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Background: Indigenous Australians score worse on both sleep and oral health. This study aimed to evaluate sleep quality and quantity associated with oral health-related quality of life (OHRQoL) among Indigenous Australian adults., Methods: A cross-sectional study involving 728 Indigenous Australian adults aged 18+ years was conducted. Exposure variables were sleep quality and quantity. The primary outcome variable was Oral Health Impact Profile-14 (OHIP14), which has been used to assess OHRQoL. Multivariable log-Poisson regression models were applied to estimate the mean ratios (MRs) for mean OHIP14 scores., Results: The average OHIP14 score was 14.9, and the average amount of sleep was 6.8 h/night. After adjusting for all covariates, self-rated very bad sleep quality was associated with 2.2 times (MR = 2.17, 95% CI: 1.97-2.37) higher OHIP14 scores than those who rated their sleep quality as very good. Participants who self-reported sleeping 7-8 h/night had 0.9 times (MR = 0.89, 95%CI: 0.83-0.95) lower OHIP14 scores than those sleeping more than 8 h., Conclusions: The average number of sleep hours for Indigenous participants were lower than recommended (7-8 h/night). Our findings indicate that poor sleep quality and quantity, and oral health-related behaviours associated with sleep deprivation were positively associated with poor oral health related quality of life among Indigenous Australian adults.

Purpose: Preference-based quality of life measures (PBMs) are used to generate quality-adjusted life years (QALYs) in economic evaluations. A PBM consists of (1) a health state classification system and (2) a utility value set that allows the instrument responses to be converted to QALYs. A new, oral health-specific classification system, the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) has recently been developed. The aim of this study was to generate an Australian utility value set for the ECOHIS-4D., Methods: A discrete choice experiment with duration (DCE TTO ) was used as the preference elicitation technique. An online survey was administered to a representative sample of Australian adults over 18 years. Respondents were given 14 choice tasks (10 tasks from the DCE design of 50 choice sets blocked into five blocks, 2 practice tasks, a repeated and a dominant task). Data were analyzed using the conditional logit model., Results: A total of 1201 respondents from the Australian general population completed the survey. Of them, 69% (n = 829) perceived their oral health status to be good, very good, or excellent. The estimated coefficients from the conditional logit models were in the expected directions and were statistically significant (p < 0.001). The utility values for health states defined by the ECOHIS-4D ranged from 0.0376 to 1.0000., Conclusions: This newly developed utility value set will enable the calculation of utility values for economic evaluations of interventions related to oral diseases such as dental caries among young children. This will facilitate more effective resource allocation for oral health services., (© 2022. The Author(s).)

Objectives: Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL., Methods: Cross-sectional analysis was performed, using data from VMAX, a cohort of people who use methamphetamine at least monthly in Victoria, Australia (n = 194). Utilising the oral health impact profile (OHIP-14), we assessed three OHRQoL outcomes: OHIP-14 prevalence, OHIP-14 extent and OHIP-14 severity. Regression analyses examined associations between independent variables and the three OHIP-14 outcome measures., Results: A significant segment of the cohort (35%) reported poor OHRQoL. Overall, no statistically significant association was detected between methamphetamine route of administration and the three OHIP-14 outcomes. Participants living in rural areas, with moderate-to-severe self-reported depression and with methamphetamine dependence had significantly worse OHRQoL levels, which persisted after adjusting for other covariates., Conclusion: Overall, VMAX cohort participants reported reduced OHRQoL levels. Our findings highlight the need for upstream interventions to improve the OHRQoL of people who use methamphetamine, with specific focus on those living in rural locations. Further research on the links between OHRQoL and mental health among people who use methamphetamine is required., (© 2023. The Author(s).)

Objectives: Indigenous Australians experience cumulative forms of oppression. Using intersectionality as the underlying analytical framework, and with oral health as an outcome, we demonstrate how oppressions are interlinked and cannot be treated in isolation. The study aimed to quantify the cumulative effect of two forms of oppression on Indigenous Australian oral health inequities., Methods: This observational study was conducted Feb 2018-Jan 2020. Recruitment occurred through Aboriginal Community Controlled Health Organisations in South Australia, Australia. Eligibility included identifying as Indigenous, residing in South Australia and aged 18+ years. Socio-demographic factors, health-related characteristics, experience of racism, negative life events and self-reported oral health outcomes were collected. The main outcomes were fair/poor self-rated oral health and oral health related quality of life, measured by OHIP-14. Effect-measure modification was used to verify differences on effect sizes per strata of negative life events and racism. The presence of modification was indicated by Relative Excess Risk due to Interactions (RERIs)., Results: Data were obtained for 1,011 participants, median age 37 years, 66% female and 63% residing in non-metropolitan locations. Over half (52%) had experienced racism in the past 12 months and 85% had experienced one or more negative life events. Around one-third (34%) rated their oral health as fair/poor and the mean OHIP-14 score was 17. A higher proportion of participants who had experienced both racism and negative life events (46%) were male (52%), aged 37+ years (47%), resided in metropolitan locations (57%), reported difficulty paying a $100 dental bill (47%), had fair/poor self-rated oral health (54%) and higher mean OHIP-14 scores (20). The RERIs observed were 0.31 for fair/poor self-rated oral health and 0.23 for mean OHIP-14. The positive RERIs indicated a super-additive effect between racism, negative life events (effect modifier) and self-reported oral health outcomes., Conclusion: The more oppressions participants experienced, in the form of racism and negative life events, the greater the burden of poor self-reported oral health. The study is one of the first to use intersectionality as a theory to explain oral health inequities as experienced by Indigenous Australians., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Jamieson et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To investigate whether the association between social support and oral health outcomes is modified by levels of household income., Methods: Data were from the National Study of Adults Oral Health (NSAOH 2004-06), a nationally representative study comprising n = 3619 adults in Australia. Effect measure modification (EMM) analysis was adopted to verify whether the association between social support and poor/fair self-rated oral health, lack of a functional dentition (<21 teeth) and low Oral Health Related Quality of Life (OHRQoL; measured using OHIP-14) varies according to levels of income. Poisson regressions adjusted for age, sex, education, country of birth, main language spoken at home and remoteness were used to estimate prevalence ratios (PR) for oral health outcomes for each stratum of social support (overall, family, friends and significant other) and income (effect modifier). We then computed the Relative Excess Risk due to Interaction (RERI), which represents the risk that is over what would be expected if the combination of low social support and low income was entirely additive. Sensitivity analyses for different cut-offs of household income were performed., Results: Adults with lower levels of social support had a 2.1, 1.2 and 1.9 times higher prevalence of fair/poor self-rated oral health, <21 teeth and poor OHRQoL respectively. The RERIs observed were 0.98 (95% CI -0.01; 1.96) for poor/fair self-rated oral health; 0.52 (95% CI -0.06; 1.10) for lack of a functional dentition and 0.50 (95% CI -0.16; 1.15) for poor OHRQoL. For all outcomes and all individual domains of social support, the positive RERIs indicated that the joint association of low social support and low household income surpassed the sum of their separate associations with objective and subjective oral health indicators., Conclusion: Individuals with lower levels of social support had poorer oral health than those with high levels of social support, although this association was small for the outcome <21 teeth. The association between social support and poor oral health indicators is modified by levels of household income. Hence, the provision of social support had a stronger association with the oral health of low-income participants, suggesting that socioeconomically disadvantaged individuals would mostly benefit from a social support intervention., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

