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Research on Oral Health Outcomes

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (20 February 2021) | Viewed by 61132

Special Issue Editor

Dr. Wael Sabbah

E-Mail Website
Guest Editor
Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK
Interests: inequalities in oral health and related behaviours; inequalities in use of dental services; relationship between oral and general health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oral diseases are the most common noncommunicable diseases affecting half of the world’s population. Oral conditions, particularly dental caries, periodontal diseases and tooth loss affect people throughout their lifetime and impact on the quality of an individual’s life and increase the cost of healthcare systems. We are organising a Special Issue on oral health outcomes in the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://0-www-mdpi-com.brum.beds.ac.uk/journal/ijerph.

Identifying the proximal and contextual determinants of oral health outcomes is important to inform public health policies and health promotion interventions aiming at reducing the burden of oral diseases and reducing inequalities in oral health. Research addressing the determinants of oral health outcomes and interventions to reduce the burden of oral diseases can provide insights to develop new public health policies and maintain existing policies aiming at addressing oral health outcomes.

This Special Issue is open to any subject area related to oral health outcomes, particularly the determinants of oral diseases, intervention to reduce the burden of oral diseases and correlations between oral and general health. The listed keywords suggest just a few of the research topics.

Dr. Wael Sabbah
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Social determinants of oral health
  • Inequalities in oral health
  • Oral health related behaviours
  • Impact of dental services on oral health
  • Impact of systemic conditions on oral health
  • Common risk factors for oral health and general health.
  • Interventions aiming at preventing oral diseases
  • Community-based health promotion policies aiming at improving oral health

Published Papers (18 papers)

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17 pages, 368 KiB  
Article
Substance Use, General Health and Health Literacy as Predictors of Oral Health in Emerging Adult Sexual Minority Men of Color: A Secondary Data Analysis
by S. Raquel Ramos, David T. Lardier, Jr., Rueben C. Warren, Melba Cherian, Sarwat Siddiqui and Trace Kershaw
Int. J. Environ. Res. Public Health 2021, 18(4), 1987; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041987 - 18 Feb 2021
Cited by 2 | Viewed by 2826
Abstract
There is limited evidence surrounding oral health in emerging adult, sexual minority men of color. This study examined the association between sociodemographic factors, health literacy, cigarette, e-cigarette, and alcohol use on oral health outcomes. Secondary data analysis was conducted with 322 sexual minority [...] Read more.
There is limited evidence surrounding oral health in emerging adult, sexual minority men of color. This study examined the association between sociodemographic factors, health literacy, cigarette, e-cigarette, and alcohol use on oral health outcomes. Secondary data analysis was conducted with 322 sexual minority men ages 18–34 in the United States. Between-group, mean-level, and multivariable logistic regression analyses examined differences on oral health outcomes. Increased cigarette (aOR = 1.84, p = 0.03), e-cigarette (aOR = 1.40, p = 0.03), and alcohol use (aOR = 2.07, p = 0.05) were associated with extended time away from the dentist. Health literacy (aOR = 0.93, p = 0.05) was negatively associated. Increased cigarette (aOR = 1.17, p = 0.04) and cigarette use (aOR = 1.26, p = 0.04) were associated with tooth loss. Health literacy was negatively associated (aOR = 0.65, p = 0.03). Increased e-cigarette (aOR = 1.74, p = 0.04) and cigarette use (aOR = 4.37, p < 0.001) were associated with dental affordability issues. Lower health literacy and racial identification as Black were associated with dental affordability issues; demonstrating an urgent need to address these factors to improve oral health in emerging adult sexual minority men of color. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
15 pages, 337 KiB  
Article
Perceived Preparedness of Dental Academic Institutions to Cope with the COVID-19 Pandemic: A Multi-Country Survey
by Nour Ammar, Nourhan M. Aly, Morenike Oluwatoyin Folayan, Yousef Khader, Simin Z. Mohebbi, Sameh Attia, Hans-Peter Howaldt, Sebastian Boettger, Jorma Virtanen, Marwa Madi, Diah A. Maharani, Anton Rahardjo, Imran Khan, Ola B. Al-Batayneh, Maher Rashwan, Verica Pavlic, Smiljka Cicmil, Kanako Noritake, Gabriella Galluccio, Antonella Polimeni, Anas A. Shamala, Arheiam Arheiam, Davide Mancino, Prathip Phantumvanit, Jin-Bom Kim, Youn-Hee Choi, Mai A. Dama, Maha M. Abdelsalam, Jorge L. Castillo, Myat Nyan, Iyad Hussein, Easter Joury, Ana P. Vukovic, Alfredo Iandolo, Arthur M. Kemoli and Maha El Tantawiadd Show full author list remove Hide full author list
Int. J. Environ. Res. Public Health 2021, 18(4), 1445; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041445 - 04 Feb 2021
Cited by 11 | Viewed by 4339
Abstract
Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and [...] Read more.
