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Objective: The aim was to evaluate the association of behavioural and socioeconomic factors with the occurrence of periodontal disease and dental caries, paying special attention to the simultaneous occurrence of these diseases. Materials and methods: The study population consisted of 5255 dentate persons aged ≥30 years from a nationally representative survey. Caries and probing pocket depth were recorded by tooth and calculated in relation to the number of existing teeth. The groups were: non-affected (A), the two most affected quintiles for periodontal disease with little or no dental caries (B), the two most affected quintiles for dental caries with little or no periodontal disease (C) and the two most affected quintiles for both periodontal disease and dental caries (D). Presence of dental plaque was determined, and behavioural and socioeconomic factors were established. Results: Dental plaque, smoking, lack of regular dental check-ups, older age and a basic level of education were strongly associated with the simultaneous occurrence of periodontal disease and dental caries. Conclusions: There are many behavioural and socioeconomic factors that associate with the occurrence of both periodontal disease and dental caries. These factors also increase the risk of individuals having these diseases simultaneously.

Purpose: The aim of the present study was to identify the underlying patterns of oral cleaning habits and the use of fluoride, and to investigate their variations by studying the socioeconomic characteristics among Finnish dentate adults aged 30 to 64 years., Materials and Methods: Participants of the nationwide Health 2000 survey who were dentate, aged 30 to 64 years, and underwent a health interview and a clinical oral examination, were included in the present study (n = 4419)., Results: In total, 79% of the women and 46% of the men reported to have brushed their teeth twice or more daily; 16% of the women and 14% of the men reported daily use of an electric toothbrush and 14% of the women and 5% of the men reported daily use of dental floss or an interdental brush. Factor analysis revealed five oral cleaning habit patterns, which were named modern, rational, before-breakfast, social and irrational. The modern cleaning pattern was associated with higher levels of education, and the rational cleaning with younger age, female gender and higher levels of education. The before-breakfast cleaning pattern was associated with male gender and lower levels of education, and the social cleaning with older age, female gender and higher levels of education. The irrational cleaning pattern was associated with older age., Conclusions: Adults have various oral cleaning habit patterns, each of which is associated with the subjects' socioeconomic characteristics.

Background: Schools can be an important setting for health education programmes, controlling the growing burden of oral diseases and promoting oral health. Aim. The aim of this study was to evaluate the short-term effect of school-based educational intervention on oral cleanliness and gingival health of 15-year-olds in Tehran, Iran., Design: The present cluster randomized trial was based on exposing students (n = 287; control, n = 130) at public schools to oral health knowledge through a leaflet or a videotape. The outcome was evaluated after 12 weeks. A positive outcome was defined as at minimum a 50% reduction in numbers of teeth with dental plaque or gingival bleeding compared to baseline. Evaluation included percentage changes, number needed to treat (NNT), and students' self-assessment., Results: At baseline, all students had dental plaque, and 93% had gingival bleeding on at least one index tooth. Positive outcome for oral cleanliness was 58% (P < 0.001) of the students in the leaflet group, 37% (P < 0.001) in the videotape group, and 10% of controls. Corresponding figures for gingival health were 72% (P < 0.001), 64% (P < 0.001), and 30%. For oral cleanliness, NNT was 2 in the leaflet and 3 in the videotape group; for gingival bleeding, NNT in both groups was 3. More than two-thirds of the students assessed their oral health behaviours as having improved moderately., Conclusion: An easy-to-organize and inexpensive school-based intervention can in the short term be effective in improving oral cleanliness and gingival health among adolescents; in particular, in countries with a developing oral health system.