In Australia, research evidence has shown that Aboriginal and/or Torres Strait Islander children experience a higher burden of oral health diseases compared to other non-Indigenous children. The impact of oral health diseases on children's functional and psychosocial outcomes led to the development of several instruments to evaluate child oral health-related quality of life (COHQoL), such as the Parental-Caregiver Perception Questionnaire (P-CPQ) and the Family Impact Scale (FIS). However, the psychometric properties of these instruments have been evaluated only in Western cultures and have not been investigated for Aboriginal children in Australia. The current study aimed to examine the psychometric properties of the short-forms P-CPQ and FIS for Aboriginal and/or Torres Strait Islander children aged 2-3 years. Data were collected from the South Australian Aboriginal Birth Cohort (SAABC), including 270 Aboriginal children aged 2-3 years. Network psychometric models were used to investigate dimensionality, item redundancy, structural consistency and item stability, model fit, internal consistency reliability and criterion validity. We propose an instrument named Aboriginal Children's Oral Health-Related Quality of Life Questionnaire (A-COHQoL). Our findings indicated that, after the exclusion of four problematic items, the A-COHQoL showed a three-dimensional structure ("Parent/Family Activities", "COHQoL" and "Family Conflict") with good model fit and reliability. The A-COHQoL is a psychometrically robust and sensitive instrument that is readily available for Aboriginal and/or Torres Strait Islander children aged 2-3 years in Australia and can be adapted in the future for Indigenous child groups in other countries., Competing Interests: The authors have declared that no competing interests exist.

Objectives: Most of the paediatric quality-of-life instruments in oral health research are not preference-based measures, thus cannot be used in economic evaluations. The Early Childhood Oral Health Impact Scale (ECOHIS) is one such instrument which assesses oral health impact on children's quality of life among three- to five-year-olds. With increasing demands for more resource allocation in oral health care, there is a need for an outcome metric which can be used as the outcome in economic evaluations. The aim of this study was to develop a preference-based, health-state classification system from the existing ECOHIS instrument., Methods: The 13-item ECOHIS instrument was applied to the carers of 280 preschoolers who participated in a clinical trial in metropolitan Perth, Western Australia. Exploratory factor analysis was conducted to assess the dimensionality of the ECOHIS. Rasch analysis was used to eliminate and select items per determined dimensions and to reduce the number of response options for each item, because six levels were not amenable to valuation. The final classification system was determined through a combination of psychometric and expert advice., Results: Items loaded on to four dimensions with the factor analysis. Using Rasch analysis, three items were selected from the first dimension (child functional and psychological impact) and one item from the second dimension (child social interaction impact). None were selected from the third dimension (parental distress and family function impact) as it is not an appropriate proxy method of measuring the level of impact on a child. The final classification system has four dimensions with three levels in each, and so it has been named the ECOHIS-4D., Conclusions: The ECOHIS-4D classification system is a new preference-based instrument derived from the existing ECOHIS instrument. Future valuation studies will develop a utility value set for the health states defined by this classification system, and this will guide economic evaluations related to oral health interventions., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: Although HRQoL tools such as the EQ-5D-3L are significant in determining health status, these measures have not been validated in general populations in Australia. This study aims to psychometrically validate the EQ-5D-3L in a large population sample in Australia for the first time., Methods: The EQ-5D-3L was included in the Dental Care and Oral Health study (DCOHS), conducted in a South Australian population sample. The participants were 23-91 years old, and 44.1% were male. The EQ-5D-3L was responded to on a three-point rating scale ("none"/"no", "some" and "extremely"/"unable"/"confined"). We employed the area under the receiver operating characteristic curve (AUROC) to evaluate whether the EQ-5D-3L total score could identify participants with diagnosed diseases and mental health disorders. Psychometric validation of the EQ-5D-3L investigated dimensionality with Exploratory Graph Analysis, model fit, floor/ceiling effects and criterion validity., Results: The EQ-5D-3L comprised two dimensions, Activities and Symptoms. According to Root Mean Squared Error of Approximation (RMSEA) (<.05) and Comparative Fit Index (CFI) (>.950), the 2-dimensional structure showed excellent model fit with good reliability for the Activities subscale (Ω c  = 0.80-95% CI [0.77, 0.83]), and poor reliability for the Symptom subscale (Ω c  = 0.56-95% CI [0.53, 0.58]). The EQ-5D-3L showed adequate reliability (Ω c  = 0.70-95% CI [0.67, 0.72]). The EQ-5D-3L showed good discrimination for diagnosed diseases (ranging from 64.3% to 86.3%). Floor/ceiling effects were observed across all items. The EQ-5D-3L total score discriminated between respondents who were experiencing health conditions (e.g. cancer, cardiovascular disease, stroke) from healthy individuals., Discussion: Despite the ceiling effects, the EQ-5D-3L displayed good psychometric properties as an HRQoL measure and discriminated between health states in the general South Australian population. Further research should investigate the psychometric properties of the EQ-5D-5L in South Australia and whether an increased number of response categories can mitigate the observed ceiling effects.