Dental academic institutions are affected by COVID-19. We assessed the perceived COVID-19 preparedness of these institutions and the characteristics of institutions with greater perceived preparedness. An international cross-sectional survey of dental academics was conducted from March to August 2020 to assess academics’ and institutional attributes, perceived preparedness, and availability of infection prevention and control (IPC) equipment. Principal component analysis (PCA) identified perceived preparedness components. Multilevel linear regression analysis assessed the association between perceived preparedness and fixed effect factors (academics’ and institutions’ attributes) with countries as random effect variable. Of the 1820 dental academics from 28 countries, 78.4% worked in public institutions and 75.2% reported temporary closure. PCA showed five components: clinic apparel, measures before and after patient care, institutional policies, and availability of IPC equipment. Significantly less perceived preparedness was reported in lower-middle income (LMICs) (B = −1.31, p = 0.006) and upper-middle income (UMICs) (B = −0.98, p = 0.02) countries than in high-income countries (HICs), in teaching only (B = −0.55, p < 0.0001) and in research only (B = −1.22, p = 0.003) than teaching and research institutions and in institutions receiving ≤100 patients daily than those receiving >100 patients (B = −0.38, p < 0.0001). More perceived preparedness was reported by academics with administrative roles (B = 0.59, p < 0.0001). Academics from low-income countries (LICs) and LMICs reported less availability of clinic apparel, IPC equipment, measures before patient care, and institutional policies but more measures during patient care. There was greater perceived preparedness in HICs and institutions with greater involvement in teaching, research, and patient care. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
10 pages, 1026 KiB  
Article
Living with Family Is Directly Associated with Regular Dental Checkup and Indirectly Associated with Gingival Status among Japanese University Students: A 3-Year Cohort Study
by Momoko Nakahara, Daisuke Ekuni, Kota Kataoka, Aya Yokoi, Yoko Uchida-Fukuhara, Daiki Fukuhara, Terumasa Kobayashi, Naoki Toyama, Hikari Saho, Md Monirul Islam, Yoshiaki Iwasaki and Manabu Morita
Int. J. Environ. Res. Public Health 2021, 18(1), 324; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010324 - 05 Jan 2021
Cited by 4 | Viewed by 2578
Abstract
Although some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and [...] Read more.
Although some studies showed that lifestyle was associated with oral health behavior, few studies investigated the association between household type and oral health behavior. The aim of this prospective cohort study was to investigate the association between household type, oral health behavior, and periodontal status among Japanese university students. Data were obtained from 377 students who received oral examinations and self-questionnaires in 2016 and 2019. We assessed periodontal status using the percentage of bleeding on probing (%BOP), probing pocket depth, oral hygiene status, oral health behaviors, and related factors. We used structural equation modeling to determine the association between household type, oral health behaviors, gingivitis, and periodontitis. At follow-up, 252 students did not live with their families. The mean ± standard deviation of %BOP was 35.5 ± 24.7 at baseline and 32.1 ± 25.3 at follow-up. In the final model, students living with their families were significantly more likely to receive regular dental checkup than those living alone. Regular checkup affected the decrease in calculus. The decrease in calculus affected the decrease in %BOP over 3 years. Living with family was directly associated with regular dental checkups and indirectly contributed to gingival status among Japanese university students. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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17 pages, 1135 KiB  
Article
Barriers and Facilitators to Promoting Oral Health Literacy and Patient Communication among Dental Providers in California
by Winston Tseng, Elizabeth Pleasants, Susan L. Ivey, Karen Sokal-Gutierrez, Jayanth Kumar, Kristin S. Hoeft, Alice M. Horowitz, Francisco Ramos-Gomez, Miku Sodhi, Jessica Liu and Linda Neuhauser
Int. J. Environ. Res. Public Health 2021, 18(1), 216; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010216 - 30 Dec 2020
Cited by 15 | Viewed by 4674
Abstract
Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant [...] Read more.
