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Objectives: To examine trends in incidence and mortality and evaluate overall survival (OS) of oral cancer in Singapore between 1968 and 2017. Methods: All diagnosed oral cancers by anatomical sites and population size were extracted from the Singapore Cancer Registry and the Department of Statistics Singapore. The trend of age‐standardized incidence rate (ASIR) and mortality rate (ASMR) (per 100 000 person‐years) of the lip, oral cavity and salivary gland cancers were evaluated by Prais‐Winsten regressions for each ethnicity and gender. Kaplan–Meier curves were performed to evaluate the OS by anatomical sites in each age group by ethnicity and sex. Results: Overall, 49, 3494 and 1066 people were diagnosed, and 28, 2310 and 476 died from lip, oral cavity and salivary gland cancers, respectively. The oral cavity cancer ASIR and ASMR reduced from 3.07 (1968–1972) to 2.01(2008–2012) and from 2.06 (1978–1982) to 1.21 (2013–2017) per 100 000 person‐years, respectively, with both highest in Indians throughout the whole period. Male:Female ratio ranged from 3.43 (1973–1977) to 1.75 (2013–2017) and from 3.41 (1978–1982) to 2.40 (2013–2017) for ASIR and ASMR, respectively. However, both salivary gland cancer ASIR and ASMR increased from 0.50 (1968–1972) to 0.80 (2008–2012) and from 0.18 (1968–1982) to 0.42 (1988–1992) per 100 000 person‐years, respectively, with both higher in males since 1993. Oral cavity cancer ASIR decreased for males aged ≥60, and Indian females ≥25, but increased among Chinese females aged ≥60. Oral cavity cancer ASMR decreased among Chinese aged 25–59, and among Malay males and Indian females. Salivary gland cancer ASIR increased among Chinese males aged ≥60 and Malay males aged 25–59; while ASMR increased among Chinese males aged ≥60. The median OS for oral cavity, lip and salivary gland cancers were 3.0, 9.3 and 18.1 years, respectively, with females surviving longer than males. Conclusions: Singapore has experienced a decline in the incidence and mortality of lip, oral cancer, an increase in in the incidence and mortality of salivary gland cancer, with an increase in the median overall survival rate. Monitoring the magnitude of oral cancer burden and the demographic, and temporal variations is necessary for tailoring health planning and setting priorities for future clinical care and research. [ABSTRACT FROM AUTHOR]

Objectives To review the effectiveness of adjusted fluoridation of public water supplies in the prevention of dental caries, with emphasis on results of studies published worldwide since 1990 and to discuss aspects of the design and reporting of these studies compared with those published before 1990. Method Studies published worldwide, in any language, reporting the effect of water fluoridation in terms of the dmf/ DMF caries index between 1990 and 2010 were examined. The literature search was by professional Internet search, back-tracking from references given in publications, hand-searching all issues of four journals and by contacting colleagues in relevant countries. For the dmf index, age 5 year was preferred, and for the DMF index, age 12 year or older was preferred. The results were compared with results obtained from worldwide literature search prior to 1990 by the same author. Results Fifty-nine studies of adjusted water fluoridation were identified, yielding 83 evaluations (30 recording dmft/s and 53 recording DMFT/ S) from 10 countries. These numbers are lower than pre-1990 results of 113 studies (66 for primary and 86 for permanent teeth) from 23 countries. For the USA, for example, four studies were indentified since 1990 compared with 61 studies before 1990. The most number of recent reports came from Brazil and Australia. There were fewer reports of per cent caries reductions (% CR) above 50% in the recent studies. 86% of the post-1990 investigations were concurrent control cross-sectional studies and, of these, 52% used multivariate statistical analysis to adjust for confounding factors. In the eight studies that provided dmf/ DMF data before and after adjustment for confounders, the % CR were little affected by these adjustments. Conclusions Fewer studies have been published recently. More of these have investigated effect at the multi-community, state or even national level. The dmf/ DMF index remains the most widely used measure of effect. % CR were lower in recent studies, and the 'halo' effect was discussed frequently. Nevertheless, reductions were still substantial. Statistical control for confounding factors is now routine, although the effect on per cent reductions tended to be small. Further thought is needed about the purpose of evaluation and whether measures of effect and study design are appropriate for that purpose. [ABSTRACT FROM AUTHOR]