Introduction: The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument to assess the subjective perception need for orthodontic treatment. The study aimed to determine the psychometric validity and reliability of PIDAQ in Australian adults., Methods: Data were collected from the National Dental Telephone Interview Survey in 2013. The PIDAQ was used, comprising 4 conceptual domains: self-confidence, social impact, psychological impact, and esthetic concern. Psychometric sensitivity was estimated for each item. Confirmatory factor analysis was performed to determine factorial validity in which the ratio of chi-square by degrees of freedom, comparative fit, and root mean square error of approximation were used as indexes of the goodness of fit. Convergent validity was estimated from the average variance extracted and composite reliability, whereas internal consistency was estimated by Cronbach standardized alpha., Results: The dataset comprised 2936 Australian adults aged ≥18 years and separated randomly into 2 subdata sets. The kurtosis and skewness values indicate an approximation to a normal distribution for each item, with acceptable thresholds for the goodness of fit and convergent validity (average variance extracted ≥0.50 and composite reliability ≥0.70), and discriminant validity was also demonstrated. Internal consistency was adequate in the 4 conceptual domains for PIDAQ for both subdata sets, with Cronbach standardized alpha being ≥0.70., Conclusions: The psychometric sensitivity, validity, and reliability of the PIDAQ instrument in a sample of the Australian adult population were found to be adequate. Both subdata sets drawn from the sample demonstrated acceptable goodness of fit and internal consistency., (Copyright © 2021 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.)

Objective: Working in partnership with Indigenous communities in South Australia, we aimed to develop, pilot test and estimate utility scores for health states relating to cervical cancer screening, precancer, and invasive cervical cancer and precancer/cancer treatment among Indigenous women., Methods: Development and pilot testing of hypothetical cervical cancer health states, specifically through the lens of being an Indigenous Australian woman, was done with an Indigenous Reference Group in conjunction with five female Indigenous community members. Six health states were developed. These included: (1) Screened: cytology normal; (2) human papillomaviruses (HPV) positive with cytology normal; (3) low grade cytology (LSIL);(4) high grade cytology (HSIL); (5) early stage cervical cancer and; (6) later stage cervical cancer. Utility scores were calculated using a two-stage standard gamble approach among a large cohort of Indigenous Australian women taking part in a broader study involving oral HPV infection. The mean and standard deviation (SD) of the rank, percentage of respondents with a utility = 1 (perfect health) and utility score of each health state was summarised. Mean (SD) and medians and inter-quartile range (IQR) over 12 months and lifetime duration were calculated. Potential differences by age and residential location were assessed using the Wilcox Sum Rank test., Results: Data was obtained from 513 Indigenous women aged 19+ years. Mean utility scores were higher for the four non-cancer health states than for invasive cervical cancer states (p-values <0.05). Lower mean utility scores were observed for late stage cervical cancer, with 0.69 at 12 months and 0.70 for lifetime duration (Intra-class correlation coefficients = 0.425). Higher utility scores were observed for the four non-cancer health states among non-metropolitan participants (ranged from 0.93 to 0.98) compared with metropolitan participants (ranged from 0.86 to 0.93) (p-values<0.05)., Conclusion: Among a large cohort of Indigenous Australian women, the reduction in quality of life (which utilities reflect) was perceived to be greater with increasing severity of cervical cancer health states. There were differences observed by geographic location, with positive cervical screening and precursor cancer-related quality of life being much higher among non-metropolitan-dwelling participants. These utility values, from one of the largest such studies ever performed in any population will be uniquely able to inform modelled evaluations of the benefits and costs of cervical cancer prevention interventions in Indigenous women., Competing Interests: The authors confirm that they have no competing interests.

Aims: To investigate the factors associated with poor oral health-related quality of life (OHRQoL) in a sample of Brazilian older adults., Methods and Results: A cross-sectional study was conducted with 535 non-institutionalized elders aged 60 years or older from Piracicaba, São Paulo, Brazil. OHRQoL was measured using the Geriatric Oral Health Assessment Index (GOHAI). Data on sociodemographic characteristics, self-perceived general health status, and health-related behaviors were obtained through a structured questionnaire. Data on chronic diseases were obtained from health records. Associations between exploratory factors and low OHRQoL (% GOHAI score <30) were evaluated using multivariate Poisson regression models to estimate adjusted prevalence ratios (PRs) and confidence intervals. The mean OHRQoL score was 30 (± 4.4). In bivariate analysis, being not married, smoking, and self-rated "fair/poor" general health status were associated with lower OHRQoL. In the adjusted model, self-rated "fair/poor" general health (PR: 1.25; 95% CI: 1.05-1.48), presence of chronic diseases (PR: 1.88; 95% CI: 1.37-2.58), smoking (PR: 1.25; 95% CI: 1.02-1.53), and reason for last dental appointment (PR: 1.34; 95% CI: 1.13-1.59) were associated with poor OHRQoL., Conclusion: Non-institutionalized older adults with a history of chronic diseases, who smoke, have a negative perception of their general health, and had the last dental appointment motivated by pain present significantly higher prevalence rates of poor OHRQoL., (© 2021 Special Care Dentistry Association and Wiley Periodicals LLC.)

