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Objectives To determine whether participants of a dental practice-based research network ( PBRN) differ in their level of oral health impact as measured by the Oral Health Impact Profile ( OHIP) questionnaire. Methods A total of 2410 patients contributed 2432 OHIP measurements (median age = 43 years; interquartile range = 28) were enrolled in four dental studies. All participants completed the Oral Health Impact Profile ( OHIP-14) during a baseline visit. The main outcome of this study was the level of oral health impact, defined as follows: no impact (' Never' reported on all items); low (' Occasionally' or ' Hardly ever' as the greatest frequency score reported on any item); and high (' Fairly often' or ' Very often' as the greatest frequency reported on any item). Polychotomous logistic regression was used to develop a predictive model for the level of oral health impact considering the following predictors: patient's age, gender, race, practice location, type of dentist, and number of years the enrolling dentist has been practicing. Results A high level of oral health impacts was reported in 8% of the sample; almost a third (29%) of the sample reported a low level of impacts, and 63% had no oral health impacts. The prevalence of impacts differed significantly across protocols ( P < 0.001). Women were more likely to be in the high oral impact group than in the no impact group compared to men ( OR = 1.46; 95% CI = 1.06-1.99). African Americans were more likely to report high oral impacts when compared to other racial/ethnic groups ( OR = 2.11; 95% CI = 1.26-3.55). Protective effects for being in the high or in the low-impact groups were observed among patients enrolled by a solo practice ( P < 0.001) or by more experienced dentists ( P = 0.01). A small but highly significant statistical association was obtained for patient age ( P < 0.001). In the multivariate model, patient's age, practice size, and gender were found to jointly be significant predictors of oral health impact level. Conclusions Patients' subjective report of oral health impact in the clinical setting is of importance for their health. In the context of a dental PBRN, the report of oral health-related quality of life ( OHRQo L) was different across four dental studies. The observed findings validate the differential impact that oral health has on the patients' perception of OHRQo L particularly among specific groups. Similar investigations to elucidate the factors associated with patient's report of quality of life are warranted. [ABSTRACT FROM AUTHOR]

Busato IMS, Ignácio SA, Brancher JA, Moysés ST, Azevedo-Alanis LR. Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus. Community Dent Oral Epidemiol 2012; 40: 62-69. © 2011 John Wiley & Sons A/S Abstract - Objectives: To investigate the influence of clinical status and salivary conditions on the presence of xerostomia on adolescents with and without type 1 diabetes mellitus (DM1), and further to investigate the influence of clinical status, salivary conditions and xerostomia on oral health-related quality of life (OHQoL) of those with DM1. Methods: A cross-sectional study was performed on 102 adolescents, 51 with DM1 and 51 nondiabetics. Xerostomia was detected by asking a question about the sensation of having 'dry mouth', and Oral Health Impact Profile-14 was used to measure the impact of xerostomia on OHQoL. The clinical status was assessed by using decayed, missing or filled and Community Periodontal indices, and by evaluating oral manifestations; and the following salivary conditions were evaluated: stimulated salivary flow, pH, buffer capacity, total protein, amylase, urea, calcium, and glucose salivary concentrations. Multiple logistic regression analysis was used to evaluate the influence of clinical status and salivary conditions on xerostomia and the impact of xerostomia on the OHQoL of adolescents with DM1. Results: Clinical status and salivary conditions was shown to have no influence on the presence of xerostomia. Bivariate ( P = 0.00) and logistic regression ( P = 0.01) analysis showed a significant association between DM1 and xerostomia. Logistic regression analysis showed association between xerostomia ( P = 0.00) and OHQoL, and caries experience ( P = 0.03) and OHQoL. Conclusions: DM1 showed to be predictive of a high prevalence of xerostomia in adolescents. Caries experience and xerostomia showed to have a negative impact on the OHQoL of adolescents with DM1. [ABSTRACT FROM AUTHOR]