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]

Objectives The aim of the present survey was to study the association between dental caries and body mass index ( BMI) in Swedish preschool children (born in 1999 ). Methods A population-based and cross-sectional study design was used comprising all 920 5-year-old children in a defined area in and around the city of Lund. Anthropometric measures for the calculation of BMI were retrieved for each child from recordings at Child Health Care Centers ( CHC). The occurrence of caries and fillings in the primary dentition, defined as deft (decayed, extracted, or filled primary teeth) and dt (decayed primary teeth), was collected from the children's dental records. Results The mean BMI was 16.1 (no differences between boys and girls). About 19.2% were overweight, of which 5.1% were obese. Overweight or obese children did not have higher deft or dt than others. However, children with low BMI (below −1 SD of national mean values for Swedish 5-year-olds) had statistically significantly higher deft and dt than children with normal BMI. Conclusions Children with low BMI may be at risk of caries development. Low BMI may be associated with eating habits endangering dental health. [ABSTRACT FROM AUTHOR]

Objectives The aim was to evaluate whether contracted private practitioners assess required treatment more extensive, demanding and economically more rewarding than mainly salaried public sector dentists and to estimate the cost consequences of using these alternative providers. Methods All dental services included in comprehensive treatments funded by the city of Turku and provided to adult patients during the year 2009 were recorded. Patients were distributed randomly without any determination of treatment needs before appointing them to different dentists. Treatment courses for 7432 patients in public clinics included 63 906 procedures and for 2932 patients assigned to treatment by contracted private practitioners included 21 194 procedures. Public sector dentists were mainly salaried with production incentives, and private practitioners worked purely on a fee-for-service basis. The cost estimates were based on the distributions of competence classifications recorded by the providers, which also formed the basis for reimbursement. Results For each studied treatment category with more than one competence classification, private contractors were less likely than their public sector counterparts to give an assessment of simple or less demanding: 8% versus 29% of examinations, 46% versus 69% of periodontal treatments, 63% versus 85% of extractions, 31% versus 46% of fillings, 18% versus 35% of root canals. The excess cost to society varied from 7.0% for root canal treatments to 21.3% for extractions, causing on average 14.4% higher cost level from use of private practitioners compared with public sector dentists. Conclusions Private practitioners systematically classified the treatment procedures they provided as more demanding, and therefore more economically rewarding, than their public sector counterparts. The findings indicate that the costs of publicly funded dental care may be increased by the use of private dental contractors. [ABSTRACT FROM AUTHOR]

Bernabé E, Watt RG, Sheiham A, Suominen AL, Vehkalahti MM, Nordblad A, Uutela A, Kivimäki M, Tsakos G. Childhood socioeconomic position, adult sense of coherence and tooth retention. Community Dent Oral Epidemiol 2012; 40: 46-52. © 2011 John Wiley & Sons A/S Abstract - Objective: To explore the role of sense of coherence (SOC) as a mediator in the relationship between childhood socioeconomic position (SEP) and tooth retention in adulthood. Methods: Data from 5401 dentate adults aged 30 and over who participated in the nationally representative Finnish Health 2000 Survey were analysed. Participants provided information on demographic characteristics (sex and age), childhood SEP (parental education), adulthood SEP (years of education and household income), the SOC scale and oral health-related behaviours (dental attendance, toothbrushing frequency, sugar intake frequency and daily smoking). They also had a clinical oral health examination. Structural equation modelling was used to test a model including adulthood SEP, SOC and oral health-related behaviours as mediators of the relationship between childhood SEP and tooth retention. Multigroup comparison was also conducted to test the hypothesized model within each sex and age group (<45 years, 45-59 years and 60+ years). Results: The relationship between childhood SEP and tooth retention in adulthood was to a large extent mediated by adulthood SEP and to a much lesser extent by SOC. There was only a weak association between childhood SEP and adult SOC, but favourable oral health-related behaviours appeared to link a strong SOC with greater tooth retention. The model was invariant across sexes and age groups. Conclusions: SOC is associated with tooth retention through oral health-related behaviours, but contributes little to the relationship between childhood SEP and tooth retention. [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]