Studies demonstrate that dental providers value effective provider-patient communication but use few recommended communication techniques. This study explored perspectives of California dental providers and oral health literacy experts in the United States on use of communication techniques. We conducted a qualitative key informant interview study with 50 participants between November 2019 and March 2020, including 44 dental providers (dentists, hygienists, and assistants) in public or private practice in California and 6 oral health literacy (OHL) experts. We undertook thematic analysis of interview transcripts and descriptive statistics about interviewees from pre-surveys. Dental providers reported frequently speaking slowly, and using simple language and models/radiographs to communicate with patients, while infrequently using interpretation/translation, illustrations, teach-back, or motivational interviewing. Providers reported using only 6 of the 18 American Medical Association’s (AMA) recommended communication techniques and only 3 of the 7 AMA’s basic communication techniques. A majority of providers indicated using one of five oral health assessment and educational strategies. Key barriers to effective communication included limited time, financial incentives promoting treatment over prevention, lack of OHL training, limited plain-language patient education materials, and patients with low OHL knowledge. Dental organizations should prioritize supporting dental providers in effective patient communication practices. Standardizing OHL continuing education, creating an evidence-based OHL toolkit for dental teams, ensuring accessible interpretation/translation services, and incentivizing dental providers to deliver education could improve oral health literacy and outcomes. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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9 pages, 339 KiB  
Article
Comparative Study of Attitudes towards Communication Skills Learning between Medical and Dental Students in Saudi Arabia
by Ahmed Abed Elwahab Nourein, Rubayyi Faris Shahadah, Marwan Abdulrahman Alnemer, Saif Saud Al-Harbi, Hani T. Fadel and Saba Kassim
Int. J. Environ. Res. Public Health 2021, 18(1), 128; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18010128 - 27 Dec 2020
Cited by 4 | Viewed by 3044
Abstract
Background: Communication skills (CS) learning is a core skill in medical and dental education. The comparison of attitudes towards CS between dental and medical students based on the taught curriculum (problem-based learning vs. traditional teaching) in Saudi Arabia awaits investigation. Aims: (1) [...] Read more.
Background: Communication skills (CS) learning is a core skill in medical and dental education. The comparison of attitudes towards CS between dental and medical students based on the taught curriculum (problem-based learning vs. traditional teaching) in Saudi Arabia awaits investigation. Aims: (1) To assess the attitudes of both undergraduate dental and medical students towards communication skills (CS) learning and (2) to compare the attitudes towards CS between Medical and Dental students in relation to sociodemographic and education-related characteristics. Methods and Materials: A cross-sectional study, using an online survey, invited 260 conveniently sampled Taibah university medical and dental undergraduate students. The survey collected data on sociodemographic characteristics, education-related factors, and CS using Communication Skills Attitude Scale (CSAS) that assess positive and negative attitudes (PAS, NAS). Data analysis included descriptive statistics and the Mann–Whitney U test. Results: Of the distributed questionnaire 91% responded (145 dental and 91 medical students). There were, overall, non-significant scores’ differences between medical and dental students on PAS (Medicine Median 51 vs. Dentistry Median 50, p = 0.059) and NAS (Medicine Median 32 vs. Dentistry Median 32, p = 0.596). Older medical students, those at clinical levels and those who reported they need to improve their communication skills and student whose parents were not doctors, tended to score statistically significantly (p = 0.032, 0.017, 0.034, and 0.004, respectively) on PAS compared with dental students; on the other hand, medical students with doctor parents scored significantly high in NAS compared to dental students (p = 0.015). Conclusion: Demographic and education-related characteristics underpinned medical student positive attitude towards CS compared to dental students. Although medical and dental students showed no differences in self-rating their attitudes towards (CS). Different factors influence medical and dental students’ attitudes towards CS learning. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
17 pages, 2643 KiB  
Article
Mortality- and Health-Related Factors in a Community-Dwelling of Oldest-Older Adults at the Age of 90: A 10-Year Follow-Up Study
by Yoshiaki Nomura, Mieko Shimada, Erika Kakuta, Ayako Okada, Ryoko Otsuka, Yasuko Tomizawa, Chieko Taguchi, Kazumune Arikawa, Hideki Daikoku, Tamotsu Sato and Nobuhiro Hanada
Int. J. Environ. Res. Public Health 2020, 17(24), 9584; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249584 - 21 Dec 2020
Cited by 3 | Viewed by 2262
Abstract
Mortality is obviously intended for epidemiological studies of community-dwelling older adults. There are several health-related factors associated with nutritional status and mortality. The aim of this study was to elucidate the risk factor for mortality in community-dwelling oldest-older adults at the age of [...] Read more.
