Journal of public health dentistry最新文献_第6页

Socioeconomic, behavioral, and psychological factors related to oral health in Myanmar: A cross-sectional study 缅甸口腔健康相关的社会经济、行为和心理因素：一项横断面研究。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-09-19 DOI: 10.1111/jphd.12585

Kaung Myat Thwin PhD, Wa Than Lin PhD, Sachiko Takehara PhD, Hiroshi Ogawa PhD

Objectives

This study aims to evaluate the effects of socioeconomic, behavioral, and psychological factors on oral health status and oral health-related quality of life in Myanmar adults.

Methods

Data were from a convenience sample of Myanmar adults who are from a township health center in Yangon city. Face-to-face interviews using a paper-based questionnaire in the Myanmar language and clinical oral examinations were performed at the health center. Mann–Whitney U test and linear regressions were used to assess the association of socio-demographic, behavioral, and psychological variables with oral health outcomes.

Results

In socio-demographic variables, significant associations were observed in individual income with periodontal pocket and OHIP-14, and history of COVID-19 infection with OHIP-14. However, there were no associations between behavioral factors and oral health outcomes. After adjustment for sex, age, educational level, and individual income, the depression subscale was statistically significant with the number of present teeth, decayed teeth, decayed, missing, and filled teeth, and OHIP-14. The anxiety subscale remained significant with periodontal pocket, but no stress subscale was associated with oral health outcomes.

Conclusion

The experiences of oral health status were high, and the oral health-related quality of life was unfavorable in Myanmar adults. A large proportion of them suffers from psychological distress. Additionally, individuals with lower income and who experienced a history of COVID-19 infection were susceptible to poor oral health-related quality of life. Psychological distress indicates a higher risk for oral health problems in Myanmar adults.

目的：本研究旨在评估社会经济、行为和心理因素对缅甸成年人口腔健康状况和口腔健康生活质量的影响。方法：数据来自仰光市一个乡镇卫生中心的缅甸成年人。卫生中心采用缅甸语纸质问卷进行了面对面访谈，并进行了临床口腔检查。Mann-Whitney U检验和线性回归用于评估社会人口、行为和心理变量与口腔健康结果的相关性。结果：在社会形态变量中，观察到个体收入与牙周袋和OHIP-14以及OHIP-14的新冠肺炎感染史之间存在显著关联。然而，行为因素与口腔健康结果之间没有关联。在对性别、年龄、教育水平和个人收入进行调整后，抑郁症分量表与现有牙齿、龋齿、龋齿、缺失和填充牙齿的数量以及OHIP-14具有统计学意义。焦虑分量表在牙周袋中仍然显著，但没有压力分量表与口腔健康结果相关。结论：缅甸成年人口腔健康状况体验较高，口腔健康生活质量较差。他们中有很大一部分人遭受心理困扰。此外，收入较低且有新冠肺炎感染史的个人易患口腔健康相关生活质量差。心理困扰表明缅甸成年人出现口腔健康问题的风险更高。

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引用次数: 0

Effectiveness of telehealth in providing preventive oral health care: A pilot evaluation of patient, carer, and clinician experience 远程保健在提供预防性口腔保健方面的有效性：对患者、护理者和临床医生体验的试点评估

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-09-07 DOI: 10.1111/jphd.12580

Carrie Tsai DMD, MPH, PGCert (Paed Dent), Aylin Savran BOH, Yvonne Chau BDSc, MDS, MRACDS (Paed Dent), Lloyd Hurrell BDS, DClinDent, Cathryn Forsyth DipDT, MEd, PhD, Harleen Kumar BDSc, DCD (Paed Dent)

Background

This pilot study aimed to characterize the experience, satisfaction, and views on feasibility of an oral health primary prevention telehealth service at a public dental hospital's department of pediatric dentistry, from the viewpoint of patients, carers, and clinicians.

Methods

Data were collected using an anonymous questionnaire for parents/guardians, a focus group for clinicians; and were summarized using descriptive statistics, chi-square tests, analysis of variance, and by thematic analysis for the qualitative data.