Crocombe LA, Brennan DS, Slade GD. The influence of dental attendance on change in oral health-related quality of life. Community Dent Oral Epidemiol 2012; 40: 53-63. © 2011 John Wiley & Sons A/S Abstract - Background: Few longitudinal studies have investigated the association between dental attendance and oral health-related quality of life (OHRQoL). These studies were limited to older adults, or to study participants with an oral disadvantage and did not assess if dental attendance had a different effect on OHRQoL for different people. Objective: This project was designed to test whether routine dental attendance improved the OHRQoL of survey participants and whether any patient factors influenced the effect of dental attendance on change in OHRQoL. Methods: Collection instruments of a service use log book and a 12 month follow-up mail self-complete questionnaire were added to the Tasmanian component of the National Survey of Adult Oral Health 2004/06. The dependent variable was change in OHIP-14 severity and the independent variable was dental attendance. Many putative confounders/effect modifiers were analysed in bivariate, stratified and three-model multivariate analyses. These included indicators of treatment need, sociodemographic characteristics, socioeconomic status, pattern of dental attendance and access to dental care. Results: None of the putative confounders were associated with both dental attendance and the change in mean OHIP-14 severity. The only statistically significant interaction for change in OHIP-14 severity was observed for dental attendance by residential location ( P < 0.01). In multivariate analysis, there was a statistically significant association of dental attendance with change in mean OHIP-14 severity. It also showed that the difference in association of attendance between Hobart, the capital city of Tasmania, and other places was statistically significant based on the interaction between residential location and attendance ( P < 0.05). Conclusion: The effect of dental attendance on OHRQoL was influenced by a patient's residential location. [ABSTRACT FROM AUTHOR]

Telford C, Murray L, Donaldson M, O'Neill C. An analysis examining socio-economic variations in the provision of NHS general dental practitioner care under a fee for service contract among adolescents: Northern Ireland Longitudinal Study. Community Dent Oral Epidemiol 2012; 40: 70-79. © 2011 John Wiley & Sons A/S Abstract - Objectives: To examine socio-economic variations in the use of publicly funded general dental practitioner care by adolescents under a fee for service arrangement. Method: Publicly funded general practitioner reimbursement data were linked to census and vital statistics data within the Northern Ireland Longitudinal Study. Data relate to 12 846 adolescents aged 11 or 12 in April 2003 included within the Northern Ireland Longitudinal Study (28% of the population). The main outcome measure was consumption of dental care between 2003/2004 and 2007/2008 by socio-economic status (as measured by National Statistics Socio-economic Classification of occupation and highest educational attainment of household reference person). Results: In multivariate analysis, socio-economic status was a significant determinant of dental care consumed. Those of the lowest socio-economic status, according to both occupation and highest educational attainment of household reference person, were less likely to have consumed orthodontics OR 0.76 (0.62, 0.95) and OR 0.79 (0.69, 0.91), respectively. Those of lower socio-economic status were, however, more likely to have undergone an extraction and restorative treatment and also consumed on average more treatment than those of higher socio-economic status. Conclusion: A demand-led service, in which practitioners are reimbursed in part on a fee for service basis, may create incentives that contribute to different patterns of utilization between social groups. Such a system may not be providing equal access for equal need and may widen existing socio-economic disparities in oral health among adolescents. [ABSTRACT FROM AUTHOR]

