙齿送给牙仙;(2) 将牙齿送给老鼠;(3) 扔掉牙齿;(4) 藏匿/保存牙齿;(5) 埋葬牙齿;(6) 将牙齿送给动物;(7) 吃掉牙齿:这项研究的结果阐明了剥落牙齿处理传统的多样性和普遍性,并强调了牙齿剥落作为儿童成长过程中一个重要里程碑的重要性。在设计与收集脱落牙齿相关的研究方案时,必须特别关注这些传统和相关的伦理问题。随着对脱落牙齿相关信仰和习俗的进一步了解,研究人员将能够更好地让儿童和家庭参与到包括脱落牙齿分析的研究中,收集牙齿作为生物样本,并扩大牙齿在研究中的应用。
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引用次数: 0
期刊
Community dentistry and oral epidemiology
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