Objective: Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is an instrument to assess the subjective perception needed for orthodontic treatment (OT). The study aimed to (1) evaluate the psychosocial impact of dental aesthetics and the potential role of OT and (2) determine associations between PIDAQ with self-rated general and oral health, oral health-related quality of life (OHRQOL), and receipt of OT among Australian adults., Methods: Data were obtained from the 2013 Australian National Dental Telephone Interview Survey (NDTIS). The PIDAQ was utilized as main outcome, comprising items from four conceptual domains: self-confidence, social impact, psychological impact, and aesthetic concern. Participants reported their socio-demographic, behavioural, self-rated general and oral health as well as the poor OHRQOL using the Oral Impact on Daily Performance (OIDP) instrument and OT. The mean of PIDAQ and four subscales score and their 95% confidence intervals (CI) were estimated. Generalized liner regression was used to estimate association between PIDAQ and covariates by calculating the mean ratio (MR) and their 95% CI., Results: There were 2936 Australian adults who completed the PIDAQ items. The mean PIDAQ score was 28.8 (95% CI: 28.0-29.6). Higher PIDAQ scores were identified among those who reported non-Australian birth, lower incomes, infrequent dental visits, less than 21 teeth and brushing teeth less than twice a day, fair/poor self-rated general and oral health, and poor OHRQOL. In multivariable modelling, the mean PIDAQ score was 1.91 (95% CI: 1.82-2.00) times higher among those with OIDP score >3 and 1.06 (95% CI:1.01-1.10) times higher in those who had OT, comparing with their counterparts. Also, higher PIDAQ scores were identified among females, last visiting a dentist more than 2 years ago, fair or poor self-rated oral and general health., Conclusions: Higher PIDAQ scores that have a greater impact on OHRQOL were associated with poorer self-rated general and oral health. This may be explained by unfavourable dental attendance and oral health habits. The positive correlation with OIDP scores verifies the validity of the PIDAQ. Those who had received OT had lower PIDAQ and OIDP scores., (© The Author(s) 2020. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Introduction: In Australia, health-related quality of life (HRQoL) instruments have been adopted in national population surveys to inform policy decisions that affect the health of Aboriginal and Torres Strait Islanders. However, Western-developed HRQoL instruments should not be assumed to capture Indigenous conceptualization of health and well-being. In our study, following recommendations for cultural adaptation, an Indigenous Reference Group indicated the EQ-5D-5L as a potentially valid instrument to measure aspects of HRQoL and endorsed further psychometric evaluation. Thus, this study aimed to investigate the construct validity and reliability of the EQ-5D-5L in an Aboriginal Australian population., Methods: The EQ-5D-5L was applied in a sample of 1012 Aboriginal adults. Dimensionality was evaluated using Exploratory Graph Analysis. The Partial Credit Model was employed to evaluate item performance and adequacy of response categories. Area under the receiver operating characteristic curve (AUROC) was used to investigate discriminant validity regarding chronic pain, general health and experiences of discrimination., Results: The EQ-5D-5L comprised two dimensions, Physiological and Psychological, and reliability was adequate. Performance at an item level was excellent and the EQ-5D-5L individual items displayed good discriminant validity., Conclusions: The EQ-5D-5L is a suitable instrument to measure five specific aspects (Mobility, Self-Care, Usual activities, Pain/Discomfort, Anxiety/Depression) of Aboriginal and Torres Strait Islander HRQoL. A future research agenda comprises the investigation of other domains of Aboriginal and Torres Strait Islander HRQoL and potential expansions to the instrument.

Background: Oral diseases negatively impact general health, affecting physical, psychological, social and emotional wellbeing, and ability to give back to community. The relationship between poor oral health, and general health and wellbeing among Indigenous Australians has not been documented. Working in partnership with seven Indigenous communities in South Australia, this study aimed to: 1) quantify self-rated oral health and health-related quality of life and; 2) investigate associations between poor self-rated oral health and general health among Indigenous Australian adults., Methods: Data was collected from a large convenience sample of Indigenous Australians aged 18+ years from Feb 2018 to Jan 2019. General health-related quality of life, as the main outcome variable, was measured by calculating disutility scores with the five individual EQ-5D dimensions (EuroQol instrument: EQ-5D-5L), then classified as 'no problem' and 'at least one problem'. Self-reported oral health, as the main explanatory, was dichotomised into 'fair or poor' and 'excellent, very good or good'. Multivariable log-Poisson regression models were used to estimate associations between poor self-rated oral health and general health by calculating mean rate ratios (MRR) for disutility scores and prevalence ratios (PR) for individual dimensions, after adjusting for social-demographic characteristics and health-related behaviours., Results: Data were available for 1011 Indigenous South Australian adults. The prevalence of 'fair or poor' self-rated oral health was 33.5%. The mean utility score was 0.82 (95% CI: 0.81-0.83). Compared with those rating their oral health as 'excellent or very good or good', those who rated their oral health as 'fair or poor' had a mean disutility score that was 1.6 (95% CI: 1.1-2.2) times higher, and the prevalence of at least one problem ranged from 90 to 160% higher for individual EQ-5D dimensions., Conclusions: Fair or poor self-rated oral health among Indigenous persons in South Australia was associated with poor general health as measured by EQ-5D-5L disutility. The relationship was especially evident with respect to mobility, self-care and anxiety/depression. The findings emphasise the importance of oral health as predictors of general health among Indigenous Australians.

Background: Interpersonal racism has had a profound impact on Indigenous populations globally, manifesting as negative experiences and discrimination at an individual, institutional and systemic level. Interpersonal racism has been shown to negatively influence a range of health outcomes but has received limited attention in the context of oral health. The aim of this paper was to examine the effects of experiences of interpersonal racism on oral health-related quality of life (OHRQoL) among Indigenous South Australians., Methods: Data were sourced from a large convenience sample of Indigenous South Australian adults between February 2018 and January 2019. Questionnaires were used to collect data on sociodemographic characteristics, cultural values, utilization of dental services, and other related factors. OHRQoL was captured using the Oral Health Impact Profile (OHIP-14) questionnaire. We defined the dependent variable 'poor OHRQoL' as the presence of one or more OHIP-14 items rated as 'very often' or 'fairly often'. Experiences of racism were recorded using the Measure of Indigenous Racism Experiences instrument. Interpersonal racism was classified into two categories ('no racism' vs 'any racism in ≥ 1 setting') and three categories ('no racism', 'low racism' (experienced in 1-3 settings), and 'high racism' (experienced in 4-9 settings)). Logistic regression was used to examine associations between interpersonal racism, covariates and OHRQoL, adjusting for potential confounding related to socioeconomic factors and access to dental services., Results: Data were available from 885 participants (88.7% of the total cohort). Overall, 52.1% reported experiencing any interpersonal racism in the previous 12 months, approximately one-third (31.6%) were classified as experiencing low racism, and one-fifth (20.5%) experienced high racism. Poor OHRQoL was reported by half the participants (50.2%). Relative to no experiences of racism in the previous 12 months, those who experienced any racism (≥ 1 setting) were significantly more likely to report poor OHRQoL (Odds Ratio (OR): 1.43; 95% Confidence Interval (CI): 1.08-1.92), after adjusting for age, education level, possession of an income-tested health care card, car ownership, self-reported oral health status, timing of and reason for last dental visit, not going to a dentist because of cost, and having no family support. This was particularly seen among females, where, relative to males, the odds of having poor OHRQoL among females experiencing racism were 1.74 times higher (95% CI: 1.07-2.81)., Conclusion: Our findings indicate that the experience of interpersonal racism has a negative impact on OHRQoL among Indigenous Australians. The association persisted after adjusting for potential confounding factors. Identifying this link adds weight to the importance of addressing OHRQoL among South Australian's Indigenous population by implementing culturally-sensitive strategies to address interpersonal racism.

