Community dentistry and oral epidemiology最新文献_第8页

Impact of the COVID-19 Pandemic on Antibiotic Prescribing by Dental Practitioners Across the United Kingdom's Four Countries: A Pharmacoepidemiological Study of Population-Level Dispensing Data, 2016–2023 2019冠状病毒病大流行对英国四个国家牙科医生抗生素处方的影响：2016-2023年人口水平配药数据的药物流行病学研究

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-03-10 DOI: 10.1111/cdoe.13037

Jonathan Bowman-Newmark, Amin Vahdati, Anup Karki, Linda Young, Gerry Cleary, Wendy Thompson

Objectives

To evaluate and compare the rates of antibiotic prescribing by dental practitioners across the constituent countries of the United Kingdom between March 2020 and August 2023 and to estimate the total ‘excess’ prescribing that occurred during this interval beyond the rates predicted based upon trends between March 2016 and February 2020.

Methods

Retrospective pharmacoepidemiological study of dental practitioners' antibiotic prescribing, by secondary analysis of population-level National Health Service dispensing data from England, Scotland, Wales and Health and Social Care dispensing data from Northern Ireland.

Results

Effective August 2023, the antibiotic items dispensed rate for each country remained in excess of that predicted based upon pre-pandemic trends. Between March 2020 and August 2023, those rates were 175.6, 227.2, 195.0 and 321.8 antibiotic items per 1000 population for England, Scotland, Wales and Northern Ireland, respectively. Those represented estimated total ‘excesses’ of 27.7% (95% confidence limit [CL], 14.8, 43.7), 43.3% (95% CL, 29.9, 60.0), 33.2% (95% CL, 20.4, 49.0) and 42.9% (95% CL, 27.6, 62.3). Pairwise comparisons showed statistically significant differences between England and Scotland, England and Northern Ireland, and Wales and Northern Ireland (p < 0.001), Scotland and Wales (p = 0.001), and Scotland and Northern Ireland (p = 0.009). There was no statistically significant difference between England and Wales.

Conclusions

With shared prescribing guidelines and a single professional regulatory framework, it was unsurprising that similar antibiotic prescribing trends were found across the United Kingdom. Further research is required to investigate the reasons for the differences.

目的评估和比较 2020 年 3 月至 2023 年 8 月期间英国各成员国牙科医生开具抗生素处方的比例，并估算在此期间根据 2016 年 3 月至 2020 年 2 月期间的趋势预测的比例之外的 "超额 "处方总量：对牙科医生的抗生素处方进行回顾性药物流行病学研究，并对英格兰、苏格兰、威尔士的全民健康服务配药数据以及北爱尔兰的健康与社会保健配药数据进行二次分析：从 2023 年 8 月起，每个国家的抗生素配药率仍高于根据大流行前趋势预测的配药率。2020 年 3 月至 2023 年 8 月期间，英格兰、苏格兰、威尔士和北爱尔兰每千人口的抗生素配药率分别为 175.6、227.2、195.0 和 321.8。估计总 "超标 "率分别为 27.7%（95% 置信限 [CL]，14.8, 43.7）、43.3%（95% 置信限，29.9, 60.0）、33.2%（95% 置信限，20.4, 49.0）和 42.9%（95% 置信限，27.6, 62.3）。配对比较显示，英格兰与苏格兰、英格兰与北爱尔兰、威尔士与北爱尔兰之间存在显著的统计学差异（p 结论：英格兰与苏格兰、英格兰与北爱尔兰、威尔士与北爱尔兰之间存在显著的统计学差异：在共享处方指南和单一专业监管框架的情况下，英国各地出现类似的抗生素处方趋势不足为奇。需要开展进一步研究，以探究造成差异的原因。

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引用次数: 0

The Exclusivity of ‘Vulnerable’: Exploring How a Canadian Community Dental Clinic Defines and Describes Its Targeted Population “脆弱”的排他性：探索加拿大社区牙科诊所如何定义和描述其目标人群。

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-28 DOI: 10.1111/cdoe.13035

Cheryl Arntson, Rob Shields, Minn N. Yoon

Objectives

Addressing inequitable oral health access is a global priority. In Canada, community dental clinics (CDCs) play a crucial role in this endeavour, yet limited resources necessitate strategically targeting communities for interventions. Various methods exist for defining communities and measuring outcomes, but how CDCs determine their target populations is under-researched. This study aimed to explore how decision-makers planning an inner-city CDC define the population they intend to serve.

Methods

Data was collected through key informant interviews, document analysis, and field observations. Purposive sampling was employed to select key informants and documents related to clinic planning and design. The researcher was immersed in the data throughout the study, which underwent inductive content analysis facilitated by NVivo software.

Results

Analysis included semi-structured key informant interviews (n = 11), textual data from public sources and key informants (n = 9), and field observations totalling 275 hours over 1 year (2020–2021). Key informants agreed that the clinic served a “vulnerable” population, but definitions of “vulnerable” varied. Initial coding revealed two distinct patient groups with differing portrayals. Based on five patient characteristics Sossauer et al. (2019) described, one group was portrayed positively, while the other was depicted negatively.