Background: Toothbrushing twice daily is a recommended component of oral self-care soon after the eruption of primary dentition. Aim. This study aims to investigate oral hygiene and frequency of oral cleaning in children up to 3 years, in relation to mother-related factors., Design: A cross-sectional study of 504 children aged 12-36 months in Tehran, Iran was implemented. Mothers answered questions about their own oral self-care and their activity in their children's oral hygiene. The child's oral hygiene was assessed on the basis of visible dental plaque on the labial surfaces of the upper central incisors. Data analysis included chi-square test, analysis of variance (anova) and logistic regression., Results: Twice daily oral cleaning was reported for 5% of all children and once daily cleaning for 19% of the 12- to 15-month-old children, 18% of the 16- to 23-month-old children, and 48% of the 24- to 36-month-old children. Of the mothers, 59% stated that they lacked the skill to clean their children's teeth. Dental plaque was observed in 65-76% of the children. Clean teeth were more likely (OR = 1.7, 95% CI 1.3-2.3) in children of mothers who themselves have a higher toothbrushing frequency., Conclusions: To improve oral hygiene in early childhood, more emphasis should be placed on mothers' own toothbrushing and their skills in their children's oral cleaning.

Purpose: To investigate the oral health behaviour and the smoking habits among diabetic adults with regard to diabetes-related factors and their background information., Materials and Methods: In 2005, a questionnaire was conducted among diabetic adults (N = 299) in Tehran, Iran. The subjects were invited to the dental clinic and were asked to complete a self-administered questionnaire. In addition to their background information, the questionnaire requested information on smoking, oral self-care, dental attendance, year of onset of diabetes and organ complications related to diabetes. The data related to the type of diabetes and the latest value of glycosylated haemoglobin level (HbA1c) were obtained from the patient records at the diabetic clinic. Chi-square test and binary logistic regression model were used for statistical analyses., Results: Of all the subjects, 29% reported brushing their teeth on a twice-daily basis. Women (P = 0.05) reported higher frequencies of twice-daily tooth brushing. Subjects with moderate diabetic control (HbA1c = 7.6-8.5%) showed the highest rate for twice-daily tooth brushing (P < 0.001). Of all the subjects, 47% reported having visited a clinician within the past 12 months; this rate was the highest among those without diabetes-related complications (52% versus 41%; P = 0.05). Subjects who had a physician referral were more likely to report having had a dental visit within the past 12 months (OR = 4.4; CI = 1.9-10.2)., Conclusions: The present results call for improvement in the level of oral self-care and the regularity of dental checkups among diabetic adults to compensate for their increased risk for oral diseases.

Purpose: To assess smoking, tooth brushing and oral cleanliness and their relationships among 15-year-olds in Tehran, Iran., Materials and Methods: A cross-sectional study based on World Health Organization criteria and the methods of the Second International Collaborative Study was carried out in autumn 2004 among 15-year-olds (n=502) in Tehran. Data were based on a self-administered questionnaire and a clinical dental examination., Results: Smokers comprised 5% of the boys and 2% of the girls (p = 0.02). Smoking was more common among students of less-educated parents (50% vs. 30%, p < 0.05). Of all students, 26% reported twice-daily tooth brushing; those of higher socio-economic backgrounds and girls did so more frequently. Of the smokers, 11% reported no tooth brushing compared to 6% of the non-smokers. Oral cleanliness was good for 13%, moderate for 32%, and poor for 55%; the rates associated positively with female gender (p = 0.002), having higher-educated parents (p = 0.03), and reporting a higher frequency of tooth brushing (p < 0.001). Those students reporting twice-daily tooth brushing had less dental plaque and gingival bleeding (p < or = 0.01) on both anterior and posterior teeth. In multivariable analyses, the best predictors for a good level of oral cleanliness were female gender (OR = 2.0) or twice-daily tooth brushing (OR = 1.7)., Conclusion: Oral cleanliness and tooth brushing among 15-year-olds were at poor levels, particularly among boys. Such poor levels call for intensive attempts to enhance rates of twice-daily tooth brushing and to improve its quality. For this age group, anti-smoking purposes should be combined into school-based oral health promotion programmes as well.