Purpose: An evaluation of the reliability and validity of two child oral health-related quality of life (COHRQoL) measures among Australian Aboriginal children who participated in a randomised trial was undertaken., Methods: Study participants completed the Early Childhood Oral Health Impact Scale (ECOHIS) and the Caries Impacts and Experiences Questionnaire for Children (CARIES-QC). The questionnaires were completed a second time to test the scales' test-retest reliability. Internal consistency, convergent and discriminant validity were evaluated through Cronbach's alpha, correlation of the scale scores with the global oral health evaluation, and comparison of scale scores among children with varying levels of caries experience, respectively., Results: Worse COHRQoL was reported by parents who rated their child's oral health as poor and by children who rated their teeth as being a lot of problem. Cronbach's alpha for the child impact section (CIS), family impact section (FIS), total ECOHIS score and the total CARIES-QC scale were 0.88, 0.81, 0.91 and 0.84, respectively. Spearman's correlations between scale scores and global oral health ratings of the CIS, FIS, total ECOHIS and the CARIES-QC were 0.42, 0.34, 0.45 and 0.70, respectively, p < 0.001. The Kruskal-Wallis test of scale scores with grouped caries experience was statistically significant, p < 0.005. Test-retest reliabilities for the ECOHIS were CIS ICC = 0.91, FIS ICC = 0.89, total ECOHIS ICC = 0.93 and for the CARIES-QC, ICC = 0.61., Conclusions: Both the ECOHIS and the CARIES-QC were reliable and valid scales for use among an Australian Aboriginal population for assessing COHRQoL of preschool children., Trial Registration: ACTRN12616001537448, date of registration-08 November 2016.

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties.

Objective: To explore whether having less than 21 teeth is associated with poorer general health in a representative population sample of South Australians., Methods: Data were from a cross-sectional state-based survey, conducted from September to December 2013. Complete data were available for 2,908 participants (58 percent response rate). General health-related quality of life (HrQOL), as measured by the EuroQol instrument (EQ-5D-5L), was the main outcome measure. Total disutility scores were calculated, with the five individual EQ-5D dimensions then dichotomized into "no problems" and "at least one problem." The main explanatory variable was self-reported missing teeth, as assessed by having <21 teeth versus 21+ teeth in a questionnaire., Results: Overall, disutility was low (0.09) (ranges from 0 to 1, with high scores indicating poorer general health). In multivariable analysis, total disutility was positively associated with older age, lower annual household income, lower levels of physical activity, being a current tobacco smoker, receiving mental health treatment and <21 teeth. When individual dimensions were considered, missing teeth remained significantly associated with mobility problems (PR 1.26, 95 percent CI 1.06, 1.50) and pain/discomfort (PR 1.16, 95 percent CI 1.06, 1.27)., Conclusions: Missing teeth was associated with poor general health status as measured by EQ-5D-5L disutility. The relationship was especially evident with respect to mobility and pain/discomfort. The findings emphasize the importance of oral health as predictors of general health., (© 2017 American Association of Public Health Dentistry.)

Aims: The aim of this study was to describe the impact of oral health conditions among a convenience sample of Indigenous Australian adults and compare findings with nationally representative data., Methods: Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Nationally representative data were obtained from the National Survey of Adult Oral Health (NSAOH). The impact of oral disease was measured using the shortened form of the oral health impact profile, OHIP-14. All data were standardised by age group and sex utilising Census data., Results: For each OHIP-14 measure the impact was greater for IOHLP participants. There was considerable variation in the degree of difference between IOHLP and NSAOH participants for individual OHIP-14 items., Conclusion: High levels of effects of oral health conditions were reported by rural-dwelling Indigenous adults. This may exacerbate the health and social disadvantage experienced by this marginalised group.

Objectives: People who inject drugs (PWID) have poor oral health. However, their oral health-related quality of life (OHRQoL) is unknown. Our study was designed to measure the OHRQoL of PWID., Methods: The Oral Health Impact Profile-14 (OHIP-14) was administered to 794 PWID recruited in Australian capital cities as part of the 2013 Illicit Drug Reporting System (IDRS). Three OHIP-14 summary indicators were examined: "Prevalence" (proportion reporting ≥1 item at least "fairly often"), "severity" (mean total OHIP-14 score), and "extent" (number of impacts reported at least "fairly often"). Associations between "prevalence" and "extent" and variables drawn from the health, drug use, and social domains were investigated., Results: All OHIP-14 summary indicators among IDRS participants were significantly higher than in the general Australian population. In multivariate analysis, the "prevalence" indicator was significantly and positively associated with female gender [adjusted odds ratio (AOR) = 1.75, 95% CI 1.27-2.38], those born in Australia (AOR = 2, 95% CI 1.25-3.23), not completing Year 10 compared with those who had completed Year 12 or a higher qualification (AOR = 1.59, 95% CI 1.03-2.44), and methadone treatment (AOR = 1.61, 95% CI 1.14-2.29). The "extent" indicator was significantly and positively associated with female gender [adjusted incidence rate ratio (AIRR) = 1.56, 95% CI 1.19-2.08], unemployment (AIRR = 1.59, 95% CI 1.01-2.44), and having an injecting career of 10-20 years (AIRR = 1.76, 95% CI 1.03-3.01)., Conclusions: PWID have poorer OHRQoL than the Australian general population. Poor OHRQoL was particularly common in female PWID and those with longer injecting careers. Interventions to improve the oral health of PWID may improve their OHRQoL., (© 2015 American Association of Public Health Dentistry.)

Objective: To evaluate general health-related quality of life (HRQoL) and oral health impact among adults treated for cleft to determine age and gender differences, and to compare against population norms., Design: Cross-sectional prospective study., Participants/setting: Nonsyndromic cleft patients treated by the Australian Craniofacial Unit from 1975 to 2009 were recruited (n  =  112). Response rate was 79% (n  =  88). Main outcome measures : HRQoL was measured by the Short Form (SF)-36 questionnaire. Oral health impact was measured by the Oral Health Impact Profile (OHIP)-14 questionnaire. State-based and national norms were used for comparative purposes., Results: There were no significant age or sex differences in the cleft sample's SF-36 and OHIP-14 scores. When compared against South Australian 2002 state-level norms, cleft participants scored higher on physical function and physical role function but lower on vitality and mental health. The prevalence of having experienced one or more of OHIP-14 items "fairly often" or "very often" was 2.7 times higher than national-level estimates, while extent was 2.8 times and severity 1.7 times higher., Conclusions: The oral health impact among cleft patients included in our study was poor compared with population-level estimates. The HRQoL showed mixed results, with the vitality and mental health components being poorer in the cleft group compared with population-level estimates. These results indicate that treatment for orofacial clefting does not entirely remove the factors contributing to poor HRQoL and oral health.