Montero J, Bravo M, López-Valverde A. Development of a specific indicator of the well-being of wearers of removable dentures. Community Dent Oral Epidemiol 2011; 39: 515-524. © 2011 John Wiley & Sons A/S Abstract - Objectives: Bearers of removable prostheses have certain particular characteristics that require the inclusion of items able to detect the specific effect on their oral functions (derived from the presence of such prostheses). We aimed to develop and validate a specific indicator for the assessment of oral health-related quality of life in bearers of dentures. Methods: A panel of experts compiled a questionnaire addressing oral health-related quality of life (11 items) to assess the degree of well-being afforded by removable dentures. After a pilot trial in patients bearing prostheses ( n = 36), a consecutive sampling of denture wearers ( n = 123) was conducted among patients not requesting odontological treatment and accompanying persons, attending their respective health centres in the City of Granada and its metropolitan area. The subjects were classified as RPP1 (removable partial prosthesis on one of the arches, RPP2 (on both) and complete prosthesis (CP on both arches). Results: The questionnaire was consistent (Cronbach alpha 0.814) and proved to have suitable validity. Factor analysis revealed three factors termed physical, psychological and social well-being, which coherently supported the interrelationship among the 11 items. The prevalence of impact was significantly higher in the CP individuals (97.1%) and in that of the RPP2 group (92.1%) than in the RPP1 subjects (80.7%). Prosthetic fit, aesthetics and self-confidence were significantly discrepant among the prosthetic groups, although the total prosthetic quality of life score was not able to differentiate them. The main prosthetic impact in all the prosthesis-wearing groups was attributed to 'food impaction', although all the groups were essentially satisfied with their mouth. Conclusions: The prosthetic quality of life (PQL) questionnaire is a valid and reliable indicator of the specific well-being of partial or complete denture wearers. [ABSTRACT FROM AUTHOR]

Lindmark U, Hakeberg M, Hugoson A. Sense of coherence and its relationship with oral health-related behaviour and knowledge of and attitudes towards oral health. Community Dent Oral Epidemiol 2011; 39: 542-553. © 2011 John Wiley & Sons A/S Abstract - Objective: To investigate the relationship between sense of coherence (SOC), oral health-related behaviour, knowledge of and attitudes towards oral health in an adult Swedish population. Methods: A cross-sectional design with a stratified random sample of 910 individuals aged 20, 30, 40, 50, 60, 70 and 80 years were invited to the study, from Jönköping, Sweden. The investigation used the Swedish short version of the SOC questionnaire comprising 13 items and self-reported questions about oral health habits and knowledge of and attitudes towards oral health. In addition, a self-report questionnaire to elicit demographic information was included. Results: A total of 525 individuals, 261 men and 264 women, answered all the 13-item SOC questions, which constituted the final number of the participants. After adjustment for all the sociodemographic factors included in the analysis, individuals with a stronger SOC had twice as high a chance of having healthier behaviour, including a lower frequency of snacks and drinks between meals, as well as a more positive attitude, such as the importance of having one's own teeth as one gets older, satisfaction with their own teeth, perceiving their teeth as good and no feeling of dental fear, compared with individuals with a poorer SOC. Moreover, SOC and a good knowledge of caries were significantly associated after adjustment for age and gender. Conclusions: SOC was significantly associated with several oral health-related behaviours, attitudes towards oral health and knowledge of dental caries. When working with oral health promotion, SOC could be a way for promoting a better understanding of the behaviour and attitudes of individuals and for enabling dental personals to use that knowledge for the guidance of the individual. [ABSTRACT FROM AUTHOR]