Conclusions

This study underscores the necessity of establishing a shared understanding of “vulnerability” in interdisciplinary projects like the CDC examined here. Assumptions about community groups hold significant consequences, shaping resource allocation, programme implementation, and policy decisions. It is imperative to critically assess who is making these decisions, their conception of vulnerability, and the repercussions of these beliefs on affected communities.

目标：解决口腔保健机会不平等的问题是全球的当务之急。在加拿大，社区牙科诊所（CDCs）在这一努力中发挥着至关重要的作用，但由于资源有限，必须战略性地针对社区进行干预。定义社区和衡量结果的方法多种多样，但对社区牙科诊所如何确定目标人群的研究却不足。本研究旨在探讨规划市内疾病预防控制中心的决策者如何界定他们打算服务的人群：方法：通过关键信息提供者访谈、文件分析和实地观察收集数据。在选择关键信息提供者和与诊所规划设计相关的文件时，采用了有目的的抽样方法。研究人员在整个研究过程中都沉浸在数据中，并在 NVivo 软件的帮助下对数据进行了归纳内容分析：分析包括半结构式关键信息提供者访谈（n = 11）、来自公共来源和关键信息提供者的文本数据（n = 9），以及为期一年（2020-2021 年）共计 275 个小时的实地观察。主要信息提供者一致认为诊所服务的是 "弱势 "人群，但对 "弱势 "的定义各不相同。初步编码显示有两个不同的患者群体，他们的描述也不尽相同。根据 Sossauer 等人（2019 年）描述的五个患者特征，一个群体被正面描述，而另一个群体则被负面描述：本研究强调了在跨学科项目中建立对 "脆弱性 "的共同理解的必要性，如本文所研究的疾病预防控制中心。对社区群体的假设具有重大影响，会影响资源分配、计划实施和政策决策。当务之急是批判性地评估谁在做这些决定、他们对脆弱性的概念以及这些信念对受影响社区的影响。

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引用次数: 0

Modelling Predictors of Homophily on Perceived Oral Health Status Among Social Network Ties in a Population of Public Housing Residents 公共住房居民社会网络关系中口腔健康状况同质性的建模预测因子。

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-26 DOI: 10.1111/cdoe.13034

Sharon M. Casey, Mabeline Velez, Robert McDonough, Julia C. Bond, Raul Garcia, Neha Gondal, Brenda Heaton

Purpose

Individual behaviours are often shared within social networks (homophily), suggesting network-level interventions hold promise for health promotion. Yet, little is known about oral health homophily. This study aimed to identify individual- and network-based predictors of oral health homophily among individual's (ego) social networks of public housing residents.

Methods

Respondents self-reported demographics, oral health status and associated risk behaviours (n = 277). They named social contacts (alters), reported on relationship attributes, demographics and behavioural characteristics (n = 889). Hypothesised predictors of oral health homophily included relationship attributes (e.g., contact frequency), respondent-level and shared characteristics. Oral health homophily was modelled using multilevel (hierarchical) logistic regression evaluating model attributes (AIC) to determine gains in explanatory power.

Results

Relationship strength, including high frequency of shared meals and contact, was associated with higher odds of oral health homophily (OR [95% CI]: 1.92 [1.05, 3.52] and 1.62 [1.00, 2.63], respectively). The best performing model included daily shared meals and contact, respondent age, smoking and oral health status.

Conclusions

Oral health homophily is predicted by relationship strength and ‘excellent/very good/good’ oral health. Respondents with poorer oral health and a smoking history were less homophilous in oral health. Multilevel interventions targeting oral health outcomes may benefit from accounting for social relationships.

目的：个体行为通常在社会网络中共享（同质性），这表明网络层面的干预措施有望促进健康。然而，人们对口腔健康的同质性知之甚少。本研究旨在找出公共住房居民个人（自我）社会网络中口腔健康同质性的个体和网络预测因子。方法：受访者自我报告人口统计学、口腔健康状况和相关危险行为（n = 277）。他们命名了社会联系人，报告了关系属性、人口统计和行为特征（n = 889）。口腔健康同质性的假设预测因子包括关系属性（如接触频率）、被调查者水平和共同特征。口腔健康同质性采用多层（分层）逻辑回归评估模型属性（AIC）来确定解释力的增益。结果：关系强度，包括共同进餐和接触频率高，与口腔健康一致性的几率较高相关（OR [95% CI]分别为1.92[1.05,3.52]和1.62[1.00,2.63]）。表现最好的模型包括每日共享膳食和接触、受访者年龄、吸烟和口腔健康状况。结论：口腔健康同质性可通过关系强度和口腔健康“优秀/非常好/良好”预测。口腔健康状况较差和有吸烟史的应答者口腔健康状况不太相似。针对口腔健康结果的多层次干预可能受益于对社会关系的考虑。

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引用次数: 0

Global Epidemiology and Socioeconomic Correlates of Salivary Gland Cancer From 2020 to 2040 2020 - 2040年唾液腺癌的全球流行病学和社会经济相关性

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-20 DOI: 10.1111/cdoe.13033

Seyed Ehsan Mousavi, Hoomaan Ghasemi, Morvarid Najafi, Seyed Aria Nejadghaderi

Objectives

To report the epidemiology and socioeconomic correlates of salivary gland cancers (SGCs) at global, regional and national levels by age, sex and country.

