Community dental health最新文献

This narrative review describes the impetus for health screening for non-communicable diseases in dental settings and highlights important considerations for evaluating such interventions. Real world cases are presented that showcase health screening interventions implemented in the UK. Non-communicable diseases including diabetes and cardiovascular disease are a global public health challenge. They are largely preventable by implementing lifestyle changes such as healthy eating and participation in physical activity, regular health screening for disease prevention, and/or early initiation of treatment. Hypertension case finding and control is one of the key five areas of focus for adult health, and oral health and diabetes are two of five key clinical areas for children and young people where efforts should be focused to intervene, improve outcomes and reduce inequalities. Links between oral and chronic diseases have been discussed in recent years. Therefore, screening for diabetes and cardiovascular disease has become of greater relevance to the dental profession. There is emerging evidence indicating that screening for the risk factors of cardiovascular diseases and diabetes in dental settings shows promise for improving health outcomes and may offer a cost-effective preventive approach for the detection of diabetes. Real-world services implementing health screening in dental settings have highlighted possibilities for the future and highlight the potential for the role of the dental team in detecting chronic diseases.

Objective: Retirement reduces income and increases dental care needs for the elderly, but there are few studies on unmet dental care needs among the low-income elderly. This study aimed to identify actors associated with unmet dental care needs of low-income elderly people in South Korea.

Method: Secondary analysis of 2020 KNHANES data relating to 1,016 elderly individuals (65+) below median income.

Results: Unmet dental care needs were higher for women at 28.9% (p ⟨0.001), those with a middle school education at 28.5% (p ⟨ 0.05), individuals who rated their health as "poor" at 31.3%, those reporting feelings of depression at 44.8% (p ⟨ 0.001), individuals who rated their oral health as "poor" at 36.2% (p ⟨ 0.001), and those who experienced toothache at 37.2% (p ⟨ 0.001). In regression analysis women (Risk Ratio = 1.59, 95% CI 1.09-2.32), people with depression (RR = 2.29, 95% CI 1.01-5.15), those who perceived their oral health as "poor" (3.20, 95% CI 1.90-5.32) and those toothache (1.88, 95% CI 1.27-2.76) had higher unmet dental needs.

Conclusion: Substantial unmet dental care needs exist among the low-income retired elderly. Comprehensive public oral health policies and community programs are needed for this population group.

Objective: To explore the role of socioeconomic factors, area deprivation and behaviours in explaining ethnic differences in the functional dentition among East London adults using multilevel modelling.

Methods: Data from a community-based health survey in East London included information on 1898 adults aged between 16 to 65 years old and belonging to 9 ethnic groups. Supervised questionnaires gathered information on demographic characteristics, socioeconomic indicators, dental behaviours and area deprivation (IMD 2007). A functional dentition was defined as having all 6 anterior plus at least 4 posterior contacts in clinical examination.

Results: The multilevel logistic regression showed that Black Africans were 75% (95%CI: 1.21-2.52) and Black Caribbean 77% (95%CI: 1.05-2.98) more likely to have a non-functional dentition than White British participants in fully adjusted models. Other factors associated with a non-functional dentition were older age and no educational attainment.

Conclusion: Black adults are at greater risk of non-functional dentition independently from sociodemographic characteristics, oral health-related behaviours and area-level characteristics. Proportionate universalism could be effective in reducing these health gaps.

Objectives: To determine the relationship between food insecurity and periodontitis among adults in the United States (US).

Methods: Secondary analysis of the 2009-2014 National Health and Nutrition Examination Survey data. The sample included 6,108 US participants aged ≥ 30 years in a probability weighted sample. Periodontitis status was measured in full-month oral examinations at 6 sites per tooth for clinical attachment loss and periodontal probing depth. Food insecurity was assessed by the 18-item US Food Security Survey Module.