Liao C-H, Chang C-S, Chang S-N, Lane H-Y, Lyu S-Y, Morisky DE, Sung F-C. The risk of temporomandibular disorder in patients with depression: a population-based cohort study. Community Dent Oral Epidemiol 2011; 39: 525-531. © 2011 John Wiley & Sons A/S Abstract - Objectives: This study used a population-based retrospective cohort design to examine whether depression is a risk factor of temporomandibular disorder (TMD) Methods: From a universal insurance database, we identified 7587 patients who are newly diagnosed individuals with depression in 2000 and 2001. A total of 30 197 comparison subjects were randomly selected from a nondepression cohort. Both groups were followed until the end of 2008 to measure the incidence of TMD. Results: The incidence of TMD was 2.65 times higher in the depression cohort than in the nondepression cohort (6.16 versus 2.32 per 1000 person-years). The hazard ratio (HR) measured by multivariate Cox's proportional hazard regression analysis of TMD for the depression cohort was 2.21 (95% confidence interval (CI) 1.83-2.66), after controlling for socio-demographic factors and other psychiatric comorbidities. Women had higher risk to develop TMD than men (HR 1.61, 95% CI 1.36-1.92 for women without depression; HR 3.54, 95% CI 2.81-4.45 for women with depression). Conclusions: This study demonstrates that patients with depression are at an elevated risk of developing TMD. [ABSTRACT FROM AUTHOR]

Arrow P, Brennan D, Spencer AJ. Quality of life and psychosocial outcomes after fixed orthodontic treatment: a 17-year observational cohort study. Community Dent Oral Epidemiol 2011; 39: 505-514. © 2011 John Wiley & Sons A/S Abstract - Background: There is little evidence to suggest that orthodontic treatment can prevent or reduce the likelihood of dental caries or of periodontal disease or dental trauma and temporomandibular disorders, but there is a modest association between the presence of malocclusion/orthodontic treatment need and quality of life. However, little is known of the long-term outcomes of orthodontic treatment. This study reports on the longitudinal follow-up of quality of life and psychosocial outcomes of orthodontic treatment among a cohort of adults who were examined as adolescents in 1988/1989. Materials and Methods: Children who were examined in 1988/1989 were invited to a follow-up in 2005/2006. Respondents completed a questionnaire, which collected information on quality of life, receipt of orthodontic treatment and psychosocial factors, and were invited for a clinical examination. Oral health conditions including occlusal status using the Dental Aesthetic Index were recorded. Analysis of variance and multiple linear regression were used to examine the relationship between the measured factors. Results: There was no statistically significant association between occlusal status at adolescence and quality of life at adulthood. Those individuals who had orthodontic treatment but did not need orthodontic treatment had higher self-esteem (23.1, SD 5.2) and were more satisfied with life (18.5, SD 3.7) than other treatment groups (self-esteem range, 20.0-22.7; life satisfaction range, 16.4-18.1), anova P < 0.01 and P < 0.05, respectively. Occlusal status at adulthood was significantly associated with quality of life, P < 0.01. Multivariate analyses showed a statistically significant association between occlusal status at adolescence ('Desirable treatment'β = 0.70, P = 0.04) and adulthood ('Desirable treatment'β = 1.66, P < 0.01) with quality of life. Orthodontic treatment was negatively associated with psychosocial factors (life satisfaction; fixed orthodontic treatment (FOT) β = −0.91, P = 0.02 and self-esteem; FOT β = −1.39, P < 0.01). Conclusions: Occlusal status appears to have limited association with quality of life and psychosocial factors. Receipt of fixed orthodontic treatment does not appear to be associated with oral health-related quality of life but appears to be negatively associated with self-esteem and satisfaction with life. [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]

Jordan RA, Hetzel P, Franke M, Markovic L, Gaengler P, Zimmer S. Class III Atraumatic Restorative Treatment (ART) in adults living in West Africa - outcomes after 48 months. Community Dent Oral Epidemiol 2011; 39: 164-170. © 2010 John Wiley & Sons A/S This observational study assessed the effectiveness of class III restorations using the atraumatic restorative treatment (ART) approach in permanent anterior teeth over a 48-month period. Dental auxiliaries placed a total of 117 class III ART restorations in 2004, using a cosmetically improved glass-ionomer (Ionofil Plus; VOCO, Cuxhafen, Germany), in 67 patients with a mean age of 27.3 years in the rural Jahali Health Center, The Gambia. Independent examiners evaluated the restorations after 24 and 48 months using the clinical ART evaluation criteria. Seventy-six of the restorations could be observed over 48 months in 51 patients. After 48 months, 53 of 76 restorations were classified as clinically acceptable (without or with minor intervention (repair) needed), and 23 restorations were classified as insufficient. There was no statistical difference in a clustered performance rating between restorations placed in central and lateral incisors ( P = 1.0). The adoption of the ART approach to class III caries cavities made restorative dental care in anterior teeth available in a West African region. The long-term performance was comparable to other studies. Longitudinal clinical studies with greater populations are required to substantiate these results. [ABSTRACT FROM AUTHOR]

Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of oral diseases and disorders on oral health-related quality of life of preschool children. Community Dent Oral Epidemiol 2011; 39: 105-114. © 2010 John Wiley & Sons A/S The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well-being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health-related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children's OHRQoL and socioeconomic conditions. Two calibrated dentists (κ > 0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0 = caries free; 1-5 = low severity; ≥6 = high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL ( P < 0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain ( P > 0.05). The increase in the child's age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL ( P < 0.05). The multivariate adjusted model showed that the high severity of ECC (RR = 3.81; 95% CI = 2.66, 5.46; P < 0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR = 0.93; 95% CI = 0.87, 0.99; P < 0.001). The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents. [ABSTRACT FROM AUTHOR]

Liu Z, McGrath C, Hägg U. Associations between orthodontic treatment need and oral health-related quality of life among young adults: does it depend on how you assess them? Community Dent Oral Epidemiol 2011; 39: 137-144. © 2011 John Wiley & Sons A/S To determine the association between orthodontic treatment need (OTN) and oral health-related quality of life (OHRQoL). A cross-sectional study involving 273 young adults seeking orthodontic care. OHRQoL was assessed by the short-form Oral Health Impact Profile (OHIP-14) and United Kingdom oral health-related quality of life measure (OHQoL-UK). Study casts were assessed for OTN by: Dental Aesthetic Index (DAI), Index of Orthodontic Treatment Need (IOTN)-Aesthetic Component (IOTN-AC) and Dental Health Component (IOTN-DHC) and Index of Complexity, Outcome and Need (ICON). Variations in OHIP-14 and OHQoL-UK were determined with respect to OTN, and the magnitude of differences was calculated (effect size: ES). There were significant but weak correlations between occlusal indices scores and OHIP-14 scores ( P < 0.05, r < 0.3) and between occlusal indices scores and OHQoL-UK scores ( P < 0.05, r < 0.4). The magnitude of the statistical difference in OHQoL-UK scores was moderate to large with respect to OTN (ES: 0.36-0.87) and largest when DHC (ES = 0.87) and ICON (ES = 0.74) were used. The magnitude of the statistical difference in OHIP-14 scores was relatively lower (ES: 0.21-0.69), but also greatest when DHC and ICON were used to determine OTN (ES 0.69 and 0.50, respectively). Orthodontic treatment need was associated with OHRQoL. The magnitude of the statistical difference between those with and without an orthodontic treatment need was larger when OHRQoL was assessed using OHQoL-UK compared to OHIP-14. DHC and ICON were more useful indices in identifying greater differences in OHRQoL with respect to orthodontic treatment need. [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]

Preisser JS, Phillips C, Perin J, Schwartz TA. Regression models for patient-reported measures having ordered categories recorded on multiple occasions. Community Dent Oral Epidemiol 2011; 39: 154-163. © 2010 John Wiley & Sons A/S The article reviews proportional and partial proportional odds regression for ordered categorical outcomes, such as patient-reported measures, that are frequently used in clinical research in dentistry. The proportional odds regression model for ordinal data is a generalization of ordinary logistic regression for dichotomous responses. When the proportional odds assumption holds for some but not all of the covariates, the lesser known partial proportional odds model is shown to provide a useful extension. The ordinal data models are illustrated for the analysis of repeated ordinal outcomes to determine whether the burden associated with sensory alteration following a bilateral sagittal split osteotomy procedure differed for those patients who were given opening exercises only following surgery and those who received sensory retraining exercises in conjunction with standard opening exercises. Proportional and partial proportional odds models are broadly applicable to the analysis of cross-sectional and longitudinal ordinal data in dental research. [ABSTRACT FROM AUTHOR]