Purpose: This study investigated the role of mothers in their preadolescents' oral self-care (OSC) and oral health in Tehran, Iran., Materials and Methods: In 2005, two self-administered questionnaires provided data on a random sample of 9-year-old children (N = 416) and their mothers. Brushing frequency, use of fluoridated dentifrice and the number of sugary snacks between meals served as OSC assessment criteria for both children and their mothers. Supervision of the child's tooth brushing and control of the child's sugary snacking indicated the mother's role that was defined as either active or inactive. Decayed, missing or filled teeth (DMFT + dmft) values facilitated the assessment of children's dental status in a voluntary clinical examination for children. The child's twice-daily tooth brushing, sound dentition and good oral hygiene were taken as the outcome measures for evaluating the impact of the mother's role. The chi-square test and logistic regression model were used for the analyses., Results: Half of the mothers were assessed as active in the supervision of their children's tooth brushing. Supervision was clearly more frequently reported by the mothers whose own OSC was favourable. In the logistic regression model, the strongest factors contributing to the explanation of twice-daily tooth brushing were the child's female gender (odds ratio, OR = 1.6; 95% confidence interval, 95% CI = 1.1 to 2.4) and the mother's active supervision (OR = 1.5; 95% CI = 1.0 to 2.2). Having sound dentition was most strongly explained by the mothers' active supervision of their children's tooth brushing (OR = 2.4; 95% CI = 1.3 to 4.5)., Conclusions: The mothers' supporting role positively reflects on twice-daily tooth brushing and sound dentition in preadolescents. More preventive efforts through mothers should be considered during the planning of promotion programmes for preadolescents.

Objectives: This trial studied the effects of interventions on the oral cleanliness of the long-term hospitalised elderly., Background: Oral cleanliness is mostly poor in long-term facilities. While many agree on the importance of oral hygiene education for nursing personnel, little information and agreement exists on how to organise this education in geriatric institutions., Materials and Methods: This is a longitudinal study with interventions. After a baseline clinical examination, the patient wards were divided into three groups (A, B and C) and the type of intervention was randomly assigned. In group A, dental hygienists provided oral hygiene measures for the subjects once every 3 weeks. In group B, the nursing staff first received hands-on instructions after which they assumed responsibility for the subjects' daily oral hygiene. Group C served as a control. Denture hygiene and dental hygiene were recorded at baseline and in the end of the 11-month study period. In total, 130 subjects completed the interventions; their mean age was 82.9 years., Results: The best outcome in both denture and dental hygiene occurred when nursing staff at the wards took care of hygiene (group B). The increase in the proportion of those with good denture hygiene was the most prominent in group B (from 11% to 56%). The proportion of subjects with poor overall dental hygiene decreased from 61% at baseline to 57% in the end, for group B from 80% to 48%., Conclusions: Organised oral health education of the nursing staff should receive more attention.

Purpose: To investigate the sources of information on oral self-care and the content of professional guidance received on it as reported by dentate elderly patients in Lithuania, and to relate such guidance to their self-assessed knowledge of oral self-care., Materials and Methods: A cross-sectional questionnaire study was carried out at two public dental offices, among dentate patients aged > or = 60. In total, 174 dentate elderly responded; mean age was 69.2 years (SD = 6.6). The self-administered questionnaire covered sources of information on and self-assessed knowledge of oral self-care, and the content of professional guidance received. Age, gender, education, and number of teeth served as background information. Statistical evaluation was by Chi-square test, correlation analysis, ANOVA, and logistic regression., Results: Most of the elderly (82%) named the dentist as the source of information. For the professional dental guidance received, 53% of our elderly reported being told how to brush, and 31% how to floss their teeth. Furthermore, 44% assessed their knowledge of oral self-care as poor, 22% as moderate, and 34% as good. At least a moderate level of knowledge of oral self-care was associated with a greater extent of professional guidance (OR 1.3; 95% CI 1.2-1.5; p < 0.001), a better dental state (OR 1.9; 95% CI 1.1-3.2; p = 0.03), and a higher level of education (OR 1.9; 95% CI 1.0-3.5; p = 0.04) in the logistic regression model, controlling for background information., Conclusions: To increase the awareness of oral self-care among the elderly, dentists play an important role as providers of versatile and regular professional guidance.