Results: Controlling for covariates, multiple logistic regression showed that periodontitis was associated with low food security (adjusted odds ratio (aOR)=1.30, 95% CI: 1.08-1.57). Risk factors for periodontitis included HbA1c ≥ 7% (aOR=1.74, 95% CI: 1.26-2.40), seeking emergency dental care (aOR=1.36, 95% CI:1.19-1.55), smoking status, racial minorities, low income, and older age. Protective factors for periodontitis were annual dental visit (aOR=0.52, 95% CI: 0.43-0.64), health insurance (aOR=0.66, 95% CI: 0.54-0.80), female gender, and college education.

Conclusions: Food insecurity was associated with a higher risk of periodontitis among US adults. Having enough food to eat is a basic human right and would improve well-being.

Objective: To determine whether tooth loss relates to patient experiences of masticatory or aesthetic problems and is a useful measure of oral health and treatment needs and to compare experiences of tooth loss among middle-aged and older Danes.

Basic research design: Cross sectional online- and telephone interview questionnaire study.

Participants: 1,060 Danish citizens aged 40 years or older.

Main outcome measures: Experiences of difficulties eating/enjoying food or smiling/showing of teeth due to tooth related problems within the last 6 months. Data analysis used tests of proportions and ordinal logistic regression.

Results: Half the participants had a full or almost full dentition. Among those with tooth loss, 21-44% reported difficulties eating/enjoying food. In ordinal logistic regression, difficulties eating were associated with being younger, having fewer teeth and having visibly missing teeth. Being unwilling to smile or show one's teeth was associated with being younger, having fewer teeth, having lower socioeconomic position and having visibly missing teeth. Wearing a prosthesis did not ameliorate eating difficulties or unwillingness to smile.

Conclusions: Tooth loss is a meaningful measure of oral health but cannot stand alone. Many adults with even substantial tooth loss did not experience functional or aesthetic problems. Tooth loss is associated with negative masticatory and aesthetic experiences among middle-aged than older adults. Removable prostheses were not associated with better functional or esthetic outcomes.

Background: Nearly one billion individuals globally live with disabilities, facing greater risk of dental issues. Systematic reviews have identified barriers to oral health care for persons with disabilities (PWDs), but a comprehensive synthesis to inform health-policy guidelines is lacking. This overview addresses this gap by summarizing the key barriers to oral health care access for PWDs.

Objectives: (1) summarize key findings on the barriers PWDs encounter in seeking dental and oral healthcare, (2) evaluate the influence of disabilities on accessibility to dental and oral health services, and (3) identify facilitators to improve access and inform future health policy.

Methods: Systematic review of systematic reviews of both cross-sectional and evaluative studies that identified barriers to oral health care access for PWDs. A comprehensive search of databases was conducted from inception to 24 February 2024, using specific keywords and Boolean operators. Data extraction and quality assessment were performed using AMSTAR 2 to ensure transparency and reliability.

Results: Five systematic reviews were included. These reviews highlighted financial constraints, provider reluctance, access difficulties, systemic barriers, and patient-related factors as major obstacles. Methodological variations across reviews were noted, affecting the transparency and reliability of findings.

Conclusion: Barriers to oral health care access for PWDs include financial, provider-related, access-related, systemic, and patient-related factors. Addressing these barriers, particularly in developing countries, should be a priority for future research and interventions.

Objectives: To explore stakeholders' perceived barriers and facilitators to the inclusion of dental services in the Great North Care Record (GNCR) by identifying the stakeholders, exploring their perspectives and using the findings to inform integration of dental services in GNCR.

Methods: Qualitative online interview study with inductive thematic analysis.

Results: Twelve stakeholders identified through purposive sampling participated. Five key themes were identified: information accuracy, efficiency, safety and security, value of records and optimal GNCR design. Inclusion of dentistry in GNCR was favoured to improve information accuracy and efficiency. However, participants raised concerns about how information accessed would be handled safely and worries about intraprofessional criticism within dentistry. Others saw a real value in including dentistry in the GNCR.

Conclusions: This study demonstrates support for the inclusion of primary care dentistry in the GNCR, provided that the data are used responsibly, and that the system aids information safety and efficiency.

Objectives: Oral health plays an important role in determining quality of life, general health, and well-being in both children and adults. The wide variation in oral health status around the world is determined by multiple factors, including oral health behaviour (OHB). The aim of this study was to explore the association of some demographic factors with OHB in children aged 5 to 17 in Algeria.

Methods: Secondary analysis of cross-sectional data involving all children aged 5 to 17 in the Multiple Indicator Cluster Survey database, conducted in 2018-2019 (MICS-6), i.e., 17019 children (8882 boys and 8137 girls). Using a logistic regression model, we assessed the contribution of different demographic, economic, and geographical factors to children's OHB.

Results: The overall prevalence of good oral hygiene practices was 9.32% (8.30% for boys and 10.36% for girls). The main factors associated with good OHB were gender (OR=1.27 [95% CI = 1.135-1.437]), residence (OR=0.641 [0.553-0.742]), geographical area particularly in the southern and highlands regions (OR=0.369; [0.28-0.48]), older age, mother's level of education (OR=2.61 [2.12-3.21]), employment status, and economic level (OR=3.30 [2.64-4.12]).

Conclusions: The identification of factors related to OHB in children is of great interest in developing countries such as Algeria, to adopt planned and targeted health promoting interventions for children, adolescents, and parents.

Objectives: To assess the potential impact of dentin hypersensitivity on the quality of life in people with chronic systemic diseases.

Methods: We included 252 volunteers, 18 years or older, with ≥ 6 teeth, and under outpatient medical follow-up for systemic chronic diseases. Short Form Health Survey 36 (SF-36) was used to assess quality of life (QoL); Oral Health Impact Profile-14 (OHIP-14) and Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) were used for oral health-related quality of life (OHRQoL). Dentin hypersensitivity pain was assessed using an evaporative and tactile test, and pain assessment was performed using a numerical rating scale and a verbal rating scale. Medical information was obtained from anamnesis forms and the hospital digital medical records.

Results: Of 252 participants, 60% had dentin hypersensitivity. There was a negative impact on the QoL/OHRQoL of individuals with dentin hypersensitivity regarding the vitality, mental health, physical functioning, and bodily pain dimensions of SF-36, and the functional limitation, physical pain, physical disability, and psychological disability dimensions of OHIP-14. Dentin hypersensitivity appeared to exert an indirect influence on QoL.

Conclusion: Dentin hypersensitivity negatively impacts the quality of life in patients with chronic systemic diseases.

Objectives: This study aimed to assess the impact of virtual reality (VR) on reducing anxiety and pain in dental patients across all age groups and dental procedures.

Methods: Systematic review with comprehensive search of PubMed and Cochrane Library databases for randomized controlled trials (RCTs) comparing VR interventions with non-VR methods in dental settings up to April 2024. The selection followed the PRISMA-P guidelines. Inclusion criteria were based on the PICOS framework, focusing on studies involving dental patients of any age, utilizing VR during dental treatments, and reporting outcomes on anxiety and pain. Data extraction and quality appraisal were performed independently by two reviewers using the ROB-2 tool and GRADE methodology. Meta-analyses used a random-effects model.

Results: Twenty-seven studies met the inclusion criteria, encompassing several dental treatments. In meta-analysis VR reduced anxiety in children (SMD -1.44, 95% CI -2.24 to -0.63) but not adults (SMD -0.35, 95% CI -1.11 to 0.4). For pain reduction, VR was effective in both children (SMD -1.11, 95% CI -1.65 to -0.57) and adults (SMD -0.59, 95% CI -1.187 to -0.001). Heterogeneity was high across studies, and evidence quality ranged from low to moderate.

Conclusions: VR is a promising intervention for reducing anxiety and pain in children during dental procedures. Its effectiveness in adults is limited to pain reduction. High heterogeneity and risk of bias suggest that findings should be interpreted with caution. Further research is needed to standardize VR content and explore its varying impacts across different age groups and dental procedures.