Methods

Data on the incidence and mortality of SGC for the year 2020 were extracted from the Global Cancer Observatory. The relationships between incidence and mortality rates with the human development index (HDI) and the ratio of current healthcare expenditure to gross domestic product were investigated using bivariate correlation tests. Also, projections for new cancer cases or mortalities in a specific nation or region between 2025 and 2040 were estimated by multiplying age-specific incidence or mortality rates, with the anticipated population for the years 2025–2040.

Results

In 2020, the global crude incidence and mortality rates of SGC were 0.69 and 0.29, respectively. Among the World Health Organization regions, the Americas and Africa had the highest SGC age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR), respectively. By HDI classification, the very high HDI group had the highest SGC ASIR at 0.69, whereas the low HDI group had the highest SGC ASMR at 0.49. Among different age groups, those aged 70+ had the highest SGC incidence and mortality crude rates. Globally, males had higher SGC incidence and mortality crude rates than females. A strong negative correlation was found between HDI and SGC ASMR and the mortality-to-incidence ratio (p < 0.001). By 2040, the global incidence and mortality numbers of SGC are projected to increase by 50% and 60%, respectively.

Conclusions

These findings provide crucial insight into the global distribution and disparities in SGC care quality. Furthermore, this report has the potential to aid in the planning of SGC control initiatives.

目的：报告全球、地区和国家各级按年龄、性别和国家划分的唾液腺癌（SGCs）的流行病学和社会经济相关性。方法：从全球癌症观测站提取2020年SGC的发病率和死亡率数据。采用双变量相关检验研究了发病率和死亡率与人类发展指数（HDI）和当前医疗保健支出与国内生产总值（gdp）之比之间的关系。此外，2025年至2040年期间某一特定国家或区域的新癌症病例或死亡率预测是通过将特定年龄的发病率或死亡率乘以2025年至2040年的预期人口来估算的。结果：2020年全球SGC粗发病率和死亡率分别为0.69和0.29。在世界卫生组织区域中，美洲和非洲分别是SGC年龄标准化发病率（ASIR）和年龄标准化死亡率（ASMR）最高的区域。按HDI分类，高HDI组SGC ASMR最高，为0.69，低HDI组SGC ASMR最高，为0.49。在不同年龄组中，70岁以上的SGC发病率和死亡率最高。在全球范围内，男性的SGC发病率和死亡率高于女性。HDI和SGC ASMR与死亡率-发病率之间存在很强的负相关(p)。结论：这些发现为SGC护理质量的全球分布和差异提供了重要的见解。此外，该报告有可能有助于SGC控制举措的规划。

{"title":"Global Epidemiology and Socioeconomic Correlates of Salivary Gland Cancer From 2020 to 2040","authors":"Seyed Ehsan Mousavi, Hoomaan Ghasemi, Morvarid Najafi, Seyed Aria Nejadghaderi","doi":"10.1111/cdoe.13033","DOIUrl":"10.1111/cdoe.13033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To report the epidemiology and socioeconomic correlates of salivary gland cancers (SGCs) at global, regional and national levels by age, sex and country.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on the incidence and mortality of SGC for the year 2020 were extracted from the Global Cancer Observatory. The relationships between incidence and mortality rates with the human development index (HDI) and the ratio of current healthcare expenditure to gross domestic product were investigated using bivariate correlation tests. Also, projections for new cancer cases or mortalities in a specific nation or region between 2025 and 2040 were estimated by multiplying age-specific incidence or mortality rates, with the anticipated population for the years 2025–2040.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 2020, the global crude incidence and mortality rates of SGC were 0.69 and 0.29, respectively. Among the World Health Organization regions, the Americas and Africa had the highest SGC age-standardised incidence rate (ASIR) and age-standardised mortality rate (ASMR), respectively. By HDI classification, the very high HDI group had the highest SGC ASIR at 0.69, whereas the low HDI group had the highest SGC ASMR at 0.49. Among different age groups, those aged 70+ had the highest SGC incidence and mortality crude rates. Globally, males had higher SGC incidence and mortality crude rates than females. A strong negative correlation was found between HDI and SGC ASMR and the mortality-to-incidence ratio (<i>p</i> < 0.001). By 2040, the global incidence and mortality numbers of SGC are projected to increase by 50% and 60%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings provide crucial insight into the global distribution and disparities in SGC care quality. Furthermore, this report has the potential to aid in the planning of SGC control initiatives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 3","pages":"316-328"},"PeriodicalIF":1.8,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467124","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