Browne D, Whelton H, O'Mullane D, Tavener J, Flannery E. The aesthetic impact of enamel fluorosis on Irish adolescents. Community Dent Oral Epidemiol 2011; 39: 127-136. © 2011 John Wiley & Sons A/S To assess the impact of differing degrees of enamel fluorosis on dental aesthetics according to Irish adolescents. The same participants also aesthetically rated other variations in dental appearances including a carious lesion, bleached teeth and a demarcated opacity. One hundred and fifty adolescents examined seven identical template photographs of an attractive dental smile displaying varying levels of enamel fluorosis (TF1, TF2, TF3), a demarcated opacity, no fluorosis (TF0), anterior caries and very white or bleached teeth. By indicating their level of agreement or disagreement with five statements on a five-point Likert scale, the participants rated the aesthetic acceptability of each of the photographs. Using paired t-tests with the Bonferroni correction, it was found that the photographs depicting the very white teeth and anterior caries were rated as the most and least aesthetically pleasing images, respectively. There was no significant difference in the ratings of the photographs displaying TF0, TF1 and TF2 levels of fluorosis indicating that these photographs were viewed similarly ( P > 0.002). The remaining two photographs (TF3 and the demarcated opacity) were rated similarly and significantly worse ( P < 0.002) than the photographs showing no or low grades of fluorosis (TF0, TF1 and TF2). TF3 level of fluorosis represented the break point at which enamel fluorosis became aesthetically objectionable to these participants. Low grades of fluorosis (TF1 and TF2) were rated similarly to the photograph depicting no fluorosis (TF0). [ABSTRACT FROM AUTHOR]

Locker D, Quiñonez C. To what extent do oral disorders compromise the quality of life? Community Dent Oral Epidemiol 2011; 39: 3-11. © 2010 John Wiley & Sons A/S Most measures of 'oral health-related quality of life' assess the presence and frequency of functional and psychosocial impacts rather than explicitly documenting their impact on the quality of life. The aim of this study was to evaluate Prutkin and Feinstein's suggestion for addressing the issue of quality of life in health outcome research by the use of global ratings. Data were collected from a national sample of Canadian adults by means of a telephone interview survey based on random digit dialing. Participants completed the OHIP-14. Those reporting one or more impacts in the previous year were asked three questions concerning the extent to which these impacts bothered them, affected their life as a whole, and affected their quality of life. These items were scored on a scale ranging from 'Not at all' to 'A great deal'. All participants were asked to rate the quality of their life using a six-point scale ranging from 'Very poor' to 'Excellent'. Interviews were completed with 2027 participants, and 2019 were included in the analysis. Overall, 19.5% reported one or more impacts 'fairly often' or 'very often'. Of these, 48.3% reported being bothered by these impacts, 40.3% that their life overall was affected, and 36.0% that their quality of life was affected. These individuals represent 9.4%, 7.8%, and 6.9% of the sample as a whole. Among those reporting impacts, there was a significant association between OHIP-14 extent and severity scores and the three ratings. Those with impacts that bothered them, that affected their life overall or affected their quality of life, rated their overall quality of life less favorably than those with impacts that did not. Analysis by household income indicated that low-income participants were more likely to be OHIP-14 'cases'. Moreover, among the 'cases', low-income participants were more likely to report an impact on the quality of life. The addition of global ratings of oral health-related quality of life and quality of life provides information of use in understanding the negative consequences of oral disorders. [ABSTRACT FROM AUTHOR]

A study is presented which examined material and sociodemographic factors influencing oral health practices and experiences of six-year-old Pacific children in New Zealand. The study is based on a cohort of infants born at Middlemore Hospital in Auckland, interviews with their mothers, and an analysis of their ethnicity and level of acculturation. Other variables assessed by the researcher are educational background, duration of breastfeeding, frequency of toothbrushing and tooth brushing supervision.