Objective: Accurate assessment of child oral health is important for guiding economic evaluations and informing healthcare decision‐making. Early Childhood Oral Health Impact Scale (ECOHIS‐4D) is a preference‐based instrument that measures the oral health‐related quality of life of young children. The aim of this study was to compare the utility scores of ECOHIS‐4D and Child Health Utility Index (CHU‐9D), against an oral health indicator to evaluate which utility score corresponds better with the oral health indicator. Method: The ECOHIS‐4D and CHU‐9D were applied to 314 parent/child dyads from preschools in a primary healthcare setting in Perth, Western Australia. Four parameters were used to assess which instrument corresponds better with the oral health indicator (decayed, missing and filled teeth score‐dmft score): (i) discrimination, the ability to discriminate between different clinical severity groups, (ii) external responsiveness, how much the utility values relate to the changes in dmft scores, (iii) correlation, the association between the two instruments and the related dimensions and (iv) differences in the utility values across the two instruments. Results: Most participants (81%) were 2–6 years old, and nearly 50% had a dmft score <3. ECOHIS‐4D demonstrated a superior ability to differentiate between dmft severity groups and respond to changes in dmft scores. A significant weak correlation was observed between dmft and ECOHIS‐4D (−0.26, 95%, CI −0.36 to −0.15) compared to a non‐significant very poor correlation between dmft and CHU‐9D (0.01, 95% CI −0.12 to 0.10). The utility scores of the two instruments had relatively good agreement towards good health and weak agreement towards poor health. Conclusions: ECOHIS‐4D, the oral health‐specific instrument, is more sensitive in assessing children's oral health‐related quality of life than the generic CHU‐9D. Thus, ECOHIS‐4D is more appropriate for utility estimates in economic evaluations of oral health‐related interventions and resource allocation decision‐making. [ABSTRACT FROM AUTHOR]

Objective: Invasive colonial influences and continuing neoliberal policies have a detrimental impact on Land, health, food and culture for Indigenous Communities. Food security and sovereignty have significant impacts on Indigenous well-being and, specifically, oral health. Aspects relating to food security, such as availability of nutritious foods, are a common risk factor of oral diseases. This scoping review aimed to collate existing evidence regarding the relationship between food sovereignty and/or food security and oral health for Indigenous Communities, globally. Design: Four databases were searched using keywords related to 'Food security' or 'Food sovereignty,' 'Indigenous Peoples' and 'Oral health.' Duplicates were removed, and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data were summarised narratively, presenting a conceptual model which illustrates the findings and relationships between food security and/or food sovereignty and oral health. Results: The search identified 369 articles, with forty-one suitable for full-text review and a final nine that met inclusion criteria. The impact of food security and food sovereignty on oral health was discussed across different populations and sample sizes, ranging from eighteen Kichwa families in Brazil to 533 First Nations and Metis households in Canada. Pathways of influence between food sovereignty and/or food security are explored clinically, quantitatively and qualitatively across oral health outcomes, including early childhood caries, dental caries and oral health-related quality of life for Indigenous Communities. Conclusions: Innovative strategies underpinned by concepts of Indigenous food sovereignty are needed to promote oral health equity for Indigenous Communities. The nexus between oral health and Indigenous food sovereignty remains largely unexplored, but has immense potential for empowering Indigenous rights to self-determination of health that honour Indigenous ways of knowing, being and doing. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) and poor oral health are inter‐related and their significant impact on each other is well established in the literature. Many systematic reviews and meta‐analyses have demonstrated a strong relationship between CKD and periodontitis, where periodontal treatment has shown potential in improving CKD outcomes. However, the quality of the studies and heterogeneity of the results show variation. The aim of this umbrella review was to review the quality of the current systematic reviews on the relationship between CKD and oral health with an emphasis on periodontal disease and to generate clinically relevant guidelines to maintain periodontal health in patients with CKD. This umbrella review was conducted and reported in alignment with the Joanna Briggs Institute and the PRISMA 2020 guidelines. The review protocol was established prior to commencing the review and registered on JBI and PROSPERO (CRD42022335209). Search strings were established for PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and Dentistry & Oral Science Source up to April 2022. All systematic reviews and meta‐analyses that considered the relationship between CKD and periodontitis or periodontal treatment were included. Of 371 studies identified through the systematic search, 18 systematic reviews met the inclusion criteria. Ten studies assessed the relationship between oral health status and CKD with a focus on periodontitis and CKD, five reviewed the impact of periodontal treatment on CKD outcomes, two included both relationship and effectiveness of periodontal treatment and one qualitatively reviewed oral health‐related quality of life in patients with kidney failure. Findings indicate there is a bidirectional relationship between CKD and periodontal disease. In view of the heterogeneity of the existing literature on CKD and periodontal disease, specific recommendations for the management of periodontitis among patients with CKD are proposed for medical professionals, dental professionals, and aged care workers based on the evidence collated in this review. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. Background: OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. Design: A cross‐sectional design following the STROBE guideline. Methods: A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health‐related quality of life. OHL was measured using the validated Chinese version of the short‐form Health Literacy of Dentistry (HeLD‐14) scale. Descriptive statistics, the Mann–Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. Results: The median HeLD‐14 score (p25–p75) was 50.0 (44.0–54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self‐reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. Conclusions: The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. Relevance to clinical practice: The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. Patient or public contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Objectives: The management of early childhood caries is challenging and the impacts of its treatment on child oral health‐related quality of life (COHRQoL) and dental anxiety among Australian Aboriginal children is relatively unknown. The aim of the study was to compare the impact on COHRQoL and dental anxiety after approximately 12 months among Aboriginal children treated for early childhood caries (ECC) using the Atraumatic Restorative Treatment and the Hall Technique (ART/HT: test) or standard care (control). Methods: Consenting Aboriginal communities in the North‐West of Western Australia were randomized into early (test) or delayed (control) intervention for the management of ECC. Children and parents/carers completed a questionnaire at baseline and at follow‐up. The questionnaire sought information on COHRQoL using the proxy‐reported Early Childhood Oral Health Impact Scale (ECOHIS) and the self‐reported Caries Impacts and Experiences Questionnaire for Children (CARIES‐QC). The test group was provided with the ART/HT care at baseline while the control group was advised to seek care through the usual care options available within the community. At follow‐up, both groups were offered care using the ART/HT approach. Changes in the mean scores from baseline to follow‐up within groups were evaluated using appropriate paired (t‐test, Wilcoxon paired test), and between groups with unpaired tests (t‐test). Multivariate regression analysis after multiple imputations of missing data used generalized estimating equation (GEE) controlling for clustering within communities. Results: Twenty‐five communities and 338 children (mean age = 3.6 years, sd 1.7) participated in the study (test = 177). One child was excluded from the analysis because of a missing questionnaire and clinical data at baseline and follow‐up. At baseline, test group children were older (test = 3.8 years, 95% CI 3.6–4.1;control = 3.3 years, 95% CI 3.1–3.6) and had higher caries experience (test dmft = 4.4, 95% CI 3.8–5.0;control dmft = 3.1, 95% CI 2.5–3.7), but there was no significant difference in COHRQoL or anxiety levels between the groups. At follow‐up, parents in the delayed intervention reported worsening of COHRQoL (70% worsening of the family impact section of the ECOHIS and 37% worsening of the total ECOHIS scale), and there was an 8% reduction in child dental anxiety among the early treatment group. Conclusions: The application of the ART/HT approaches was feasible, effective, and impacted positively on child oral health‐related quality of life and child dental anxiety among Aboriginal children in remote communities. The model of care as tested in this study should be further developed for inclusion in main‐stream service delivery programmes. [ABSTRACT FROM AUTHOR]