Why Aren't Antenatal Care Providers Adopting Oral Health Guidelines? A Qualitative Exploration 为什么产前保健提供者不采用口腔健康指南？质的探索。

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-18 DOI: 10.1111/cdoe.13030

Annika Wilson, Cailin Davies, Silvana Bettiol, Heather Bridgman, Leonard Crocombe, Ha Hoang

Objective

The current Australian Pregnancy Care guidelines recommend that antenatal care providers discuss oral health, provide advice and refer women to dental professionals as needed. However, the delivery of oral health recommendations in antenatal settings appears substandard. This study aimed to identify the barriers and enablers influencing antenatal care providers' adoption of the oral health guidelines.

Methods

A qualitative study was conducted using semi-structured interviews with a purposive sample of antenatal care providers in Tasmania, Australia. Data analysis followed a thematic coding method using the Capability, Opportunity, Motivation - Behaviour (COM-B) model and Theoretical Domains Framework to identify implementation barriers and enablers and to inform recommendations.

Results

Twenty-five antenatal care providers participated (midwives n = 14, general practitioners n = 10 and obstetrician-gynaecologist n = 1). Thirty-two explanatory themes were identified and mapped directly to six COM-B constructs and 11 Theoretical Domains Framework domains. Eight main themes were identified as both impeding and enabling when viewed in different contexts: (1) perceived patient knowledge and awareness; (2) professional oral health knowledge, training and skills; (3) awareness of the guidelines on oral health; (4) patient education and professional resources; (5) interprofessional collaboration and support; (6) streamlined referral processes and access to dental services; (7) perceived outcomes of oral health interventions; and (8) perceived professional responsibility related to oral health.

Conclusions

Key strategies include improvements to the promotion and dissemination of relevant guidelines, professional education and training, and development and adoption of oral health-centred models of care to support interprofessional collaboration. Future research should focus on developing brief and sustainable interventions that address antenatal care providers’ practice behaviours.

目的：目前的澳大利亚怀孕护理指南建议产前护理提供者讨论口腔健康，提供建议，并根据需要将妇女转介给牙科专业人员。然而，在产前环境中提供的口腔健康建议似乎不合格。本研究旨在确定影响产前保健提供者采用口腔健康指南的障碍和促进因素。方法：一项定性研究进行了半结构化访谈与目的样本的产前保健提供者在塔斯马尼亚州，澳大利亚。数据分析遵循主题编码方法，使用能力、机会、动机-行为（COM-B）模型和理论领域框架来识别实施障碍和推动因素，并为建议提供信息。结果：共有25名产前保健提供者参与调查（助产士14名，全科医生10名，妇产科医生1名）。确定了32个解释性主题，并将其直接映射到6个COM-B结构和11个理论领域框架领域。在不同的背景下，八个主要主题被确定为既阻碍又促进：(1)感知患者的知识和意识；(2)专业的口腔卫生知识、培训和技能；(3)对口腔健康指南的了解程度；(4)患者教育和专业资源；(5)跨专业协作与支持；(6)简化转介程序和提供牙科服务；(7)口腔健康干预措施的感知结果；(8)与口腔健康相关的职业责任感知。结论：关键战略包括改进相关指南的宣传和传播、专业教育和培训，以及制定和采用以口腔健康为中心的护理模式，以支持专业间合作。未来的研究应侧重于发展简短和可持续的干预措施，以解决产前保健提供者的实践行为。

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引用次数: 0

Adverse Childhood Experiences and the Co-occurrence of Poor Oral Health and Multimorbidity: Findings From the Canadian Longitudinal Study on Aging 不良童年经历与口腔健康不良和多种疾病的共同发生：来自加拿大老龄化纵向研究的发现。

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-18 DOI: 10.1111/cdoe.13032

Abby L. J. Hensel, Kathryn Nicholson, Kelly K. Anderson, Noha A. Gomaa

Objectives

To investigate the extent of the association of adverse childhood experiences (ACEs) with co-occurring poor self-reported oral health (SROH) and multimorbidity in middle-aged and older adults, and whether these associations differ by age and sex.

Methods

This cross-sectional study used data from 27 765 adults aged 45–85 years from the first follow-up wave (2015–2018) of the Canadian Longitudinal Study on Aging (CLSA). Four categories were generated to assess co-occurring SROH and multimorbidity: (i) good SROH, no multimorbidity; (ii) poor SROH, no multimorbidity; (iii) good SROH, multimorbidity and (iv) poor SROH and multimorbidity. Age-and sex-stratified multinomial logistic regressions were used to examine associations of ACEs (e.g. childhood maltreatment, neglect, parental death, serious illness or separation) with co-occurring poor SROH and multimorbidity, adjusted for the confounders race/ethnicity, income, level of education, smoking status and alcohol consumption.