Weng Y, Korte JE. Racial disparities in being recommended to surgery for oral and oropharyngeal cancer in the United States. Community Dent Oral Epidemiol 2012; 40: 80-88. © 2011 John Wiley & Sons A/S Abstract - Objectives: To investigate the impact of race on the likelihood of patients being recommended for surgery after a diagnosis of oral and oropharyngeal cancer. Methods: A total of 68 445 cases of oral and oropharyngeal cancer were extracted from the 1988 to 2005 Surveillance, Epidemiology, and End Results (SEER) database. County-level rurality data and income data were merged using the US Department of Agriculture Rural-Urban Continuum Codes dataset and US Census Bureau Small Area Income & Poverty Estimates dataset. We used logistic regression analyses to investigate the impact of race on being recommended to surgery for oral and oropharyngeal cancer, adjusting for demographic, socioeconomic, and clinical factors. Stratified analyses were further conducted by tumor site and rural/urban status. Results: Recommendation to surgery varied significantly by race, with black patients less likely than white patients to be recommended to surgery for their oral and oropharyngeal cancer. The racial difference in recommendation to surgery varied significantly by age, geography, and tumor subsite. Racial disparities are most evident in lip and buccal cancer from rural areas (OR, 4.4; 95% CI, 2.6-7.5); and least evident in oropharyngeal cancer from urban areas (OR, 1.2; 95% CI, 1.1-1.3). The magnitude of the racial disparity is attenuated with increasing age. Conclusions: We observed substantial racial disparities in surgery recommendation for oral and oropharyngeal cancer in the United States. Our results suggest the need to improve accessibility to better health care in racial minority groups, particularly in rural areas, and call for individual and institutional efforts to avoid physician bias related to the patient's sociodemographic characteristics in healthcare service. [ABSTRACT FROM AUTHOR]

Aida J, Kuriyama S, Ohmori-Matsuda K, Hozawa A, Osaka K, Tsuji I. The association between neighborhood social capital and self-reported dentate status in elderly Japanese - The Ohsaki Cohort 2006 Study. Community Dent Oral Epidemiol 2011; 39: 239-249. © 2010 John Wiley & Sons A/S Little is known about the influence of social capital on dental health. The aim of the present cross-sectional study was to determine the association between neighborhood social capital, individual social networks and social support and the number of remaining teeth in elderly Japanese. In December 2006, self-administered questionnaires were sent to 31 237 eligible community-dwelling individuals (response rate: 73.9%). Included in the analysis were 21 736 participants. Five neighborhood social capital variables were calculated from individual civic networks, sports and hobby networks, volunteer networks, friendship networks and social support variables. We used multilevel logistic regression models to estimate the odds ratio (OR) of having 20 or more teeth according to neighborhood social capital variables with adjustment for sex, age, individual social networks and social support, educational attainment, neighborhood educational level, dental health behavior, smoking status, history of diabetes and self-rated health. The average age of the participants was 74.9 (standard deviation; 6.6) years, and 28.5% of them had 20 or more teeth. In the univariate multilevel model, there were statistically significant associations between neighborhood sports and hobby networks, friendship networks and self-reported dentate status. In the multivariable multilevel model, compared with participants living in lowest friendship network neighborhoods, those living in highest friendship network neighborhoods had an OR 1.17 (95% confidence interval, 1.04-1.30) times higher for having 20 or more teeth. There is a significant association between one network aspect of neighborhood social capital and individual dentate status regardless of individual social networks and social support. [ABSTRACT FROM AUTHOR]

Jung S-H, Watt RG, Sheiham A, Ryu J-I, Tsakos G. Exploring pathways for socio-economic inequalities in self-reported oral symptoms among Korean adolescents. Community Dent Oral Epidemiol 2011; 39: 221-229. © 2010 John Wiley & Sons A/S This study aimed to assess socio-economic inequalities in self-reported oral symptoms in Korean adolescents and to assess the association of health behaviours, psychosocial factors and material factors on social gradients in oral symptoms. Cross-sectional data were from the national 2007 Korean Youth Risk Behavior Web-based Survey (KYRBWS). Self-reported oral symptoms included toothache, bad breath, and fractured teeth. Self-assessed socio-economic status (SES) was selected as a measure of SES. To assess socio-economic inequalities in oral symptoms, we used logistic regression models for toothache, bad breath and fractured teeth, and ordinal logistic regression models for the aggregate variable on oral symptoms. We used models adjusting for socio-demographic factors (Model 1) and compared them to models additionally adjusting for health behaviours (Model 2), psychosocial factors (Model 3) and material factors (Model 4). A total of 78 834 students were invited to participate, and the response rate was 94.8% ( n = 74 698). We found that lower self-assessed SES was significantly associated with higher prevalence of each of the three self-reported oral symptoms. Social gradient in the prevalence of each oral symptoms persisted when adjusted for behavioural, psychosocial and material factors. The odds ratio (OR) for the aggregate variable on oral symptoms in the lower SES group was 2.25 (95% CI 2.04, 2.49), and the respective figures after adjusting for behavioural, psychosocial and material factors were 2.17 (95% CI 1.96, 2.39), 1.90 (95% CI 1.73, 2.10) and 2.26 (95% CI 2.04, 2.50). While adjusting for psychosocial factors decreased the OR in the aggregate variable on oral symptoms for lower SES groups, adjusting for health behaviours and material factors hardly changed the OR. There were clear social gradients in three self-reported oral symptoms (toothache, bad breath and fractured teeth) in Korean adolescents. Psychosocial factors explained part of the social inequalities in oral symptoms. Future longitudinal research is required to better address the pathways that explain socio-economic inequalities in oral symptoms during adolescence. [ABSTRACT FROM AUTHOR]