Objectives: Network analysis is an innovative, analytic approach that enables visual representation of variables as nodes and their corresponding statistical associations as edges. It also provides a new way of framing oral health‐related questions as complex systems of variables. We aimed to generate networks of oral health variables using epidemiological data of Indigenous children, and to compare network structures of oral health variables among participants who received immediate or delayed delivery of an oral health intervention. Methods: Epidemiological data from 448 mother‐child dyads enrolled in a randomized controlled trial of dental caries prevention in South Australia, Australia, were obtained. Networks were estimated with nodes representing study variables and edges representing partial correlation coefficients between variables. Data included dental caries, impact on quality of life, self‐rated general health, self‐rated oral health, dental service utilization, knowledge of oral health, fatalism and self‐efficacy in three time points. Communities of nodes, centrality, clustering coefficient and network stability were estimated. Results: The oral health intervention interacted with the network through self‐rated general health and knowledge of oral health. Networks depicting groups shortly after receiving the intervention presented higher clustering coefficients and a similar arrangement of nodes. Networks tended to return to a preintervention state. Conclusion: The intervention resulted in increased connectivity and changes in the structure of communities of variables in both intervention groups. Our findings contribute to elucidating dynamics between variables depicting oral health networks over time. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate associations of sociodemographic, lifestyle, medical conditions, and caries experience with oral health‐related quality of life (OHRQoL) in a large sample of adults with mental disorders. A sample of 753 adults diagnosed with schizophrenia or depression, who were users of 10 public mental health outpatient clinics located in the city of São Paulo, Brazil, participated in the study. Participants provided data on sociodemographic characteristics, psychiatric diagnosis, medication use, and health behaviors. Oral examinations to evaluate dental caries (using the decayed, missing, and filled teeth ([DMFT] index) and dental plaque (using the Silness–Löe plaque index) were conducted. Oral health‐related quality of life was evaluated using the 14‐item Oral Health Impact Profile (OHIP‐14) questionnaire. Log‐Poisson regression was used to evaluate associations between the outcome and independent variables. The prevalence of one or more OHIP‐14 impacts occurring fairly often/often was 72.3%. Physical pain was the OHIP domain with the highest prevalence, followed by psychological discomfort. Multivariable analysis showed that higher prevalence of the reponses 'fairly often/often' in the OHIP‐14 was associated with being female, aged 35 to 54 years, having a low family income, a diagnosis of depression, a smoking habit, and fewer than 20 teeth. Adults with mental disorders had a high prevalence of impacts on their OHRQoL, which were associated with caries experience, sociodemographic characteristics, type of psychiatric diagnosis, and behavioral risk indicators. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a 4-item child oral health-related quality of life (OHRQoL) instrument that might be more amenable for uptake in large scale, multifaceted surveys of children's health and wellbeing than current, longer-form child OHRQoL instruments. Methods: Data were obtained from a study of the South Australian School Dental Service population designed to investigate OHRQoL among school children aged 8–13 years in 2002–2003. The Child Perception Questionnaire (CPQ8-10 and CPQ11-14) was utilised, which comprises 25 & 37 items representing four conceptual domains: oral symptoms, functional limitations, emotional wellbeing and social wellbeing. Initially, the psychometric properties of the short form 8-item CPQ were tested in both age groups using Confirmatory Factor Analysis. The rationale was that, if the 8-item CPQ8-10 and CPQ11-14 did not display good psychometric properties, there was no reason to proceed with further shortening into 4-item versions. Following a good fit of the 8-item CPQ, items with higher factor loadings in each domain were maintained and tested in the development of a 4-item CPQ. Exploratory Factor Analysis was conducted to determine dimensionality, followed by tests for reliability and validity. Model fits were assessed using Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Standardized Root Mean Square Residual (SRMR). Results: There were 308 children aged 8–10 years who completed CPQ8-10 and 461 children aged 11–13 years who completed CPQ11-14. For the short-form 8-item instrument, satisfactory goodness of fit was demonstrated for the two age groups, with acceptable thresholds for RMSEA, CFI, and SRMR. The four items with the highest factor loading in each domain were the same for the 8-item CPQ8-10 and CPQ11-14. and these items were selected to comprise the 4-item CPQ8-10 and CPQ11-14. The 4-item short form displayed good criterion validity, with expected score patterns found in the majority of the known groups evaluated. Conclusions: We developed short-form 4-item CPQ8-10 and CPQ11-14 instruments that were tested in a large convenience sample of South Australian school children. The instruments demonstrated acceptable reliability and validity. Implications for practice are discussed. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate associations between oral health literacy (OHL), self‐rated oral health (SROH), and oral health‐related quality of life (OHRQoL) in Brazilian adults. A sample of 523 Brazilian adults completed the short‐form Health Literacy in Dentistry (HeLD‐14) and the Oral Health Impact Profile‐14 (OHIP‐14) instruments that measure OHL and OHRQoL, respectively. The prevalence ratios (PRs) for outcome variables and their 95% CIs were quantified. Multivariable log‐binomial regression models were applied, as the statistical models, to estimate bivariate and multivariable relationships of oral health outcomes with OHL, after adjusting for covariates. No significant association was found between poor SROH (as measured by single items) and OHL (PR = 1.28; 95% CI: 0.87–1.88); by contrast, significant associations were found between poor SROH and income (PR = 1.52; 95% CI: 1.04–2.21), toothbrushing frequency (PR = 1.69; 95% CI: 1.11–2.58), reason for dental visiting (PR = 1.48; 95% CI: 1.03–2.13), and self‐rated general health (PR = 3.44; 95% CI: 2.38–4.97). The OHL level (PR = 1.76; 95% CI: 1.21–2.56), educational level (PR = 0.62; 95% CI: 0.41–0.93), reason for dental visiting (PR = 1.84; 95% CI: 1.30–2.61), and self‐rated general health (PR = 1.51; 95% CI: 1.03–2.23) were associated with poor OHRQoL. [ABSTRACT FROM AUTHOR]