Results

Over a third of participants reported having multimorbidity (35.3%), 10.4% reported poor SROH, and almost 30% of participants had experienced at least one ACE. There was a gradient in the association between higher ACEs and each of the health outcome categories, with the greater odds being for the co-occurrence of poor SROH and multimorbidity (OR = 1.37, 95% CI: 1.30, 1.44). The associations between ACEs and adverse health outcomes in later life were significant across age groups and sexes, with middle-aged females demonstrating the strongest associations.

Conclusions

ACEs are linked to an increased non-communicable chronic disease burden and poor oral health among middle-aged and older Canadians, highlighting the importance of prevention in early life and the focus on psychosocial factors over the life course for healthy aging.

目的：探讨不良童年经历（ace）与中老年人同时发生的不良自我报告口腔健康（SROH）和多病的关联程度，以及这些关联是否因年龄和性别而异。方法：本横断面研究使用了27765名年龄在45-85岁之间的成年人的数据，这些数据来自加拿大老龄化纵向研究（CLSA）的第一波随访（2015-2018）。产生了四个类别来评估同时发生的SROH和多病：(i)良好的SROH，无多病；（ii） SROH较差，无多病；（iii）良好的SROH，多病症；（iv）较差的SROH和多病症。使用年龄和性别分层的多项逻辑回归来检查ace（例如儿童虐待、忽视、父母死亡、严重疾病或分离）与同时发生的不良SROH和多病的关联，并根据混杂因素种族/民族、收入、教育水平、吸烟状况和饮酒进行调整。结果：超过三分之一的参与者报告有多重发病（35.3%），10.4%的参与者报告不良的SROH，近30%的参与者至少经历过一次ACE。较高的ace与每个健康结局类别之间存在相关性梯度，同时出现不良SROH和多病的几率更大（OR = 1.37, 95% CI: 1.30, 1.44）。ace与晚年不良健康结果之间的关联在不同年龄组和性别中都是显著的，其中中年女性表现出最强的关联。结论：ace与加拿大中老年人群非传染性慢性疾病负担增加和口腔健康状况不佳有关，强调了生命早期预防的重要性，以及对健康老龄化生命过程中社会心理因素的关注。

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引用次数: 0

Using Propensity Score Subclassification to Estimate the Population-Average Causal Effect of Temporomandibular Dysfunction Experience on Oral Health-Related Quality of Life Among Australian Adults 使用倾向评分亚分类估计澳大利亚成年人颞下颌功能障碍经历对口腔健康相关生活质量的人口平均因果效应。

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-17 DOI: 10.1111/cdoe.13027

Kamal Hanna, Ninuk Hariyani, Gloria Mejia, Lisa Jamieson, David S. Brennan

Background

Temporomandibular dysfunction (TMD) experience might impair oral health-related quality of life (OHRQoL). Causal inference using population-based cross-sectional data is challenging given the potential for bias. Propensity Score Subclassification (PS-Subclassification) provides a tool to mitigate confounding bias. The aim of this study was to estimate the Population-Average Treatment Effect (PATE) of having TMD experience among Australian adults on OHRQoL using PS-Subclassification and statistically estimated Minimally Important Differences (MID-S).

Method

Australia's National Survey of Adult Oral Health (NSAOH) 2004–06 data were used which included a Computer Assisted Telephone Interview, mailed questionnaire and oral epidemiological examination. Data included demographics, socioeconomics, caries experience (DMFT index), periodontitis, TMD experience using the TMD Diagnostic Criteria Question, the Oral Health Impact Profile (OHIP-14) and perceived stress. Analysis steps included: (1) generating propensity scores (PS) for TMD experience probability using causal model-derived confounders while incorporating survey design elements; (2) PS-Subclassification and weighting; (3) assessing common support and group balance and (4) estimating the PATE for TMD experience on OHIP-14 overall and domains scores using complex samples GLM.

Results

Of the 4063 NSAOH participants, 397 with TMD and 3656 without TMD were included in PS-Subclassification (all data were used) and shared common support for their PS and established adequate covariate balance (SMD < 0.2). Experiencing TMD had higher OHIP-14 total scores (B = 3.498, 95% CI: 2.218–4.778) with a small MID-S (Cohen's F² = 0.03). TMD experience impaired all OHIP-14 domains (p < 0.05) with physical pain and psychological domains among the highest impaired OHIP-14 domains with a small MID-S.

Conclusion

TMD experience impaired the overall OHRQoL measured by the OHIP-14 among Australian adults with a small MID-S. Physical pain and psychological domains were among the highest impaired OHRQoL domains with a small MID-S. Clinicians and policymakers might consider these findings to support TMD screening and patient-centred management.