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]

A study is presented which examined clinical indicators associated with the development of dental root caries in elderly patients who are enrolled in Family Medicine Unit Number 28 of the Mexican Institute of Social Security (IMSS) in Mexico City, Mexico. The data collection, instrument for data collection, clinical indicators for oral health and statistical analysis of the study are included. The study shows that patients who developed root caries have limited basic daily life activities (BDLA).

A study is presented which examined the impact of tooth loss on the perception of the usage of the mouth in patients who are attending Aleppo Faculty of Dentistry, University of Allepo in Syria. The study adopted a standardized visual analogue scales to ascertain the value each patients placed on oral health. Other variables assessed using statistical means are age groups and tooth type.

Dorri M, Sheiham A, Watt R. The influence of peer social networks on toothbrushing behaviour in Iranian adolescents in Mashhad. Community Dent Oral Epidemiol 2010; 38: 498-506. © 2010 John Wiley & Sons A/S This study aimed to assess the association between the quality and quantity of peer social networks and toothbrushing behaviours of Iranian adolescents in Mashhad. The second objective was to examine whether peer social networks go some way to explain the sex difference in toothbrushing behaviours in Iranian adolescents in Mashhad. A representative stratified random sample of 1132 sixth grade Iranian students in Mashhad, with an average age of 12.4 (SD = 0.8) years, answered a 37-item questionnaire. The questionnaire had items on sociodemographic characteristics (age, sex and parents' education level), education achievement (last year's final average mark), frequency of toothbrushing behaviours and peer social networks (number of close friends, frequency of meeting friends, club membership and quality of peer groups). Binary logistic regression analysis was employed to test the association between toothbrushing frequency and peer social networks. Adolescents who met their friends moderately often and had stronger ties with their friends were more likely to brush their teeth twice or more a day; P = 0.05 and P < 0.001, respectively. Club membership and number of close friends were not associated with toothbrushing frequency. Girls were significantly more likely to brush their teeth twice or more a day. They had weaker peer social networks than boys ( P < 0.001). When adjusted for sex and father's education level, all peer social networks variables were significantly associated with toothbrushing frequency. However, the interaction between sex and peer social networks variables was not significant. Peer social networks are related to toothbrushing frequency among Iranian adolescents in Mashhad but do not explain the differences in toothbrushing frequency between sixth grade Iranian boys and girls. [ABSTRACT FROM AUTHOR]

Vermaire JH, Hoogstraten J, van Loveren C, Poorterman JHG, van Exel NJA. Attitudes towards oral health among parents of 6-year-old children at risk of developing caries. Community Dent Oral Epidemiol 2010; 38: 507-520. © 2010 John & Wiley & Sons A/S Parental attitudes are likely to play a role in achieving and maintaining a desired level of oral health in children. To be useful in individually delivered caries prevention programmes, parental attitudes should be identified at individual level. Q-methodology has been proved successful in identifying attitudes in a wide range of disciplines but in dentistry Q-studies are scarce. In this study Q-methodology was used to identify parents' prevailing attitudes towards the oral health of their children. Thirty-nine parents ranked 37 statements regarding the dental health behaviour they apply to their 6-year-old child. They later explained their rankings during a short interview. In Q-methodology, rather than reporting one average composite attitude and opinion, various combinations of opinions and attitudes concerning these statements are identified using by-person factor analysis. Based on their beliefs, attitudes and cognitions, five categories of parents were found: (i) conscious and responsible, (ii) trivializing and fatalistic, (iii) appearance-driven and open-minded, (iv) knowledgeable but defensive and (v) conscious and concerned. Q-methodology appears to be a fruitful way to structure the complexity of parents' opinions and attitudes towards their children's dental health. It appears that Q-methodology provides comprehensive clusters of individual attitudes, based on various levels of responses to a wide range of questions. The five identified profiles may be useful in developing tailor-made prevention strategies in caries prevention. [ABSTRACT FROM AUTHOR]