This study aimed to assess the effect of caries increment on Oral Health-related Quality of Life (OHRQoL) of Brazilian adolescents and to evaluate the responsiveness of the Child Perceptions Questionnaire (CPQ11-14) in this group. A population-based sample of 515 Brazilian 12-year-olds from a large city located in the southeast of Brazil was evaluated according to a random multistage sampling design at baseline and 291 at three years follow-up, using the DMFT index and the CPQ11-14 instrument. To evaluate the responsiveness to change, the measures of effect size and longitudinal construct validity were used. It was verified that OHRQoL among adolescents with DMFT increment across the three years worsened significantly (p<0.05) in relation to their counterparts. The effect size varied from small to moderate. The longitudinal construct validity of CPQ11-14 was satisfactory. Caries increment impacted on OHRQoL of adolescents in Brazil. The CPQ11-14 instrument demonstrated acceptable responsiveness properties. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the short- and long-term orthodontic treatment (OT) expectations, malocclusion severity, and oral health-related quality of life (OHRQoL) status of adolescent patients using qualitative and quantitative methodology. Materials and methods: Adolescents (n = 105; 42 males and 63 females) aged between 12 and 17 years participated in this interview and questionnaire-based study. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the Oral Impacts on Daily Performances (OIDP) scale evaluated OHRQoL status. Study casts were analysed using the Dental Aesthetics Index (DAI) and the Index of Complexity, Outcome and Need (ICON). Mann–Whitney test and Spearman's correlations tested various univariate variables. Results: With similar index-determined OT need (DAI, P = 0.371 and ICON, P = 0.932) females tended to have worse OHRQoL status (PIDAQ scores, P-values ranged from 0.006 to 0.0001 and scores for the OIDP question related to smiling, laughing, and showing teeth without embarrassment, P-value = 0.015). Occlusal index scores did not have statistically significant associations with the OHRQoL scales. Better dental appearance was expected by 85 per cent of the adolescents in the short-term and by 51 per cent in the long-term after OT. The associated psycho-social expectations were: 1. improved dental self-confidence, 2. positive psychological impact/improved self-worth, and 3. positive social impact. Conclusions: Female adolescent patients tended to experience worse psycho-social impacts related to their malocclusions compared with males with similar index-determined OT need. Index-determined OT need scores did not correlate with the OHRQoL scales. Adolescent patients expected OT to improve their dental appearance and QoL aspects. [ABSTRACT FROM AUTHOR]

This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on- reserve communities in Ontario and Manitoba. One- third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off- reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes. [ABSTRACT FROM AUTHOR]

Objective: To evaluate general health-related quality of life (HRQoL) and oral health impact among adults treated for cleft to determine age and gender differences, and to compare against population norms. Design: Cross-sectional prospective study. Participants/setting: Nonsyndromic cleft patients treated by the Australian Craniofacial Unit from 1975 to 2009 were recruited (n = 112). Response rate was 79% (n = 88). Main outcome measures: HRQoL was measured by the Short Form (SF)-36 questionnaire. Oral health impact was measured by the Oral Health Impact Profile (OHIP)-14 questionnaire. State- based and national norms were used for comparative purposes. Results: There were no significant age or sex differences in the cleft sample's SF-36 and OHIP-14 scores. When compared against South Australian 2002 state-level norms, cleft participants scored higher on physical function and physical role function but lower on vitality and mental health. The prevalence of having experienced one or more of OHIP-14 items "fairly often" or "very often" was 2.7 times higher than national-level estimates, while extent was 2.8 times and severity 1.7 times higher. Conclusions: The oral health impact among cleft patients included in our study was poor compared with population-level estimates. The HRQoL showed mixed results, with the vitality and mental health components being poorer in the cleft group compared with population-level estimates. These results indicate that treatment for orofacial clefting does not entirely remove the factors contributing to poor HRQoL and oral health. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusion Oral health is often overlooked in ageing health issues, despite its impact on overall health and quality of life. Older Australians, especially those in rural and remote areas, face difficulties accessing oral health services. The aim of the study was to investigate the factors that contribute to financial barriers to accessing dental services among the ageing population in Australia in relation to their residential location.The study included a weighted sample of Australian adults aged 65 years and over from a population‐based survey called the National Study of Adult Oral Health (NSAOH) conducted in 2017–18. Descriptive analysis was conducted and generated cross‐tabulation tables to investigate the distributions of the outcome, exposure and covariates, including Sex, Education level (the highest level of education), Equivalised household income, Dental insurance, Concession card ownership, Difficulty paying a dental bill and last dental visit. Blinder‐Oaxaca decomposition counterfactual analysis was used to explore the potential impact of a person's residence on their financial difficulty accessing dental services.The findings showed that 26.2% (95% CI: 24.3–29.3) of major city residents and 30.1% (95% CI: 26.9–33.3) of rural residents avoided or delayed dental visits due to cost. The decomposition analysis indicated that 53.8% of the disparities in the prevalence of avoided or delayed dental visits due to cost were explained by the selected variables, while 46.2% remained unexplained. The explanatory variable with the largest contribution was difficulty paying a $200 dental bill, accounting for 62.4% of the differences, followed by dental insurance, last dental visit and equivalised household income, which explained 42.1%, 20.8% and 14.9% of the differences, respectively.Regional/remote populations experience more financial barriers to accessing dental care than major city populations and the identified factors explain a significant proportion of these disparities. