Community dental health最新文献

BackgroundAsylum seekers and refugees (ASR) experience disproportionately poor oral health due to socioeconomic disadvantage and barriers to accessing routine dental care. Although ASR are entitled to free dental treatment through HC2 exemption, practical challenges persist. Charitable organisations such as Dentaid provide mobile community clinics to address this gap.AimThis retrospective mixed-methods service evaluation assessed the accessibility, utilisation, and impact of Dentaid's dental clinics for ASR in England.MethodsQuantitative data from 88 clinics delivered across 11 locations between April 2023 and August 2024 were analysed. Variables included demographics, presenting complaint, treatment provided, and smoking status. A dental-charted subsample of 50 adults was compared with national data. Fisher's Exact Test explored differences between clinic sites. A SWOT-based stakeholder survey was performed and analysed thematically to identify barriers and facilitators in service delivery.ResultsA total of 647 patients received care, with 70% presenting in pain and 42% reporting smoking, almost double the national average. The subsample demonstrated high levels of untreated decay and previous extractions. Common treatments included restorations, extractions, and preventive care. Fisher's Exact Test reported no significant differences between sites. Stakeholders highlighted improved accessibility, cultural sensitivity, and reduced financial barriers, but reported challenges with consistent funding for follow-up clinics and interpreter provision.ConclusionsDentaid's clinics improved access to urgent and preventive care for ASR who struggle to use mainstream dental services. However, reliance on charitable provision reflects structural inequity. Integration with commissioned NHS pathways and sustained Inclusion Health support are required to ensure equitable, long-term access.

Objective: Assess the association between childhood dental visits and self-reported problems with mouth and gums in adulthood. Methods: Data came from the 1958 National Child Development Study (NCDS) and 1970 British Cohort Study (BCS70), two birth cohort studies following individuals born in the UK throughout their lives. Information on dental visits was collected at three points during childhood; and at adulthood, participants answered two questions regarding problems with their mouth and gums in the last year or persistently since age 16. The association between number of childhood dental visits and self-reported mouth and gums problems was tested in logistic regression models, crude and adjusted for socio-demographic factors and cohort year. Results: 15,885 participants were included in the analysis. Odds of persistent and last-year self-reported problems with mouth and gums decreased as the number of dental visits during childhood increased. The fully adjusted models showed participants visiting the dentist three times having 24% (OR: 0.76, 95%CI 0.59-0.98) lower odds of self-reported persistent mouth and gums problems; similarly, those visiting the dentist one, two and three times during childhood, were 26% (OR: 0.74; 95%CI 0.59-0.94), 25% (OR: 0.75; 95%CI 0.60-0.95), and 27% (OR:0.73; 95%CI 0.55-0.97) less likely to report problems with mouth and gums in the previous year as those who never visited the dentist. Conclusion: Regular dental visits during childhood are linked to fewer self-reported oral health problems in adulthood.

Dental caries remains a significant public health problem with almost a quarter of children in England having experience of caries by the time they are five. This implementation focused paper presents an overview of the local dental public health team working collaboratively with health visiting teams in the South West of England to deliver a multistranded oral health improvement programme embedded into the Healthy Child Programme. At aged nine to 12 months children receive a mandated health check conducted by health visitors which provides an opportunity to deliver an oral health intervention. The intervention, First Dental Steps, includes oral health training, distribution of oral health packs, a referral pathway for high-risk children and a data capture template. Health visiting teams have shown high levels of engagement with the initiative, which has also included the innovative recording of oral health information as part of clinical notes taken by health visiting teams. Implementation of First Dental Steps varied across local teams, with fidelity of programme delivery, such as distribution of oral health packs and appointment of oral health champions, differing between health visiting teams. This evaluation relied primarily on process-based outcomes, which posed challenges for health visitors to collect consistently due to differences in electronic patient record systems and the need for resource-intensive manual extraction in some localities. Future plans for the programme involve adapting the intervention for inclusion health groups and creating a repository of oral health resources for health visiting teams.

In response to overlooked oral health needs among hospitalised children in Alder Hey Children's Hospital (AHCH), an initiative known as 'Mini Mouth Care Matters' (MMCM), was implemented to improve children's mouthcare by appropriately training healthcare professionals (HCPs) to be confident and knowledgeable in assessing, providing and promoting oral health among hospitalised children. Commissioned by Liverpool City Council, the launch of MMCM in AHCH commenced in February 2024. Previous surveys in the hospital indicated a need for oral care training. Implementation of MMCM involved streaming an e-learning course and videos for HCPs and children on the hospital website, drop-in sessions in the wards, study day training sessions, allocation and training of champions and provision of mouth care packs. Several challenges were encountered during the preparation of the resources and the implementation of the intervention. One key lesson learned is that it is preferable for the manager or team responsible for implementation to come from within the organisation. This allows them to leverage their connections and navigate the hospital's workload dynamics. Theory-based process and outcomes evaluation is planned to understand the effect of MMCM implementation on its effectiveness and to study MMCM normalisation within routine clinical practice. The evaluation of MMCM will contribute to understanding the impact of oral health interventions in hospital settings and will inform future strategies to improve oral care practices and outcomes for hospitalised children.

Introduction: Oral health, though linked with overall health and well-being, is often neglected in low- and middle-income countries such as India. Tooth loss, primarily caused by dental caries and periodontal disease, has been associated with malnutrition, obesity, cardiovascular disease, diabetes, and even mortality. Despite the increasing burden of multiple long-term conditions (MLTCs), limited research in India has explored the association between tooth loss and MLTCs. The study aimed to estimate the prevalence of complete tooth loss and assessed its association with MLTCs using nationally representative data from the second wave of the Study on Global Ageing and Adult Health (SAGE).

Methods: The study utilized data from the second wave of SAGE conducted in 2015 in India. Data collection covered six states using a multistage stratified sampling approach. MLTCs were defined as the co-occurrence of two or more chronic conditions, assessed via self-reported diagnoses and clinical measurements. The analysis included 7,595 participants aged ≥45 years. Statistical analyses were conducted using weighted estimates and logistic regression models.

Results: The prevalence of loss was 12%, while 25.1% of individuals had MLTCs. Among those with MLTCs, 15.4% experienced tooth loss. Tooth loss was significantly associated with MLTCs and ageing. The likelihood of tooth loss was higher in individuals with MLTCs [AOR: 1.30 (95% CI: 1.06-1.59), p-value: 0.012].

Conclusion: Tooth loss and MLTCs were found to be associated among adults aged ≥45 years in India, emphasizing the need to integrate oral health into chronic disease management strategies.

Objective: To investigate the associations between mental health vulnerabilities and periodontal disease among Korean adults using nationally representative data.

Basic research design: We analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) (2010-2017). Logistic regression models adjusted for sociodemographic, behavioral, and oral health covariates were used to assess the associations between mental health factors (perceived stress, depression, suicidal ideation, and mental health counseling) and periodontal disease.

Participants: A total of 11,019 adults aged ≥40 years who participated in the KNHANES (2010-2017).

Main outcome measures: Associations between mental health factors (perceived stress, depression, suicidal ideation, and mental health counseling) and periodontal disease.

Results: High perceived stress, depressive symptoms, and suicidal ideation were independently associated with higher odds of periodontal disease. In contrast, a history of mental health counseling was not significantly associated with periodontal disease.

Conclusion: Mental health vulnerabilities were associated with periodontal disease. Although a causal relationship and temporal sequence could not be determined, the findings highlight the need for integrated public health strategies that link dental care with mental health screening and community support systems.

Dental caries is the most prevalent chronic disease in children worldwide, disproportionately affecting socioeconomically disadvantaged populations. In Chile, national data from 2007 reported significant inequities in dental caries among six-year-old children, with higher prevalence in rural and low-income areas. This study aimed to evaluate socioeconomic inequalities in the distribution of dental caries among Chilean children aged 6 years from 2008 to 2023, considering recent public health interventions. This ecological study utilized anonymized routine health records from the Chilean public health system and socioeconomic data at the municipal level, covering 2008-2023, with data from up to n = 323 municipalities nationwide. Caries experience was measured as the proportion of six-year-old children with decayed, extracted, or filled primary teeth (dmft > 0) per municipality and year, following WHO criteria. Socioeconomic inequalities were assessed using the Slope Index of Inequality (SII) and Relative Index of Inequality (RII), with linear regression models to evaluate trends over time. A reduction in caries experience among six-year-old children - decreasing from 75.8% in 2008-2011 to 60.4% in 2020-2023 - was observed. Absolute inequality in caries experience between the least and most advantaged groups declined from 14.9% in 2008-2011 to 9.5% in 2020-2023. However, profound socioeconomic inequities in caries distribution persisted throughout the study period. The findings indicate a trend towards reduced socioeconomic inequalities in dental caries among six-year-old Chilean children, possibly influenced by preventive public health programs. Nevertheless, significant inequities and high caries levels remain, highlighting the need for sustained and equitable oral health interventions.

Introduction: Xerostomia, or the subjective sensation of dry mouth, is known to cause difficulties in speech, swallowing, and maintaining oral hygiene.

Aim: To study the association between xerostomia and polypharmacy among dental patients.

Materials and methods: This case-control study was conducted at Saveetha Dental College and Hospitals, Chennai, Tamil Nadu. A total of 120 participants were included, comprising 60 cases with clinically diagnosed xerostomia and 60 controls without xerostomia. Data was retrieved from the institutional electronic record system for the period between January 2023 and January 2024. Variables such as age, gender and medication history were recorded and their association with xerostomia was analyzed.

Results: Xerostomia was more commonly reported among females and in the 31-40 and 61-70 age groups. Among individuals diagnosed with xerostomia, 33.3% were under polypharmacy, while a higher proportion (66.7%) were under monotherapy. An adjusted multivariate regression analysis revealed a positive association between xerostomia and polypharmacy (OR = 3.545), which was found to be statistically significant. The most frequently used drug class in monotherapy patients with xerostomia was antipsychotics (28%) followed by hypoglycaemics (24%) and antidepressants (24%).

Conclusion: This study found that polypharmacy was significantly associated with increased odds of xerostomia after adjusting for confounders. Drug classes such as antipsychotics, antidepressants, and hypoglycaemics were found to be administered as monotherapy amongst patients with xerostomia. These findings, along with the multivariate analysis, suggest that both the number of medications and the type of drugs prescribed are important contributors to the risk of developing xerostomia.

Background: Inequalities in oral health disproportionately affect low and middle income countries and a pattern of increased prevalence of dental caries in children has been reported. Objectives: To determine the burden of disease and behavioural and toothache history of six- and 12-year-old Malawi schoolchildren. Methods: Ethical approval was granted by Malawi's National Health Sciences Research Committee. The survey was undertaken by nine Malawian dental therapists and three UK dentists in 24 schools. Stratified cluster sampling ensured that the children were representative of Malawi's three Regions. Dental caries (into dentine), fluorosis, oral hygiene and PUFA index data were collected via a dental examination. Questionnaires were completed by each child and by the Head Teacher from each school. Results: A total of 1,330 six-year-old and 1,611 12-year-old children were examined, evenly split between the sexes. Dental caries was identified in 47% of six-year-olds and 23% of 12-year-olds. None of the children had filled teeth. The mean dmft/DMFT for children with caries experience was 3.0 for six-year-olds and 1.8 for 12-year-olds. Dental fluorosis was recorded for 7% of 12-year-olds. A history of toothache was reported by 29% of six-year-olds and 42% of 12-year-olds. Conclusions: The prevalence of caries and absence of signs of past clinical care highlight the need to implement activities identified in Malawi's National Oral Health Policy around the provision of appropriate preventive and treatment services for children.

Oral health disparities remain a stark reflection of broader systemic inequities within healthcare. Marginalized and underserved populations consistently experience limited access to dental care, poorer health outcomes, and heightened barriers to achieving equitable care. The dental profession faces a critical, existential moment: it must determine what role it will play in society and how it will respond to pressing issues of health inequity. As stewards of public trust and oral health, dental practitioners and educators must determine how to leverage their influence to address pressing issues of health inequity. This responsibility is particularly significant for dental schools, as they shape the ethical compass, cultural competency, and community engagement capabilities of future practitioners and thus bear a special responsibility in this transformative endeavor. This manuscript thus argues that dental schools should move beyond their traditional role of clinical training to engage more deeply with ethics, social determinants of health (SDOH), and community engagement. By doing so, they can prepare practitioners capable of advancing health equity and reshaping the role of dentistry in society.