Aim: To describe oral self-care practices and the use of dental services among dentate elderly patients attending public dental service in Kédainiai, Lithuania, and relate these parameters to the number of remaining teeth., Design: Cross-sectional questionnaire study., Setting: Two public dental offices in Kédainiai, Lithuania., Participants: Dentate patients aged 60+., Methods: A self-administered questionnaire covering oral hygiene practices, use of sugar, utilisation of dental services, and number of teeth. Age, gender, and education served as background factors., Results: In all, 174 dentate elderly people responded, their mean age being 69.2 years (CI 95% 68.2-70.2) and mean number of teeth reported 16.2 (CI 95% 15.4-17.1). Of these respondents, 30% reported that they brushed their teeth twice daily and 57% that they always used fluoridated tooth paste. Having 21+ teeth was strongly associated (p < 0.001) with these habits, with brushing in the evening, and with enrolment in higher education, but not with gender. After controlling for various self-care and background factors, frequent tooth brushing remained as the only significant factor in the logistic regression model (OR 2.0, CI 95% 1.2-3.3, p = 0.01) to explain subjects' retention of 21+ teeth., Conclusions: Elderly Lithuanians' oral self-care is far from meeting recommendations. To preserve their natural teeth, dentate elderly people should improve their oral self-care practices, in particular as regards tooth brushing. To reach that goal, all efforts by the community and dental profession are welcomed.

Purpose: The objective of the present study was to compare the self-assessed and the clinically determined findings of oral health and their determinants among 15-year-olds in Tehran, Iran.Materials and Methods: A cross-sectional study based on World Health Organization criteria and the methods of the Second International Collaborative Study was carried out among the 15-year-olds (N = 509). The data were based on a self-administered questionnaire and a clinical dental examination.Results: Altogether 78% of the 15-year-olds assessed their oral health as good or better. Based on self-assessment, 46% reported gingival bleeding, 28% reported the need for a filling and 23% for teeth straightening. Clinical examinations showed that 40% of the students had sound dentition (decayed, missing or filled teeth, DMFT = 0), 40% had current caries (decayed teeth, DT > 0), 92% had gingival bleeding and 26% had a definite need for orthodontic treatment. Most of those with DMFT = 0 and DT = 0 assessed their oral health as good or better. Compared with clinical findings, sensitivity for self-assessed need for fillings, gingival bleeding and the need for teeth straightening were 42%, 49% and 37%, respectively, whereas the corresponding specificities were 82%, 80% and 81%, respectively. Good or better self-perceived oral health was more likely among those with sound dentition (odds ratio, OR = 2.1, P = 0.01), with no self-assessed need for fillings (OR = 2.1, P = 0.01), with a self-assessed absence of gingival bleeding (OR = 2.9, P < 0.001) or with highly educated parents (OR = 1.2, P = 0.007).Conclusions: When compared with clinical evaluations, the students most accurately detected healthy conditions. Educating the students on the signs of dental diseases could increase the reliability of self-assessment to provide a useful method for reporting oral conditions, especially in countries with developing oral health care systems. [ABSTRACT FROM AUTHOR]