背景：颞下颌功能障碍（TMD）经历可能会损害口腔健康相关生活质量（OHRQoL）。考虑到潜在的偏差，使用基于人群的横断面数据进行因果推断是具有挑战性的。倾向评分子分类（PS-Subclassification）提供了一种减轻混杂偏差的工具。本研究的目的是使用ps亚分类和统计估计的最小重要差异（MID-S）来估计澳大利亚成年人中有TMD经历的人群平均治疗效果（PATE）。方法：采用2004- 2006年澳大利亚全国成人口腔健康调查（NSAOH）资料，包括计算机辅助电话访谈、邮寄问卷和口腔流行病学检查。数据包括人口统计学、社会经济学、龋病经历（DMFT指数）、牙周炎、使用TMD诊断标准问题的TMD经历、口腔健康影响概况（OHIP-14）和感知压力。分析步骤包括：(1)结合调查设计元素，利用因果模型衍生的混杂因素生成TMD经验概率的倾向得分（PS）；(2) ps -分级及权重；(3)评估共同支持和群体平衡；(4)使用复杂样本GLM估计TMD经验在OHIP-14总体和领域得分上的PATE。结果：在4063名NSAOH参与者中，397名TMD患者和3656名非TMD患者被纳入PS亚分类（所有数据均被使用），并对他们的PS有共同的支持，并建立了足够的协变量平衡（SMD 2 = 0.03）。结论：TMD经历损害了OHIP-14的所有域(p)。结论：TMD经历损害了OHIP-14测量的总体OHRQoL。生理疼痛和心理领域是OHRQoL受损程度最高的领域，具有较小的MID-S。临床医生和决策者可能会考虑这些发现来支持TMD筛查和以患者为中心的管理。

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引用次数: 0

Developing a Prototype Home-Based Toothbrushing Support Tool for Families in Scotland: A Mixed-Methods Study With Modified Delphi Survey and Semi-Structured Interviews 为苏格兰的家庭开发一个基于家庭的牙刷支持工具的原型：一种混合方法的研究与改进的德尔菲调查和半结构化访谈。

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-12 DOI: 10.1111/cdoe.13031

Emma Fletcher, Andrea Sherriff, Denise Duijster, Maddelon de Jong-Lenters, Al Ross

<div> <section> <h3> Background</h3> <p>Scotland's National Oral Health Programme for Children, Childsmile, provides targeted home toothbrushing support for families of young children (0–3 years) in the home setting. The study describes the adaptation of an existing dental practice-based intervention from the Netherlands using pictorial cards (<i>Uitblinkers</i>) for use in the programme. The aims were to modify Uitblinkers for the setting and context in Scotland by: (1) identifying the barriers that parents/carers in need of extra support face in implementing supervised toothbrushing; (2) explore consensus about behaviour change techniques that are appropriate and valid to address these; and (3) making recommendations for the design of a co-produced home-support tool and identifying facilitators for implementation in practice.</p> </section> <section> <h3> Methods</h3> <p>A modified Delphi study was carried out consisting of two survey rounds with a purposively recruited expert panel (<i>n</i> = 21) to develop consensus on home toothbrushing barriers (aim 1), behaviour change techniques (aim 2) and considerations for implementation (aim 3). Proposition statements for the Delphi were derived from literature, discussions with project advisors and from <i>Uitblinkers</i>, an existing behaviour change intervention for parents developed by the Academic Centre for Dentistry Amsterdam (ACTA) and delivered in dental practice. Then 12 in-depth, semi-structured interviews were conducted with Dental Health Support Workers in Scotland (delivering the home support toothbrushing intervention) to gather the views on the proposed toothbrushing barriers, behaviour change techniques and considerations for implementation (aim 1 to 3). Delphi results are presented descriptively in terms of percentage agreement and priority ratings. Interview transcripts were analysed using Template Analysis.</p> </section> <section> <h3> Results</h3> <p>From the Delphi study, a final set of 11 overlapping child, parent and environmental/social toothbrushing barriers was agreed upon (aim 1), to be addressed through a tool based on applied Motivational Interviewing, and a combination of Operant Conditioning, Stimulus Control and Goal-Setting techniques (aim 2). Experts supported the tool as realistic for delivery in the home setting, provided staff were trained. A physical ‘paper’ tool was preferred to a proposed electronic version (aim 3). Themes from interviews were: (1) the barriers present an exhaustive set and are valid from staff experience with families; (2) Motivational interviewing is appropriate and fits with usual practice; (3) the included behaviour change techniques are wo

背景：苏格兰国家儿童口腔健康规划Childsmile为家庭环境中有幼儿（0-3岁）的家庭提供有针对性的家庭刷牙支持。该研究描述了在该方案中使用图片卡（Uitblinkers）的荷兰现有的基于牙科实践的干预措施的适应性。目的是修改Uitblinkers，以适应苏格兰的环境和背景：(1)确定需要额外支持的父母/照顾者在实施监督刷牙时面临的障碍；(2)探索关于行为改变技术的共识，这些技术是适当和有效的，以解决这些问题；(3)为设计共同制作的家庭支持工具提出建议，并确定在实践中实施的促进者。方法:一项改进的德尔菲研究由两轮调查组成，其中有目的地招募了一个专家小组（n = 21），以就家庭刷牙障碍（目标1）、行为改变技术（目标2）和实施考虑（目标3）达成共识。德尔菲的命题陈述来自文献、与项目顾问的讨论以及来自Uitblinkers。由阿姆斯特丹牙科学术中心（ACTA）开发并在牙科实践中交付的现有父母行为改变干预措施。然后，对苏格兰的牙科健康支持工作者进行了12次深入的半结构化访谈（提供家庭支持刷牙干预），以收集关于拟议的刷牙障碍、行为改变技术和实施考虑因素的意见（目标1至3）。德尔菲结果以百分比协议和优先级评级的方式描述性地呈现。访谈记录采用模板分析法进行分析。结果：从德尔菲研究中，最终达成了11个重叠的儿童、父母和环境/社会刷牙障碍（目标1），通过基于应用动机访谈的工具，以及操作性条件反射、刺激控制和目标设定技术的组合（目标2）来解决。专家们支持该工具在家庭环境中实现，只要员工接受培训。与拟议的电子版本相比，实体“纸质”工具更受欢迎（目标3）。访谈的主题是：(1)障碍是一套详尽的集合，从工作人员与家庭打交道的经验来看是有效的；(2)动机性访谈是适当的，符合惯例；(3)所包含的行为改变技巧是可行的；(4)工具在Childsmile家访操作范围内普遍可行；(5)该工具同样适用于有额外支持需要的儿童。结论：基于卡片的对话干预，为苏格兰家庭环境中的幼儿（0-3岁）家庭提供有针对性的家庭刷牙支持，借鉴荷兰的模板，已被认为值得进一步测试，基于专家共识和工作人员对所面临障碍的看法，适当的行为改变技术来解决这些问题，以及物理工具的设计。

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引用次数: 0

Sociodemographic Inequalities in Oral Health-Related Quality of Life in Older Adults: 15 Years Follow-Up of the 1932 and 1942 Birth Cohorts in Sweden 老年人口腔健康相关生活质量的社会人口不平等：瑞典1932年和1942年出生队列的15年随访

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-05 DOI: 10.1111/cdoe.13029

Anne Nordrehaug Åstrøm, Berit Mastrovito, Josefine Sannevik, Stein Atle Lie, Anders Johansson, Ann-Katrin Johansson

Objectives

Focusing on two birth cohorts of older adults, this study aimed to (1) describe the development of oral health-related quality of life (OHRQoL) across time from 2007 to 2022 and (2) assess sociodemographic inequalities in OHRQoL and whether these inequalities remain stable, widen or narrow during the follow-up period.

Methods

In 1992 and 2007 the 1942 and 1932 birth cohorts living in the Swedish counties of Örebro and Östergotland participated with 6346 (response 71.4%) and 3735 individuals (response 71.9%), respectively. Of the 6346 1942 birth cohort participants, 2479 (38.5% of baseline) completed postal follow-ups in 1997, 2002, 2007, 2012, 2017 and 2022. Of the 3735 1932 birth cohort participants, 751 (20% of baseline) participated also in 2012, 2017 and 2022. Oral impacts of daily performance (OIDP) and socio-demographic characteristics were assessed at each survey year. A cohort table depicted the prevalence rates of OIDP (OIDP > 0) across time, disentangling age, period and cohort effects. Logistic mixed models with interaction terms of each socio-demographic covariate and time were used to test differences in socio-demographic inequalities of oral impacts over time.

Results

Between 2007 and 2022, OIDP > 0 varied from 22.7% to 28.7% in the 1932 birth cohort (age 75–90) and from 25.3% to 26.6% in the 1942 cohort (age 65–80). Mixed models revealed that cluster specific odds ratios (ORs) for OIDP > 0 varied from 0.2 to 2.5 with respect to avoidance of dental care due to cost and health perceptions in the 1942 cohort. Corresponding OR estimates in the 1932 cohort were 0.2 and 2.1. In both cohorts, inequality estimates according to country of birth and education were smaller in 2022 than in 2007. In the 1932 cohort, inequality according to sex was larger in 2022 than in 2007.

Conclusion

Higher prevalence of oral impacts with increasing age and overtime were observed for both cohorts. Narrowing and widening of oral health socio-demographic disparities occurred. Further examination of the interaction of socio-demographic factors with age or time may allow for targeted policy strategies aimed to alleviate oral health disparities in older ages.