Results

Thirty-seven parents/guardians and four clinicians were included. The mean patient age was 5 years (SD = 3.3). Over half of the parents (51.4%) were aged 30–39 years. There was high satisfaction (97.3%) and acceptability (81.1%) of the telehealth service. Native English-speakers were significantly more likely to agree that telehealth was an acceptable mode of preventive care and that they would use it again (p = 0.033). Parents reporting difficulty traveling to dental appointments were significantly more likely to score favorably in categories of usefulness, technical quality, and satisfaction relating to telehealth (all p < 0.001). Important themes from the clinician focus group included specific benefits for patients with special needs or who live rurally, reduced stress on families, and an enhanced focus on prevention.

Conclusions

The findings suggest ongoing benefits of providing preventive oral health services as an adjunct to face-to-face care, especially to the identified subset of patients who will benefit the most.

背景这项试点研究旨在从患者、照护者和临床医生的角度，描述一家公立牙科医院儿童牙科部的口腔健康初级预防远程保健服务的体验、满意度和对可行性的看法。方法采用匿名问卷调查的方式收集家长/监护人的数据，以焦点小组的方式收集临床医生的数据；采用描述性统计、卡方检验和方差分析的方法对数据进行总结，并对定性数据进行主题分析。结果 37 名家长/监护人和 4 名临床医生参与了调查。患者平均年龄为 5 岁（SD = 3.3）。一半以上的家长（51.4%）年龄在 30-39 岁之间。远程医疗服务的满意度（97.3%）和接受度（81.1%）都很高。母语为英语的家长更倾向于认为远程保健是一种可接受的预防保健方式，并且他们会再次使用远程保健服务（p = 0.033）。在与远程医疗相关的实用性、技术质量和满意度方面，表示前往牙科就诊有困难的家长获得好评的可能性明显更高（均为 p < 0.001）。临床医生焦点小组讨论的重要主题包括对有特殊需求或居住在偏远地区的患者的具体益处、减轻家庭压力以及加强对预防的关注。结论研究结果表明，作为面对面治疗的辅助手段，提供预防性口腔健康服务具有持续的益处，尤其是对已确定的受益最大的患者群体。

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引用次数: 0

Factors associated with dental implant loss/complications in the Veterans Health Administration, 2015–2019 2015-2019年退伍军人健康管理局中与种植牙缺失/并发症相关的因素

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-09-05 DOI: 10.1111/jphd.12584

Geneva M. Wilson MPH, PhD, Jessina C. McGregor PhD, Gretchen Gibson DDS, MPH, M. Marianne Jurasic DMD, MPH, Charlesnika T. Evans MPH, PhD, Katie J. Suda PharmD, MS, FCCP

Objectives

Twelve percent of the U.S. population has a dental implant. Although rare, implant loss/complications can impact quality of life. This study evaluated indicators for implant loss/complications.

Methods

Veterans with dental implants placed between 2015 and 2019 were included. Implant loss/complications were defined as implant removal or peri-implant defect treatment within 90 days. Binomial logistic regression identified factors associated with implant loss/complications.

Results

From 2015 to 2019, 48,811 dental implants were placed in 38,246 Veterans. Implant loss/complications was identified for 202 (0.4%) implants. In adjusted analyses, Veterans aged 50–64 years (OR = 1.92 (95% confidence interval (CI): 1.06, 3.46)) and ≥65 (OR = 2.01 (95% CI: 1.14, 3.53)) were more likely to have implant loss/complications. History of oral infection, tooth location, and number of implants placed all significantly increased the odds of loss/complications.

Conclusion

Dental implant loss/complications are rare outcomes. Older age, location of implant, and the number of implants placed during a visit were significant predictors of loss/complication.

目标美国有 12% 的人口种植了牙齿。种植体脱落/并发症虽然罕见，但会影响生活质量。本研究评估了种植体缺失/并发症的指标。方法纳入在 2015 年至 2019 年期间植入过牙科植入物的退伍军人。种植体脱落/并发症定义为 90 天内种植体移除或种植体周围缺损治疗。二项逻辑回归确定了与种植体缺失/并发症相关的因素。结果从 2015 年到 2019 年，共为 38246 名退伍军人植入了 48811 个牙科植入体。发现有 202 个（0.4%）种植体脱落/并发症。在调整分析中，年龄在 50-64 岁（OR = 1.92（95% 置信区间 (CI)：1.06, 3.46））和≥65 岁（OR = 2.01（95% 置信区间 (CI)：1.14, 3.53））的退伍军人更有可能发生种植体缺失/并发症。口腔感染史、牙齿位置和植入种植体的数量都会显著增加种植体缺失/并发症的几率。结论牙种植体缺失/并发症是罕见的结果。高龄、种植体位置和就诊时植入的种植体数量是导致种植体缺失/并发症的重要预测因素。

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引用次数: 0

Dental Health Services Victoria value-based health care principles for oral health models of care 维多利亚州口腔健康服务中心基于价值观的口腔健康护理原则。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-08-16 DOI: 10.1111/jphd.12581

Clare Elizabeth Lin BDS, MPH, Tan Minh Nguyen MPH, MSc, Roisin McGrath MPH, PhD, Amy Patterson MPH, Martin Hall BDS, MPH

Background

Efforts to progress oral healthcare reform can be challenging with competing interests of governments and service providers to achieve the intended outcomes. The value-based health care approach has been adopted in many areas of healthcare but has had limited applications to oral healthcare systems. Dental Health Services Victoria, an Australian state government funded entity, commenced its journey to value-based health care in 2016, to shift away from traditional dental service models that reward activity and volume towards a stronger emphasis on value and outcomes.

Aims

To maintain the value-based health care agenda focus, Dental Health Services Victoria developed three key principles, which can be adopted by other organisations engaged in reforming oral healthcare, to improve the oral health for the population it serves.

Materials & Methods

In 2018, Dental Health Services Victoria developed a value-based health care framework, which has informed strategic organisation priorities for action. In 2023, the following three key principles are identified as being essential to support the operationalisation and development of effective models of oral healthcare: Principle 1 – Care is co-designed with the person or population Principle 2 – Prevention and early intervention are prioritised. Principle 3 – Consistent measurement of health outcomes and costs are embedded.

Discussion

The exploration of the three key principles is an important communication tool to translate value-based health care into practice with key stakeholders. Further work is required to socialise them to within dental teams.

Conclusion

Organisations looking to commence the value-based health care agenda can apply Dental Health Services Victoria's three key principles as a first step.

背景：推进口腔医疗改革的努力可能具有挑战性，政府和服务提供商的利益相互竞争，以实现预期结果。基于价值的医疗保健方法已在医疗保健的许多领域被采用，但在口腔医疗保健系统中的应用有限。澳大利亚州政府资助的实体维多利亚牙科健康服务公司于2016年开始了其基于价值的医疗保健之旅，从奖励活动和数量的传统牙科服务模式转向更加重视价值和结果。目标：为了保持基于价值的医疗保健议程重点，维多利亚牙科健康服务制定了三项关键原则，可供其他参与口腔保健改革的组织采用，以改善其服务人群的口腔健康。材料和方法：2018年，维多利亚牙科健康服务公司制定了一个基于价值的医疗保健框架，为战略组织的行动重点提供了信息。2023年，以下三项关键原则被确定为支持口腔保健有效模式的实施和发展至关重要：原则1-护理与个人或人群共同设计原则2-预防和早期干预优先。原则3——嵌入了对健康结果和成本的一致衡量。讨论：探索三个关键原则是与关键利益相关者将基于价值的医疗保健转化为实践的重要沟通工具。需要进一步的工作来将他们融入牙科团队。结论：希望启动基于价值观的医疗保健议程的组织可以将维多利亚牙科健康服务中心的三项关键原则作为第一步。

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引用次数: 1

Preventive dental care utilization and dental caries for Medicaid-enrolled adolescents in Oregon 俄勒冈州Medicaid注册青少年的预防性牙科护理利用和龋齿。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-07-31 DOI: 10.1111/jphd.12583

Kimia Imani MS, Lloyd A. Mancl PhD, Courtney M. Hill BS, Donald L. Chi DDS, PhD

Objectives

This study aimed to evaluate the relationship between preventive dental care utilization and untreated dental caries for Medicaid-enrolled adolescents and to determine if the relationship is moderated by chronic conditions (CC).

Methods

This analysis was based on 2015–2016 Medicaid claims files and survey data collected from adolescents ages 12–18 years enrolled in Oregon Medicaid, who received a dental screening between December 2015 and December 2016 (n = 240). To assess the relationship between preventive dental care utilization and untreated dental caries (defined as decayed tooth surfaces), prevalence ratios (PR) and 95% confidence intervals (CI) were generated using log-linear regression models. We also tested for an interaction between preventive dental care utilization and CC.

Results

About 60.4% of adolescents utilized preventive dental care, 21.7% had CC, and 29.6% had ≥1 decayed tooth surfaces. There were no significant differences in untreated dental caries between adolescents who did and did not utilize preventive dental care (PR: 0.73, 95% CI: 0.33–1.60; p = 0.43). There was not a significant interaction between preventive dental care utilization and CC (p = 0.65). Preventive dental care utilization was not significantly associated with untreated dental caries for adolescents with CC (PR: 0.51, 95% CI: 0.10–2.65; p = 0.42) nor among adolescents without CC (PR: 0.79, 95% CI: 0.33–1.91; p = 0.61).

Conclusions

Preventive dental care was not shown to be associated with lower untreated dental caries for Medicaid-enrolled adolescents or those with CC. Future work that is adequately powered should continue to elucidate this relationship in Medicaid enrollees.

目的：本研究旨在评估Medicaid注册青少年的预防性牙科护理利用率与未经治疗的龋齿之间的关系，并确定这种关系是否受慢性病（CC）的调节。方法：该分析基于2015-2016年Medicaid索赔文件和收集自12-18岁青少年的调查数据参加俄勒冈州医疗补助的年，在2015年12月至2016年12月期间接受牙科筛查（n = 240）。为了评估预防性牙科护理利用率与未治疗龋齿（定义为龋齿表面）之间的关系，使用对数线性回归模型生成患病率（PR）和95%置信区间（CI）。我们还测试了预防性牙科护理的使用与CC之间的相互作用。结果：约60.4%的青少年使用了预防性牙齿护理，21.7%患有CC，29.6%的青少年有≥1个蛀牙表面。在使用和不使用预防性牙科护理的青少年之间，未经治疗的龋齿没有显著差异（PR:0.73，95%CI:0.33-1.60；p = 0.43）。预防性牙科护理的使用与CC之间没有显著的相互作用（p = 0.65）。预防性牙科护理利用率与未经治疗的CC青少年龋齿无显著相关性（PR:0.51，95%CI:0.10-2.65；p = 0.42），在没有CC的青少年中也没有（PR:0.79，95%CI:0.33-1.91；p = 0.61）。结论：对于参加医疗补助计划的青少年或CC患者，预防性牙科护理没有显示出与较低的未经治疗的龋齿相关。未来有足够力量的工作应该继续阐明医疗补助申请者的这种关系。

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引用次数: 0

Exposure to household dysfunction at childhood and later number of teeth among older Japanese adults: A life course study from the Japan Gerontological Evaluation Study 日本老年人儿童时期暴露于家庭功能障碍和后期牙齿数量：日本老年评估研究的一项生命历程研究。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-07-31 DOI: 10.1111/jphd.12582

Hazem Abbas BDS, MSc, PhD, Kenji Takeuchi DDS, PhD, Sakura Kiuchi DDS, PhD, Katsunori Kondo MD, PhD, Ken Osaka MD, PhD

Objectives

The aim of this retrospective cohort study was to investigate the life course association between exposure to two household dysfunctions (father violence against mother and parental divorce) at childhood (≤18 years) with later number of remaining teeth (≥65 years) in functionally independent older Japanese population. This was the first study to investigate this research question in the Asian context.

Methods

The Japan Gerontological Evaluation study (JAGES) self-reported retrospective data gathered in 2013 was used (n = 21,604). Each household dysfunction was binary variable (Yes/No), while the five categories of the number of remaining teeth were ≥20, 10–19, 5–9, 1–4, and no teeth. Sex-stratified ordered logistic regression models were used to calculate the odds ratios (OR) of having fewer teeth. The models were adjusted for age, economic adversity in childhood, educational attainment, comorbidities, and smoking status.

Results

Overall, 46.4% were men and a total of 1149 participants (5.3%) experienced household dysfunction at childhood [men = 642 (6.4%), women = 507 (4.4%)]. The regression models showed higher OR of having fewer teeth among men who experienced a household dysfunction [OR = 1.16; 95% Confidence interval (CI) = 1.00–1.36] than men who did not. This association was not observed among women [OR = 0.94; 95% CI = 0.79–1.13]. Similar magnitude and direction of the association was observed among men but not among women when the two components of household dysfunction were used separately and aggregately as exposure variables.

Conclusion

An exposure to a household dysfunction at childhood was associated with having fewer teeth in later life among men but not among women.

目的：这项回顾性队列研究的目的是调查儿童时期（≤18岁）暴露于两种家庭功能障碍（父亲暴力侵害母亲和父母离婚）之间的生活过程关联年），剩余牙齿数量较晚（≥65颗年）。这是第一项在亚洲背景下调查这一研究问题的研究。方法：使用2013年收集的日本老年评估研究（JAGES）自我报告的回顾性数据（n = 21604）。每个家庭功能障碍是二元变量（是/否），而五类剩余牙齿数量分别为≥20颗、10-19颗、5-9颗、1-4颗和无牙齿。使用性别分层有序逻辑回归模型来计算少牙的优势比（OR）。模型根据年龄、儿童时期的经济逆境、教育程度、合并症和吸烟状况进行了调整。结果：总体而言，46.4%为男性，共有1149名参与者（5.3%）在儿童时期经历过家庭功能障碍[男性 = 642人（6.4%），女性 = 507（4.4%）。回归模型显示，在经历家庭功能障碍的男性中，牙齿较少的OR较高[OR = 1.16；95%置信区间 = 1.00-1.36]。在女性中没有观察到这种关联[OR = 0.94；95%CI = 0.79-1.13]。当家庭功能障碍的两个组成部分分别和综合用作暴露变量时，在男性中观察到相似的关联程度和方向，但在女性中没有。结论：儿童时期接触家庭功能障碍与男性晚年牙齿数量减少有关，但与女性无关。

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引用次数: 0

Effect of CDC adjustment of state-reported data on community water fluoridation statistics 美国疾病控制与预防中心对州报告数据的调整对社区饮水氟化统计的影响。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-07-04 DOI: 10.1111/jphd.12579

Erin K. Hamilton PhD, Susan O. Griffin PhD, Lorena Espinoza DDS, MPH

Objectives

Advancing community water fluoridation (CWF) coverage is a national health objective. The Centers for Disease Control and Prevention began adjusting state-reported data to calculate CWF coverage in 2012, and then modified methods in 2016. We evaluate improvements attributable to data adjustment and implications for interpreting trends.

Methods

To assess adjustment, we compared the percentage deviation of state-reported data and data adjusted by both methods to the standard estimated by the U.S. Geological Survey. To assess effects on estimated CWF trends, we compared statistics calculated with data adjusted by each method.

Results

The 2016 method outperformed on all points of evaluation. The CWF national objective measure (percentage of community water system population receiving fluoridated water) was negligibly affected by method. Percentage of US population receiving fluoridated water was lower with the 2016 method versus the 2012.

Conclusions

Adjustment of state-reported data improved overall quality of CWF coverage measures and had minimal impact on key measures.

目标：提高社区氟化水（CWF）的覆盖率是国家卫生目标。2012年，美国疾病控制与预防中心开始调整州报告的数据，以计算CWF覆盖率，然后在2016年修改了方法。我们评估了数据调整带来的改进以及对解释趋势的影响。方法：为了评估调整，我们将州报告数据和两种方法调整的数据的百分比偏差与美国地质调查局估计的标准进行了比较。为了评估对估计CWF趋势的影响，我们将计算的统计数据与每种方法调整的数据进行了比较。结果：2016年的方法在所有评估点上都表现出色。CWF国家目标指标（接受含氟水的社区供水系统人口的百分比）受该方法的影响可忽略不计。与2012年相比，2016年的方法使接受含氟水的美国人口比例更低。结论：对州报告数据的调整提高了CWF覆盖措施的总体质量，对关键措施的影响最小。

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引用次数: 1

Motivations and experiences among dentists in rural private practice: A qualitative study 乡村私人诊所牙医的动机和经历：一项定性研究。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-06-18 DOI: 10.1111/jphd.12575

Zachary Prouty DDS, Julie C. Reynolds DDS, MS, Natoshia Askelson PhD

Objectives

Despite the critical importance of access to dental care for rural residents and concerns about a shrinking rural dentist workforce, few studies have examined rural dentist motivations to practice in rural areas. The aim of this study was to explore practicing rural dentists' motivations and experiences qualitatively through semi-structured interviews to help inform and guide recruitment and retention efforts in rural areas.

Methods

Dentists were included in the sample frame if they were general dentists in private practice and had a primary practice located in a rural Iowa county. Rural dentists with publicly available email addresses were contacted by email to participate. Semi-structured interviews were administered to 16 private practice general dentists. All interviews were audio recorded, transcribed, and coded using pre-set and emergent codes.

Results

Participants were most commonly male (75%), under age 35 (44%), white (88%), and practiced in a partnership arrangement (44%). The main codes regarding dentists' experiences and motivations to practice in a rural area included familiarity with a rural area, community, financial factors, and clinical care delivery. Having been raised in a rural area was a major influence in most dentists' decisions about where to locate.

Conclusions

The importance of rural upbringing in this study underscores the need to consider rural upbringing in dental student admissions. Additional findings, such as financial benefits of a rural practice and other practice-related factors can be used to inform recruitment efforts.

目标：尽管农村居民获得牙科护理至关重要，而且人们担心农村牙医队伍的萎缩，但很少有研究调查农村牙医在农村地区执业的动机。本研究的目的是通过半结构化访谈，定性地探索执业乡村牙医的动机和经验，以帮助了解和指导农村地区的招聘和留用工作。方法：如果牙医是私人诊所的普通牙医，并且主要诊所位于爱荷华州农村县，则将他们纳入样本框架。通过电子邮件联系了拥有公开电子邮件地址的农村牙医参与其中。对16名私人执业全科牙医进行了半结构化访谈。所有访谈都是录音、转录和编码的，使用预设和紧急代码。结果：参与者最常见的是男性（75%）、35岁以下（44%）、白人（88%），并在伴侣关系安排中实践（44%）。关于牙医在农村地区执业的经验和动机的主要准则包括熟悉农村地区、社区、财务因素和临床护理提供。在农村长大是大多数牙医决定去哪里的主要影响因素。结论：农村教育在本研究中的重要性强调了在牙科学生招生中考虑农村教育的必要性。其他调查结果，如农村实践的经济效益和其他与实践相关的因素，可用于为招聘工作提供信息。

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引用次数: 0

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-06-16 DOI: 10.1111/jphd.12574

Amit Gupta PharmD, Travis Salway PhD, MSc, Abbas Jessani DDS, MSc, PhD

Objectives

This study estimates the frequency of cost-related oral health service avoidance (CROHSA) among lesbian, gay, and bisexual (LGB) individuals in Canada relative to heterosexual persons.

Methods

Heterosexual and sexual minority individuals in Canada were compared using the national probability-based Canadian Community Health Survey 2017–2018. Logistic regression was used to quantify associations between LGB status and CROHSA. Mediators were tested following Andersen's behavioral model of health service utilization and included partnership status, oral health status, presence of dental pain, educational attainment, insurance status, smoking status, general health status, and personal income.

Results

From our sample of 103,216 individuals, 34.8% of LGB individuals reported avoiding oral health care due to cost compared to 22.7% of heterosexual persons. Disparities were most pronounced among bisexual individuals (odds ratio [OR] 2.29 95% confidence interval [CI] 1.42, 3.49). Disparities persisted despite adjustment for confounding using age, gender/sex, and ethnicity (OR 2.23 95% CI 1.42, 3.49). Disparities were fully mediated by eight hypothesized mediators namely, educational attainment, smoking status, partnership status, income, insurance status, oral health status, and the presence of dental pain (OR 1.69 95% CI 0.94, 3.03). In contrast, lesbian/gay individuals did not have elevated odds of experiencing CROHSA compared to heterosexual individuals (OR 1.27 95% CI 0.84, 1.92).

Conclusion

CROHSA is elevated for bisexual individuals relative to heterosexual individuals. Targeted interventions should be explored to improve oral healthcare access among this population. Future research should assess the role of minority stress and social safety on oral health inequities among sexual minority groups.

目的：本研究估计了与异性恋者相比，加拿大女同性恋、男同性恋和双性恋（LGB）人群中与成本相关的口腔健康服务回避（CROHSA）的频率。方法：使用2017-2018年基于全国概率的加拿大社区健康调查，对加拿大的异性恋和性少数群体进行比较。Logistic回归用于量化LGB状态与CROHSA之间的相关性。调解员按照Andersen的健康服务利用行为模型进行测试，包括伴侣关系状况、口腔健康状况、是否存在牙痛、教育程度、保险状况、吸烟状况、总体健康状况和个人收入。结果：在我们对103216名个体的样本中，34.8%的LGB个体报告称，由于费用原因，他们避免了口腔保健，而异性恋者的这一比例为22.7%。差异在双性恋个体中最为明显（优势比[OR]2.29 95%置信区间[CI]1.42，3.49，保险状况、口腔健康状况和牙痛（OR 1.69 95%CI 0.94，3.03）。相比之下，女同性恋/男同性恋者经历CROHSA的几率并不比异性恋者高（OR 1.27 95%CI 0.84，1.92）。结论：相对于异性恋者，双性恋者的CROHSA升高。应探索有针对性的干预措施，以改善这一人群获得口腔保健的机会。未来的研究应该评估少数群体的压力和社会安全对性少数群体口腔健康不平等的作用。

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引用次数: 0

Exploring factors associated with parent-reported early childhood caries with Alaska's childhood understanding behaviors survey data 利用阿拉斯加儿童理解行为调查数据，探索与父母报告的儿童早期龋齿相关的因素。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-06-13 DOI: 10.1111/jphd.12577

Laura Grage MPH, RN, Frances Wise PhD, Jennifer Meyer PhD, MPH, RN

Objectives

Early Childhood Caries (ECC) can negatively impact the lives of young children, despite being preventable. The purpose of this study was to utilize available data in Alaska to describe changes in parent reports of ECC, and identify factors related to ECC.

Methods

The Childhood Understanding Behaviors Survey (CUBS) is a population-based survey of parents of 3-year-old children and was utilized to describe changes in: parent-reported ECC among children with a dental visit, access to and or utilization of dental care, and consumption of three or more cups of sweetened beverages between 2009–2011 and 2016–2019. Logistic regression modeling was used to explore factors associated with parent-reported ECC among children with a dental visit.

Results

Over time, a significantly smaller proportions of parents whose 3-year-old child had seen a dental professional reported ECC. Additionally, a smaller proportion of parents reported three or more cups of sweetened beverage consumption by their child, while larger proportions had seen a dental professional by age 3. Factors associated with parent-reported ECC included consumption of three or more cups of sweetened beverages, and enrollment in Medicaid or Tribal health care insurance, while protective factors included a parent earning a college degree, and military insurance.

Conclusions

Although at the statewide level, improvements were observed in parent-reported measures over time, regional disparities were apparent. Social and economic factors as well as excessive consumption of sweetened beverages appear to play important roles in ECC. CUBS data can help identify trends in ECC within Alaska.

目标：幼儿龋齿（ECC）虽然可以预防，但会对幼儿的生活产生负面影响。本研究的目的是利用阿拉斯加的可用数据来描述父母报告的ECC的变化，并确定与ECC相关的因素，2009-2011年至2016-2019年期间，获得和/或利用牙科护理，以及消费三杯或三杯以上的加糖饮料。使用Logistic回归模型来探索与父母报告的儿童牙科就诊ECC相关的因素。结果：随着时间的推移，3岁孩子看过牙科专业医生的父母中报告ECC的比例明显较小。此外，较小比例的父母报告他们的孩子喝了三杯或三杯以上的加糖饮料，而较大比例的父母在3岁时看过牙科专业医生。与父母报告的ECC相关的因素包括饮用三杯或三杯以上的加糖饮料，以及参加医疗补助或部落医疗保险，而保护因素包括父母获得大学学位和军事保险。结论：尽管在全州范围内，随着时间的推移，家长报告的措施有所改善，但地区差异明显。社会和经济因素以及过量饮用加糖饮料似乎在ECC中起着重要作用。CUBS数据可以帮助确定阿拉斯加ECC的趋势。

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引用次数: 0