Purpose: To study risk-based preventive practice among Iranian dentists.Materials and Methods: A questionnaire survey was conducted at two annual dental meetings in 2004 and 2005 in Tehran. Using a five-point Likert scale, respondents indicated their level of agreement with taking preventive measures including oral hygiene, use of fluoride, diet and dental check-up for a high- and a low-risk (HR and LR, respectively) hypothetical patient case. Respondent's smoking and activity in smoking cessation were enquired about as well. Of 1033 responding dentists, 980 (64% men) were eligible for this study. Statistical evaluation was by the chi-square test and logistic regression.Results: The top four of the eight measures were instructions on tooth brushing and flossing, advice related to fluoridated toothpaste, and regular dental check-ups, with the choice 'fully agree' being more prevalent for the HR (74%-58%) than for the LR case (59%-41%). For the HR case, 45% of the respondents fully agreed with applying chair-side tooth cleaning, 41% with advice on diet modification, and 38% with advice on home-use of sodium fluoride mouthwash. Of all respondents, 76% were nonsmokers and 56% reported that they always recommend their smoking patients to quit. Female gender and activity in professional reading were associated with higher levels of agreement for applying preventive measures to the HR case. Non-smoking was the strongest explanatory factor (OR = 3.6, 95% CI = 2.6-5.1) of dentist's higher involvement in smoking cessation.Conclusion: Risk-based preventive dental care should be emphasised and applied in order to maximise efficient use of resources. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the oral health-related behaviors of unemployed people with those of employed people and to assess whether they differ according to the length of unemployment. This study is part of the Health 2000 Survey in Finland. The cross-sectional data were based on interviews and questionnaires. The present study comprised dentate participants, 30-63 yr of age ( n = 4,670). Current employment status (employed vs. unemployed) and length of current unemployment (≤1, >1-2, >2-5, and >5 yr) were used as exposures. Binary logistic regression models were fitted separately for the oral health-related behaviors, and latent class analysis ( LCA) was used to form behavioral clusters. Current unemployment and being unemployed for longer than 5 yr were inversely associated with regular use of dental services. Current unemployment indicated non-regular dental attendance, infrequent use of xylitol, daily smoking, and risky use of alcohol. Findings from the LCA supported the assumption that unemployed people could be considered as a risk group for poor oral health-related behaviors. [ABSTRACT FROM AUTHOR]

Objectives The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. Methods As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents ( n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. Results The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. Conclusions The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed. [ABSTRACT FROM AUTHOR]

Background: Health behaviors play a major role in the prevention of the most common oral diseases. To investigate health behaviors related to the potential transmission of oral bacteria from mother to child using novel multiple correspondence analysis (MCA). Methods: Mothers (n = 313) with children under three years attending two municipal child health clinics in Finland completed a self-administered questionnaire on health knowledge and behaviors such as sharing a spoon with their child, kissing on the lips, and the mothers' tooth brushing, smoking, age, and level of education. We used MCA to reveal the relationships between the mothers' behaviors and background factors, along with unconditional, binary, multivariable logistic regression models, odds ratios (OR) and their 95 % confidence intervals (95 %CI). Results: Of the mothers, 38 % kissed their child on the lips and 14 % shared a spoon with their child; 11 % believed that oral bacteria cannot be transmitted from mother to child. Two-thirds (68 %) of them reported tooth brushing twice daily, and 80 % were non-smokers. MCA revealed two diverging dimensions of the mothers' behaviors: a ‘horizontal' one showing clear evidence of relationships between tooth brushing, smoking, age and education, whereas the ‘vertical' one revealed the mothers' habits of kissing the child on the lips and sharing a spoon related to each other. Spoon sharing was related to the kissing on lips (OR 10.3), a higher level of education (OR 3.1), and, inversely, older age (OR 0.1), whereas kissing on lips behavior was inversely related to a higher level of education (OR 0.5). Conclusion: The study revealed two diverging dimensions of the mothers' health behaviors. More emphasis in health education ought to be put to how to avoid bacterial transmission from caregiver to child during feeding. [ABSTRACT FROM AUTHOR]

Objectives: Smoking may impact oral self-care (OSC). This study aimed to analyze the role of smoking in OSC among Iranian dental health professionals. Materials and Methods: The cross-sectional data were collected at two annual dental meetings and seven randomly selected dental schools in Iran. A total of 1,459 respondents composed of 967 general dental practitioners (GDPs), 229 dental educators (DE), and 263 senior dental students (DS) anonymously completed a self-administered questionnaire inquiring about smoking status and OSC. Results: Thirty percent of the men and 12% of women reported smoking with no difference according to their professional status. Women reported better OSC than did men, but only 26% of the women and 17% of the men followed the three most important recommendations for OSC. Smoking was associated with infrequent tooth brushing and flossing, irregular use of fluoride containing toothpaste, consumption of sugary snacks, and weak adherence to the recommended OSC guidelines. Conclusion: Dental health education should place more emphasis on smoking counseling and cessation among dental health professionals. [ABSTRACT FROM AUTHOR]

Background: Evidence from cross-sectional studies implies that dental behaviours partially explain inequalities in oral health. Objective: To assess whether dental behaviours completely eliminate inequality in increments of dental caries in a sample of Finnish adults. Methods: The baseline data were collected from the Health 2000 survey, a nationally representative survey of 8,028 individuals aged 30 years or older living in mainland Finland. Four years later, 1,248 subjects were invited for oral re-examination, and 1,049 agreed to participate (84% response rate). At baseline, participants provided information on demographics, education and dental behaviours (dental attendance, tooth brushing with fluoride toothpaste, sugar consumption and daily smoking). Oral examinations at baseline and follow-up were identical. Results: Adults with basic education had significantly greater increments of DMFT (incidence rate ratio 1.41, 95% CI 1.07-1.85) and DT (incidence rate ratio 2.23, 95% CI 1.27-3.90) than those with high education. Adjusting for single behaviours attenuated but did not eliminate education inequality in DMFT and DT increments, tooth brushing having the greatest impact on inequality. Simultaneous adjustment for all behaviours eliminated the significant relationship between education and caries increment. Conclusions: Accounting for important dental behaviours appears to explain all education inequality in dental caries in Finnish adults. The results should be interpreted with caution when applied to less egalitarian populations. © 2014 S. Karger AG, Basel [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]

Tseveenjav B, Suominen AL, Hausen H, Vehkalahti MM. The role of sugar, xylitol, toothbrushing frequency, and use of fluoride toothpaste in maintenance of adults' dental health: findings from the Finnish National Health 2000 Survey. Eur J Oral Sci 2011; 119: 40-47. © 2011 Eur J Oral Sci We assessed the effect of certain oral health-related behaviours on adults' dental health. As part of the Finnish nationwide Health 2000 Survey, dentate subjects, 30-64 yr of age, reported their frequency of consumption of eight sugar- and xylitol-containing products, together with toothbrushing frequency and use of fluoride toothpaste, and underwent clinical oral examination ( n = 4,361). The mean number of teeth present (NoT) was 24.2 and the mean numbers of sound teeth (ST), filled teeth (FT), and decayed teeth (DT) were 10.8, 12.1, and 1.1 for men and 9.6, 13.8, and 0.5 for women, respectively. Consumption of sugar-sweetened beverages was more frequent than that of other sugar-containing products, and greater in men than in women. Daily use of xylitol chewing gum was reported by 13% of the men and by 22% of the women. Toothbrushing at least twice daily was reported by 47% of the men and by 79% of the women; 86% and 96%, respectively, reported daily use of fluoride toothpaste. The frequency of consumption of sugar- and xylitol-containing products and of toothbrushing, as well as use of fluoride toothpaste, play a role in the dental health of dentate adults, with the impact being weak on NoT, ST, and FT, but stronger on DT, especially concerning toothbrushing frequency (relative risk = 1.5) and use of fluoride toothpaste (relative risk = 1.8). Understanding the impact of certain oral health-related behaviours on dental health in adults would facilitate better targeting of oral self-care messages. [ABSTRACT FROM AUTHOR]

Aim: To assess the relationship between education level and several oral health outcomes in Finnish adults, using three conceptual lifecourse models. Materials and Methods: This study analysed data from 7112 subjects, aged 30 years or over, who participated in the nationally representative Finnish Health 2000 Survey. Parental and own education levels were the childhood and adulthood socioeconomic measures, respectively. Oral health was indicated by edentulousness, perceived oral health and levels of dental caries and periodontal disease. Three conceptual lifecourse models, namely critical period, accumulation and social trajectories, were separately tested in regression models. Results: In line with the critical period model, parental and own education levels were independently associated with oral health after mutual adjustment. There was also a graded linear relationship between the number of periods of socioeconomic disadvantage and oral health, corresponding to the accumulation model. Gradual declines in oral health were evident between social trajectories from persistently high to upwardly mobile, downwardly mobile and persistently low groups. Conclusion: There was similar support for the lifecourse models of critical period, accumulation and social trajectories. They collectively contribute to a better understanding of oral health inequalities. [ABSTRACT FROM AUTHOR]

Aim: To assess the relationship between sense of coherence (SOC) and oral health, and the role of oral health-related behaviours in this relationship. Materials and Methods: This is a cross-sectional study of 5401 dentate adults who participated in the nationally representative Health 2000 Survey in Finland. The survey gathered information on SOC, demographic characteristics, education, income, preexisting diabetes, daily smoking, dental attendance, toothbrushing frequency and sugar intake frequency. Oral health was assessed through clinical outcomes, such as number of teeth, number of decayed teeth and extent of periodontal pockets and perceived oral health. Results: A strong SOC was related to having more teeth, fewer decayed teeth, lower extent of periodontal pockets and good perceived oral health after adjustment for confounders, such as demographic and socioeconomic factors (all p⩽0.003). These associations were attenuated but remained significant after further adjustment for potential mediators (oral health-related behaviours), except for the association of SOC with the extent of periodontal pockets, which was fully accounted for by pre-existing diabetes, oral health-related behaviours and dental plaque (p = 0.549). Conclusion: SOC is positively associated with various aspects of adult oral health, in part because of the better oral health-related behaviours among people with a strong SOC. [ABSTRACT FROM AUTHOR]

Objective: To investigate the oral health status of 18-year-old Iranians in relation to their gender, place of residence and level of education. Subjects and Methods: Thirty-three calibrated examiners in 2002 collected data as part of a national survey, according to World Health Organization criteria for sampling and clinical diagnoses, across 28 provinces. The study sample was 4,448; male: 2,021 and female: 2,427 made up of urban: 2,564 and rural: 1,884. Oral health status was assessed in terms of number of teeth, decayed teeth (DT), filled teeth (FT), decayed, missing or filled teeth (DMFT), community periodontal index and plaque index. Results: The mean number of teeth was 27.4, with DMFT: 4.3, DT: 3.0 and FT: 0.7. The mean number of sound teeth was higher (p < 0.01) in men (24.1 vs. 23.3 in women), FT in urban residents (1.0 vs. 0.2 in rural residents) and DT in women (3.3 vs. 2.8 in men). Three of 4 subjects were in need of restorative treatments. All subjects had dental plaque; 387 (8%) healthy gingiva; 1,016 (23%) exhibited bleeding; 2,025 (48%) calculus and 1,020 (21%) deepened pockets. Men’s periodontal status was worse than women’s (p < 0.002). Low level of education was associated with having 27 or fewer teeth (OR = 1.7), calculus (OR = 1.5) or deep periodontal pockets (OR = 2.7). Conclusion: A majority of 18-year-old Iranians seem to enjoy a full dentition. High prevalence of dental plaque, calculus, periodontal pockets and untreated dental cariesespecially among underprivileged groups may put them at risk for tooth loss in adulthood. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective . Our aim was to evaluate the association between dental attendance and dental fear while considering the simultaneous effects of perceived oral health and treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Material and methods . The two-stage stratified cluster sample (n=8028) represented Finnish adults aged 30 years and older. The response rate to this nationwide sample was 88%. Dental fear was measured with the question: "How afraid are you of visiting a dentist?" Multiple logistic regression analyses were used to determine the association between dental fear and dental attendance, including the following independent variables: perceived oral health, perceived treatment need, satisfaction with oral health services, age, gender, marital status, and attained level of education. Results . Among all ages, except 30 to 34-year-olds, irregular attenders were more likely to be very afraid of visiting a dentist than regular attenders were. The association was stronger the older the age group. Only age modified the association between dental fear and attendance. Irregular dental attendance can be attributed to high dental fear (etiologic fraction among exposed) in 41% of cases. Conclusion . Reducing dental fear would increase the number of regular attenders, especially among older age groups. Individuals for whom oral health services have been provided regularly since childhood seem to continue to use these services regularly despite high dental fear. [ABSTRACT FROM AUTHOR]

Objective: To investigate the oral health status of 35- to 44-year-old Iranians in relation to gender, place of residence and education. Subjects and Methods: In 2002, data (n = 8,301) were collected as part of a national survey using WHO criteria for sampling and clinical diagnoses across 28 provinces by 33 calibrated examiners who performed examinations under a dental light with a WHO probe. The study sample was 8,301; male: 3,625 and female: 4,676; urban: 4,854 and rural: 3,447. Oral health status was assessed by number of decayed (DT), filled (FT) and missing (MT) teeth and by DMFT and need for periodontal treatment [community periodontal index for treatment needs (CPITN)] indices. Gender, age, place of residence and level of education served as socio-demographic information. Estimates were adjusted for the 35- to 44-year-old provincial population. ANOVA, χ2 test and logistic regression analysis with odds ratios (OR) and their 95% confidence intervals (CI) were the methods of statistical evaluation used. Results: The mean number of teeth was 21.5 ± 6.2, with DMFT: 11.0 ± 6.4, DT: 2.6 ± 2.7, and FT: 1.8 ± 3.2. DT existed in 6,080 (73%) of the subjects and FT in 3,209 (41%). The mean number of FT was greater (p < 0.001) among urban residents, women and those with a higher level of education. Only 1% had a CPITN of 0; 6% exhibited bleeding, 40% had calculus, 43% shallow and 10% deep pockets. Illiterate subjects were more likely to have DT (OR = 1.6, 95% CI = 1.4–1.8) and calculus or periodontal pockets (OR = 6.3, 95% CI = 5.1–7.8). Conclusion: The findings indicate an impaired oral health status in Iranian adults, particularly those of low social status and educational level. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To investigate oral health-related well-being of the long-term hospitalised elderly as reported by their primary nurses in relation to subject's oral health assessed either by primary nurses or by a clinical dental examination.Background Data: Little is known about oral health-related well-being of the medically compromised, long-term hospitalised elderly, most of whom are unable to express their feelings and opinions.Materials and Methods: A cross-sectional study using a questionnaire for primary nurses about oral health and oral health-related well-being regarding functional, pain/discomfort-related, and psychosocial limitations of the subjects (n = 255) and assessment of oral health by clinical examination. The total number of limitations and the number of limitations in each category was calculated.Results: Most (77%) of our subjects were unable to eat normal food. Functional limitations dominated followed by psychosocial and pain/discomfort-related limitations. Overall assessment by each subject's primary nurse ranked oral health of as good for 9% of subjects, as moderate for 44%, and as poor for 47%. Clinical examination-based assessment ranked oral health as good for 19%, as moderate for 33%, and as poor for 48% of our subjects, with good oral health being ranked as good for more men than women (26% vs. 16%; p = 0.045). Fewer limitations were recorded for those with better oral health assessed both by primary nurse and by clinical examination.Conclusion: More efforts are called for to maintain the oral health of the long-term hospitalised elderly so as to improve their well-being. [ABSTRACT FROM AUTHOR]

Objective: To evaluate caries-preventive treatment practices in relation to caries state and eruption of first permanent molars(FPMs) among 6-year-olds (n=3489) examined and treated in public dental clinics in Helsinki during 1992 Methods: The study subjects were selected on the basis of their caries state using a two-point study design the high-caries group (n=99) had the greatest number of DT+dt, the cavity-free group (n=32) had neither past nor present caries Evaluation of dentists' caries-preventive treatment decisions was based on data from detailed personal oral health records. Results: In total, 22% of the high-caries patients (mean DT+dt 8 7; range 4-18) had been judged by their dentists as high-risk patients. Eruption of FPMs had no influence on dentists' judgement on caries risk. A subject's number of DT+dt had no influence on the intensity of preventive treatment given, but those with a high-risk judgement from a dentist received mote preventive measures per visit than did other high-caries patients For high-caries patients with erupting FPMs, three visits in 10 included preventive intervention other than sealants, compared to nine in the cavity-free group. Intensity of oral hygiene instruction. correlated with presence of erupting FPMs, yet 86% of the patients with erupting FPMs had received no oral hygiene instruction. Conclusions: Dentists should be encouraged to use standardized criteria, including data on caries state and eruption stage, in judging each patient's risk of caries to provide intensified caries-preventive treatment to those most in need. [ABSTRACT FROM AUTHOR]