Mortality is obviously intended for epidemiological studies of community-dwelling older adults. There are several health-related factors associated with nutritional status and mortality. The aim of this study was to elucidate the risk factor for mortality in community-dwelling oldest-older adults at the age of 90 and clarify the structure of health-related factors associated with mortality. A 10-year follow-up study was performed for 93 subjects at the age of 90. The mean and median of their survival days were 2373 and 2581 days for women, and 1694 and 1793 days for men. By Cox’s proportional hazards model, health-related factors associated with mortality were self-assessed for chewing ability, activities of daily living (ADLs), serum albumin, total cholesterol, serum creatinine, and gripping power for women but not for men. These factors interacted with each other, and the association of these factors was different in women and men. Self-assessed chewing ability was a powerful risk factor for mortality in women at the age of 90. It acted independently from nutritional status. For older adults, addressing healthy food choices together with improved oral functions is useful. However, risk factors for mortality may depend on the life stage of subjects. To investigate the risk factor for the mortality, the life course approach is necessary. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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9 pages, 1359 KiB  
Article
Oral Health Profiles and Related Quality of Life in Thalassemia Children in Relation to Iron Overload: A Cross-Sectional Study
by Hani T. Fadel, Mohammed A. Zolaly, Manal O. Alharbi, Lujain A. Qarah, Maher S. Alrehili, Abdulaziz D. Alamri and Ahmed M. Tarawah
Int. J. Environ. Res. Public Health 2020, 17(24), 9444; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17249444 - 16 Dec 2020
Cited by 6 | Viewed by 2601
Abstract
The aim was to assess the oral health of children with β-thalassemia major (BTM) and their oral health-related quality of life (OHRQoL) in relation to the serum ferritin level (SFL). Thirty-nine children with BTM underwent an interview, salivary sampling and an oral clinical [...] Read more.
The aim was to assess the oral health of children with β-thalassemia major (BTM) and their oral health-related quality of life (OHRQoL) in relation to the serum ferritin level (SFL). Thirty-nine children with BTM underwent an interview, salivary sampling and an oral clinical examination. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess their OHRQoL. The mean age of the participants was 9 ± 3 years, with 62% females. The body mass index and salivary secretion rate were within normal ranges. The mean plaque index, gingival bleeding index and number of decayed, missing and filled tooth surfaces were 70 ± 29, 38 ± 25 and 3.2 ± 4, respectively, with no significant differences between individuals with SFL below or above 2000 ng/mL (p > 0.05). No significant differences were observed between the two groups in any of the ECOHIS questions (p > 0.05). The mean ECOHIS score was 4.2 ± 4. Individuals with SFL ≥2000 ng/mL had a significantly higher mean score in the family domain “Parent Distress” than those with lower SFL (p ≤ 0.05). Within the study limits, children with β-thalassemia major generally had high dental caries experience and gingival inflammation, yet an acceptable OHRQoL. Those with high SFL had less favorable scores in the domain “Parent Distress”. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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10 pages, 1264 KiB  
Article
Awareness and Practice of Oral Health Measures in Medina, Saudi Arabia: An Observational Study
by Selma A Saadaldina, Elzahraa Eldwakhly, Ahmad A Alnazzawi, Rayan A Alharbi, Bushra K Alghamdi, Osama A Abu Hammad and Mai Soliman
Int. J. Environ. Res. Public Health 2020, 17(23), 9112; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17239112 - 06 Dec 2020
Cited by 8 | Viewed by 3242
Abstract
The aim of this observational study is to investigate the oral health status and practices in the multicultural community of Medina, Saudi Arabia. A cross-sectional questionnaire was distributed that asked about oral health, dental and periodontal conditions, personal attitudes toward dental care, and [...] Read more.
The aim of this observational study is to investigate the oral health status and practices in the multicultural community of Medina, Saudi Arabia. A cross-sectional questionnaire was distributed that asked about oral health, dental and periodontal conditions, personal attitudes toward dental care, and smoking habits. Cross tabulation with chi-squared testing was carried out to investigate the association of toothbrush usage and smoking with several variables. Four-hundred and sixty subjects enrolled in the study. The majority of the respondents were students and Saudi males. More than 75% of the participants had neither a family dentist nor dental insurance; 7% were smokers, 84% used a toothbrush, 17% used dental floss and 34% used miswak (a teeth cleaning twig made from the Salvadora persica tree). Some of the individuals complained of tooth sensitivity, halitosis and bleeding gums. The main reason for dental visits was pain, with 23% of the participants having never visited a dentist. Tooth brushing was significantly associated with gender, nationality, occupation, education, marital status, having kids and dental insurance (p ≤ 0.05). Tobacco consumption was significantly associated with age, occupation, education level, marital status, having children, having bleeding gingivae and halitosis. Effective dental education programs are needed to improve dental knowledge and awareness in the Medina community. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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13 pages, 880 KiB  
Article
Five Predictors Affecting the Prognosis of Patients with Severe Odontogenic Infections
by Nathalie Pham Dang, Candice Delbet-Dupas, Aurélien Mulliez, Laurent Devoize, Radhouane Dallel and Isabelle Barthélémy
Int. J. Environ. Res. Public Health 2020, 17(23), 8917; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17238917 - 30 Nov 2020
Cited by 15 | Viewed by 2238
Abstract
Background: Dental cellulitis management is no longer a simple procedure, as more and more patients are needing long-time hospitalization, several surgeries and intensive care follow-up. This prospective study seeks to highlight criteria that can split patients with severe odontogenic infection into two [...] Read more.
Background: Dental cellulitis management is no longer a simple procedure, as more and more patients are needing long-time hospitalization, several surgeries and intensive care follow-up. This prospective study seeks to highlight criteria that can split patients with severe odontogenic infection into two groups: those with simple evolution and those for whom complex management is necessary. Methods: In this observational study, all patients considered with a severe odontogenic infection (which necessitated hospital admission, intravenous antibiotics and general anaesthesia) were enrolled between January 2004 and December 2014 from Clermont-Ferrand University Hospital (France). They were split into two groups: those who needed one surgical intervention with tooth extraction and collection drainage combined with probabilistic antibiotic to treat infection and those who need several surgeries, intensive care unit follow-up or tracheotomy to achieve healing. Results: 653 patients were included, of which 611 (94%) had one surgery, 42 (6%) had more than one surgery before healing. Penicillin allergy (p < 0.001), psychiatric disorders (p = 0.005), oropharyngeal oedema (p = 0.008), floor oedema (p = 0.004), fever (p = 0.04) and trismus (p = 0.018) on admission were the most relevant predictors of complex evolution. A conditional inference tree (CTREE) illustrated the association of prognostic factors and the need of multiple surgery. Conclusions: Besides clinical symptoms of severity, complications of severe odontogenic infection are predicted by measurables and objectives criteria as penicillin allergy, mandibular molar, C-reactive protein level, psychiatric disorders and alcohol abuse. Their specific association potentialize the risks. IRB number: CE-CIC-GREN-12-08. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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17 pages, 1016 KiB  
Article
Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India
by Priyanka Athavale, Nehaa Khadka, Shampa Roy, Piyasree Mukherjee, Deepika Chandra Mohan, Bathsheba (Bethy) Turton and Karen Sokal-Gutierrez
Int. J. Environ. Res. Public Health 2020, 17(22), 8629; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228629 - 20 Nov 2020
Cited by 19 | Viewed by 7263
Abstract
In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with [...] Read more.
In India, globalization has caused a nutrition transition from home-cooked foods to processed sugary snacks and drinks, contributing to increased early childhood caries (ECC). This mixed-methods study describes risk factors for ECC and associations with undernutrition in low-income communities in Mumbai. Interviews with mothers of 959 children, ages six-months through six-years, addressed maternal-child nutrition and oral health, and children received dental exams and anthropometric assessments. Focus groups with community health workers and mothers explored experiences and perceptions of oral health, nutrition, and ECC. Descriptive and logistic regression analyses of quantitative data, and content analysis of qualitative data were performed. Eighty percent of children lived 5 min from a junk-food store, over 50% consumed junk-food and sugary tea daily, 50% experienced ECC, 19% had severe deep tooth decay, 27% experienced mouth pain, and 56% experienced chronic and/or acute malnutrition. In children ages 3–6, each additional tooth with deep decay was associated with increased odds of undernutrition (Odds Ratio [OR] 1.10, Confidence Interval [CI] 1.02–1.21). Focus groups identified the junk-food environment, busy family life, and limited dental care as contributors to ECC. Policy interventions include limits on junk-food marketing and incorporating oral health services and counseling on junk-food/sugary drinks into maternal–child health programs. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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9 pages, 481 KiB  
Article
Association between Household Exposure to Secondhand Smoke and Dental Caries among Japanese Young Adults: A Cross-Sectional Study
by Hikari Saho, Ayano Taniguchi-Tabata, Daisuke Ekuni, Aya Yokoi, Kouta Kataoka, Daiki Fukuhara, Naoki Toyama, Md Monirul Islam, Nanami Sawada, Yukiho Nakashima, Momoko Nakahara, Junya Deguchi, Yoko Uchida-Fukuhara, Toshiki Yoneda, Yoshiaki Iwasaki and Manabu Morita
Int. J. Environ. Res. Public Health 2020, 17(22), 8623; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228623 - 20 Nov 2020
Cited by 5 | Viewed by 2912
Abstract
The long-term effects of secondhand smoke (SHS) on dental caries among Japanese young adults remain unclear. The purpose of this cross-sectional study was to evaluate whether household exposure to SHS is associated with dental caries in permanent dentition among Japanese young adults. The [...] Read more.
The long-term effects of secondhand smoke (SHS) on dental caries among Japanese young adults remain unclear. The purpose of this cross-sectional study was to evaluate whether household exposure to SHS is associated with dental caries in permanent dentition among Japanese young adults. The study sample included 1905 first-year university students (age range: 18–19 years) who answered a questionnaire and participated in oral examinations. The degree of household exposure to SHS was categorized into four levels according to the SHS duration: no experience (−), past, current SHS < 10 years, and current SHS ≥ 10 years. Dental caries are expressed as the total number of decayed, missing, and filled teeth (DMFT) score. The relationships between SHS and dental caries were determined by logistic regression analysis. DMFT scores (median (25th percentile, 75th percentile)) were significantly higher in the current SHS ≥ 10 years (median: 1.0 (0.0, 3.0)) than in the SHS—(median: 0.0 (0.0, 2.0)); p = 0.001). DMFT ≥ 1 was significantly associated with SHS ≥ 10 years (adjusted odds ratio: 1.50, 95% confidence interval: 1.20–1.87, p < 0.001). Long-term exposure to SHS (≥10 years) was associated with dental caries in permanent dentition among Japanese young adults. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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8 pages, 317 KiB  
Article
Inequalities in Untreated Root Caries and Affordability of Dental Services among Older American Adults
by Fatma Badr and Wael Sabbah
Int. J. Environ. Res. Public Health 2020, 17(22), 8523; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17228523 - 17 Nov 2020
Cited by 8 | Viewed by 2164
Abstract
The growing geriatric population is facing numerous economic challenges and oral health changes. This study explores the relationship between affordability of dental care and untreated root caries among older American adults, and whether that relationship is independent of ethnicity and socioeconomic factors. Data [...] Read more.
The growing geriatric population is facing numerous economic challenges and oral health changes. This study explores the relationship between affordability of dental care and untreated root caries among older American adults, and whether that relationship is independent of ethnicity and socioeconomic factors. Data from 1776 adults (65 years or older) who participated in the National Health and Nutrition Examination Survey (NHANES) were analyzed. The association between affordability of dental care and untreated root caries was assessed using logistic regression models. Findings indicated that untreated root caries occurred in 42.5% of those who could not afford dental care, and 14% of those who could afford dental care. Inability to afford dental care remained a statistically significant predictor of untreated root caries in the fully adjusted regression model (odds ratio 2.79, 95% confidence interval: 1.78, 4.39). Other statistically significant predictors were gender (male), infrequent dental visits, and current smoking. The study concludes that the inability to afford dental care was the strongest predictor of untreated root caries among older Americans. The findings highlight the problems with access to and use of much needed dental services by older adults. Policy reform should facilitate access to oral healthcare by providing an alternative coverage for dental care, or by alleviating the financial barrier imposed on older adults. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
11 pages, 331 KiB  
Article
Relationship between the Normative Need for Orthodontic Treatment and Oral Health in Mexican Adolescents Aged 13–15 Years Old
by Álvaro Edgar González-Aragón Pineda, Alvaro García Pérez, Raúl Rosales-Ibáñez and Eduardo Stein-Gemora
Int. J. Environ. Res. Public Health 2020, 17(21), 8107; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218107 - 03 Nov 2020
Viewed by 1784
Abstract
This cross-sectional study aimed to establish a relationship between the Normative Need for Orthodontic Treatment (NNOT) and oral health among Mexican adolescents aged 13–15 years old. A convenience sample of 424 subjects in Mexico City participated in the study. The dependent variable used [...] Read more.
This cross-sectional study aimed to establish a relationship between the Normative Need for Orthodontic Treatment (NNOT) and oral health among Mexican adolescents aged 13–15 years old. A convenience sample of 424 subjects in Mexico City participated in the study. The dependent variable used was NNOT, which was determined via the dental health component (grades 4 and 5) of the Index of Orthodontic Treatment Need (IOTN). The variables for oral health were as follows: caries experience, oral hygiene, self-reported temporomandibular joint pain, and self-reported bruxism. Logistic regression models were fitted to determine the association between NNOT and oral health. The prevalence of NNOT was 66.0% (280/424), and the crowding was the most prevalent occlusal anomaly with 36.1% (n = 135). Multivariate models showed that subjects with NNOT were more than twice as likely to present poor hygiene (OR = 2.56; p = 0.001) as subjects presenting crowding (>4 mm) (OR = 1.99; p = 0.004) and increased overjet (>6 mm) (OR = 1.74; p = 0.046). Those schoolchildren who presented anterior guidance were 72% less likely to present NNOT (OR = 0.28; p < 0.001). In conclusion, the risk of presenting NNOT in Mexican adolescents is high, with a prevalence of over 50% of which the most prevalent occlusal anomaly was crowding. On the other hand, poor oral hygiene was associated with crowding and increased overjet. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
16 pages, 1136 KiB  
Article
Cohort Profile: ZOE 2.0—A Community-Based Genetic Epidemiologic Study of Early Childhood Oral Health
by Kimon Divaris, Gary D. Slade, Andrea G. Ferreira Zandona, John S. Preisser, Jeannie Ginnis, Miguel A. Simancas-Pallares, Cary S. Agler, Poojan Shrestha, Deepti S. Karhade, Apoena de Aguiar Ribeiro, Hunyong Cho, Yu Gu, Beau D. Meyer, Ashwini R. Joshi, M. Andrea Azcarate-Peril, Patricia V. Basta, Di Wu and Kari E. North
Int. J. Environ. Res. Public Health 2020, 17(21), 8056; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17218056 - 01 Nov 2020
Cited by 14 | Viewed by 3383
Abstract
Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals’ susceptibility or genomic risk [...] Read more.
Early childhood caries (ECC) is an aggressive form of dental caries occurring in the first five years of life. Despite its prevalence and consequences, little progress has been made in its prevention and even less is known about individuals’ susceptibility or genomic risk factors. The genome-wide association study (GWAS) of ECC (“ZOE 2.0”) is a community-based, multi-ethnic, cross-sectional, genetic epidemiologic study seeking to address this knowledge gap. This paper describes the study’s design, the cohort’s demographic profile, data domains, and key oral health outcomes. Between 2016 and 2019, the study enrolled 8059 3–5-year-old children attending public preschools in North Carolina, United States. Participants resided in 86 of the state’s 100 counties and racial/ethnic minorities predominated—for example, 48% (n = 3872) were African American, 22% white, and 20% (n = 1611) were Hispanic/Latino. Seventy-nine percent (n = 6404) of participants underwent clinical dental examinations yielding ECC outcome measures—ECC (defined at the established caries lesion threshold) prevalence was 54% and the mean number of decayed, missing, filled surfaces due to caries was eight. Nearly all (98%) examined children provided sufficient DNA from saliva for genotyping. The cohort’s community-based nature and rich data offer excellent opportunities for addressing important clinical, epidemiologic, and biological questions in early childhood. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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13 pages, 2280 KiB  
Article
Associations between Child Snack and Beverage Consumption, Severe Dental Caries, and Malnutrition in Nepal
by Neha Zahid, Nehaa Khadka, Madhurima Ganguly, Tanya Varimezova, Bathsheba Turton, Laura Spero and Karen Sokal-Gutierrez
Int. J. Environ. Res. Public Health 2020, 17(21), 7911; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17217911 - 28 Oct 2020
Cited by 16 | Viewed by 4091
Abstract
The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is [...] Read more.
The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is poorly understood. This cross-sectional study aims to assess this relationship among a convenience sample of 273 children age six months to less than 12 years in three communities in Nepal, using parent/caregiver interviews, child dental exams, and anthropometric measurements. Fisher’s exact test and independent t-tests examined associations between dietary practices and severe caries and between severe caries and malnutrition, respectively. Children consumed sugar-sweetened beverages and processed snacks frequently: 80% consumed tea with sugar, 60% consumed sweet snacks, and 65% consumed processed savory snacks daily. Overall, 74% of children had untreated tooth decay, and 21% exhibited stunting malnutrition, 14% were underweight, and 6% presented wasting. Significant associations were found between daily consumption of sweets and processed snacks with severe caries and between severe caries and poorer nutritional status. These findings underscore the need to incorporate nutrition and oral health promotion and dental treatment into maternal–child health services and schools and to strengthen policies to reduce children’s access to junk food. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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13 pages, 696 KiB  
Article
Exploring the Intersection between Social Determinants of Health and Unmet Dental Care Needs Using Deep Learning
by Man Hung, Eric S. Hon, Bianca Ruiz-Negron, Evelyn Lauren, Ryan Moffat, Weicong Su, Julie Xu, Jungweon Park, David Prince, Joseph Cheever and Frank W. Licari
Int. J. Environ. Res. Public Health 2020, 17(19), 7286; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17197286 - 06 Oct 2020
Cited by 13 | Viewed by 3167
Abstract
The goals of this study were to develop a risk prediction model in unmet dental care needs and to explore the intersection between social determinants of health and unmet dental care needs in the United States. Data from the 2016 Medical Expenditure Panel [...] Read more.
The goals of this study were to develop a risk prediction model in unmet dental care needs and to explore the intersection between social determinants of health and unmet dental care needs in the United States. Data from the 2016 Medical Expenditure Panel Survey were used for this study. A chi-squared test was used to examine the difference in social determinants of health between those with and without unmet dental needs. Machine learning was used to determine top predictors of unmet dental care needs and to build a risk prediction model to identify those with unmet dental care needs. Age was the most important predictor of unmet dental care needs. Other important predictors included income, family size, educational level, unmet medical needs, and emergency room visit charges. The risk prediction model of unmet dental care needs attained an accuracy of 82.6%, sensitivity of 77.8%, specificity of 87.4%, precision of 82.9%, and area under the curve of 0.918. Social determinants of health have a strong relationship with unmet dental care needs. The application of deep learning in artificial intelligence represents a significant innovation in dentistry and enables a major advancement in our understanding of unmet dental care needs on an individual level that has never been done before. This study presents promising findings and the results are expected to be useful in risk assessment of unmet dental care needs and can guide targeted intervention in the general population of the United States. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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10 pages, 402 KiB  
Article
Factors Related to Oral Healthcare Service Utilization among Korean Adults Aged 25–79 Years
by Han-Na Kim, Sang-Jun Han, Eun-Joo Jun and Jin-Bom Kim
Int. J. Environ. Res. Public Health 2020, 17(17), 6032; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph17176032 - 19 Aug 2020
Cited by 6 | Viewed by 2536
Abstract
The factors related to oral healthcare service utilization (OHSU) among Korean adults aged 25–79 years were assessed using the Andersen model with the sixth Korean National Health and Nutrition Examination Survey data. The study included 12,937 participants aged 25–79 years who answered questions [...] Read more.
The factors related to oral healthcare service utilization (OHSU) among Korean adults aged 25–79 years were assessed using the Andersen model with the sixth Korean National Health and Nutrition Examination Survey data. The study included 12,937 participants aged 25–79 years who answered questions on the predisposing, enabling, and need factors related to OHSU at dental clinics within the past 1 year. Age, sex, and education level were selected as predisposing factors; household income, residence region, and national and private health insurance status as enabling factors; and self-perceived oral health, dental pain, chewing status, and discomfort while speaking as need factors. These factors were assessed using multivariable complex logistic regression models. OHSU at dental clinics within the past 1 year was lower among less-educated participants, those with low, middle–low, and middle–high household income levels, rural participants, those benefiting from the Medicaid system, and non-insured participants. OHSU was higher among older participants, those who rated their self-perceived oral health status as bad, those with experience of dental pain, and those who experienced discomfort while chewing and speaking. The need factors were the most influential. Thus, interventions to reduce inequalities in OHSU are required to promote oral health for all. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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Review

Jump to: Research

11 pages, 1549 KiB  
Review
Systematic Review of Intervention Studies Aiming at Reducing Inequality in Dental Caries among Children
by Anqi Shen, Eduardo Bernabé and Wael Sabbah
Int. J. Environ. Res. Public Health 2021, 18(3), 1300; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18031300 - 01 Feb 2021
Cited by 21 | Viewed by 4941
Abstract
(1) Background: The objective is to systematically review the evidence on intervention programs aiming at reducing inequality in dental caries among children. (2) Methods: Two independent investigators searched MEDLINE, Cochrane library, and Ovid up to December 2020 to identify intervention studies assessing the [...] Read more.
(1) Background: The objective is to systematically review the evidence on intervention programs aiming at reducing inequality in dental caries among children. (2) Methods: Two independent investigators searched MEDLINE, Cochrane library, and Ovid up to December 2020 to identify intervention studies assessing the impact on socioeconomic inequalities in dental caries among children. The interventions included any health promotion/preventive intervention aiming at reducing caries among children across different socioeconomic groups. Comparison groups included children with alternative or no intervention. Cochrane criteria were used to assess interventional studies for risk of bias. (3) Results: After removal of duplicate studies, 1235 articles were retained. Out of 43 relevant papers, 13 articles were identified and used in qualitative synthesis, and reported quantifiable outcomes. The included studies varied in measurements of interventions, sample size, age groups, and follow-up time. Five studies assessed oral health promotion or health-education, four assessed topical fluorides, and four assessed water fluoridation. Interventions targeting the whole population showed a consistent reduction of socioeconomic inequalities in dental caries among children. (4) Conclusion: The quality of included papers was moderate. High heterogeneity did not allow aggregation of the findings. The overall findings suggest that whole population interventions such as water fluoridation are more likely to reduce inequalities in children’s caries than target population and individual interventions. Full article
(This article belongs to the Special Issue Research on Oral Health Outcomes)
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