Marlow NM, Slate EH, Bandyopadhyay D, Fernandes JK, Salinas CF. An evaluation of serum albumin, root caries, and other covariates in Gullah African Americans with type-2 diabetes. Community Dent Oral Epidemiol 2011; 39: 186-192. © 2010 John Wiley & Sons A/S Associations between dental conditions and overall health have been previously reported. Investigators have also shown significant inverse relationships between serum albumin (a general health status marker) and root caries. This relationship was explored among a study population of Gullah African Americans (who have a considerably lower level of non-African genetic admixture when compared to other African American populations) with type-2 diabetes (T2DM) and self-reported history of normal kidney function ( N = 280). Root caries indices were defined as total decayed and/or filled root surfaces. The coronal caries index [total decayed, missing, and/or filled coronal surfaces (DMFS)], level of glycemic control, total number of teeth, and other covariates were also evaluated. Logistic regression models were used to evaluate the associations between these factors and hypoalbuminemia (serum albumin concentrations <4 g/dl). Serum albumin concentrations ranged 2.4-4.5 g/dl (mean = 3.8, SD = 0.3), with 70.4% exhibiting hypoalbuminemia. Root caries totals ranged 0-38 (mean = 1.3, SD = 4.5) surfaces decayed/filled, while total teeth ranged 1-28 (mean = 19.4, SD = 6.2). DMFS totals ranged 2-116 (mean = 55.2, SD = 28.0). We failed to detect significant associations for root caries; however, the final multivariable logistic regression models showed significant associations between hypoalbuminemia and total teeth [odds ratio (OR) = 0.93, P = 0.01], poor glycemic control (OR = 2.49, P < 0.01), elevated C-reactive protein (OR = 1.57, P < 0.01), glomerular filtration rates ≥60 (OR = 0.31, P = 0.03), and age (OR = 0.97, P = 0.03). Previously reported inverse relationships between serum albumin and root caries were not evident in our study population. We propose that these null findings are because of the considerably lower level of root caries as well as other differing characteristics (including oral health status, the chronic presence of T2DM, and predominantly younger age) within our study population compared to these previously assessed groups. [ABSTRACT FROM AUTHOR]

Ferracane J, Hilton T, Korpak A, Gillette J, Speed McIntyre P, Berg J, Northwest PRECEDENT. Use of caries prevention services in the Northwest PRECEDENT dental network. Community Dent Oral Epidemiol 2011; 39: 69-78. © 2010 John Wiley & Sons A/S This cross-sectional study assessed the use of caries preventive services by Northwest PRECEDENT dental network practitioners and compared the caries experience of patients who received such services in the past 12 months with those who had not. An oral health survey was conducted on approximately 20 patients seen by each of 97 private practice dental practitioners in the network. Eligible patients (total of 1877 aged 3-92) were randomly assessed for the occurrence of one or more new caries lesions as well as having received the following preventive services within the past 12 months: fluoride varnish or gel, sealant in molar or premolar, and prophylaxis. Patients were stratified by gender and age (1-17 years old, 18-64 years old, and 65+ years old). Logistic regression was used to investigate the association between the practitioner characteristics and the use of preventive services, as well as the preventive services and the presence of a new caries lesion in the past 12 months. The percent of patients in age category 1-17 years old/18-64 years old/65+ years old receiving each preventive treatment varied as follows: 95%/85%/81% for prophylaxis, 87%/24%/22% for fluoride, and 27%/2%/0% for sealant. There was a very limited association between the use of a specific preventive service and practitioner gender, and no significant association between use of services and practice location (rural, urban or suburban). There was a significant association between greater use of sealants for dentists with 0-15 years of practice experience as compared with those having more than 25 years of experience. For the 1-17 -year-old age group, boys had about 1.7 times the odds of having a new lesion than girls in the past 12 months, and patients receiving a sealant had 1.9 times the odds of having a new caries lesion. In the 18-64 -year-old group, receiving a prophylaxis in the past 12 months was significantly associated with lower odds for having a new lesion (odds ratio = 0.57). This study reports that aside from prophylaxis, which more than 85% of the patients had received, about one-third of the patients overall received preventive services consisting of either sealants or some type of fluoride treatment in private dental practices in the Northwest PRECEDENT network. [ABSTRACT FROM AUTHOR]