目的：本研究聚焦于两个老年人出生队列，旨在(1)描述2007年至2022年期间口腔健康相关生活质量（OHRQoL）的发展；(2)评估OHRQoL的社会人口不平等，以及这些不平等在随访期间是否保持稳定、扩大或缩小。方法：1992年和2007年，居住在瑞典Örebro和Östergotland县的1942年和1932年出生队列分别有6346人（应答71.4%）和3735人（应答71.9%）参与。在6346名1942年出生队列参与者中，2479名（占基线的38.5%）在1997年、2002年、2007年、2012年、2017年和2022年完成了邮政随访。在3735名1932年出生队列参与者中，751名（基线的20%）也参加了2012年，2017年和2022年。在每个调查年度评估日常工作的口腔影响（OIDP）和社会人口特征。一个队列表描述了OIDP的患病率（OIDP b>）在不同的时间，解开年龄，时期和队列效应。使用具有每个社会人口协变量和时间相互作用项的Logistic混合模型来检验口头影响的社会人口不平等随时间的差异。结果：2007年至2022年间，1932年出生队列（75-90岁）的OIDP >从22.7%变化到28.7%，1942年队列（65-80岁）的OIDP >从25.3%变化到26.6%。混合模型显示，在1942年队列中，由于成本和健康观念而避免牙科护理的OIDP群体特定比值比（ORs）从0.2到2.5不等。在1932年的队列中，相应的OR估计为0.2和2.1。在这两个队列中，2022年根据出生国和受教育程度估计的不平等程度都小于2007年。在1932年的队列中，2022年的性别不平等比2007年更严重。结论：在两组人群中，随着年龄的增长和时间的延长，口腔影响的患病率均较高。口腔健康的社会人口差距缩小和扩大。进一步研究社会人口因素与年龄或时间的相互作用，可能有助于制定有针对性的政策战略，以减轻老年人口腔健康差异。

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引用次数: 0

The Association Between Periodontal Status, Oral Health-Related Quality of Life and Self-Rated Oral Health in Socially Underprivileged Adolescents 社会贫困青少年牙周状况、口腔健康相关生活质量和自评口腔健康之间的关系

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Community dentistry and oral epidemiology

Pub Date : 2025-02-02 DOI: 10.1111/cdoe.13028

Andréia Coelho Gomes Ripardo, Adriana Corrêa de Queiroz, Ana Paula Corrêa de Queiroz Herkrath, Fernando José Herkrath, Janete Maria Rebelo Vieira, Juliana Vianna Pereira, Maria Augusta Bessa Rebelo, Mario Vianna Vettore

Objectives

To assess the associations between periodontal conditions, dental caries, sex, psychosocial factors, socioeconomic status, oral health-related quality of life (OHRQoL), and self-rated oral health among adolescents living in socially deprived neighbourhoods.

Methods

A school-based survey was conducted in a random sample of 406 12-year-old adolescents in 11 neighbourhoods in the East region of Manaus, Brazil. Gingival status, dental calculus (Community Periodontal Index), and dental caries (DMFT index) were registered through clinical examinations. Adolescents self-completed questionnaires to assess psychosocial factors (self-esteem, sense of coherence, and oral health beliefs), socioeconomic status (family income, parent's schooling, number of goods, and house crowding), oral health-related quality of life (OHRQoL) (CPQ_11–14), and self-rated oral health. Direct and indirect relationships between variables were tested using structural equation modelling guided by the Wilson and Cleary model.

Results

Greater gingival bleeding was directly associated with worse self-rated oral health. Poor OHRQoL was directly linked to the number of teeth with dental calculus, more teeth with dental caries experience, and worse psychosocial factors. Worse socioeconomic status and dental calculus were associated with gingival bleeding. Dental calculus and socioeconomic status were indirectly associated with self-rated oral health via gingival status. OHRQoL mediated the association of dental caries experience and psychosocial factors with self-rated oral health.

Conclusions

Gingival bleeding and dental calculus may negatively affect self-reported oral health in adolescents. Socioeconomic status and psychosocial factors were also relevant determinants for oral health in this age group.

目的：评估生活在社会贫困社区的青少年牙周状况、龋齿、性别、社会心理因素、社会经济地位、口腔健康相关生活质量（OHRQoL）和自评口腔健康之间的关系。方法：在巴西马瑙斯东部地区11个社区随机抽取406名12岁青少年进行校本调查。通过临床检查登记牙龈状况、牙石（社区牙周指数）、龋齿（DMFT指数）。青少年自行完成问卷，以评估心理社会因素（自尊、连贯感和口腔健康信念）、社会经济地位（家庭收入、父母受教育程度、物品数量和房屋拥挤程度）、口腔健康相关生活质量（OHRQoL）（CPQ11-14）和自评口腔健康。使用Wilson和Cleary模型指导的结构方程模型检验变量之间的直接和间接关系。结果：较多的牙龈出血与较差的自评口腔健康直接相关。较差的OHRQoL与患牙石的牙齿数量、有龋齿经历的牙齿数量和较差的心理社会因素直接相关。较差的社会经济地位和牙石与牙龈出血有关。牙石和社会经济地位通过牙龈状况与自评口腔健康间接相关。OHRQoL介导龋病经历和心理社会因素与自评口腔健康的关联。结论：牙龈出血和牙石可能对青少年自我报告的口腔健康产生负面影响。社会经济地位和社会心理因素也是这一年龄组口腔健康的相关决定因素。

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引用次数: 0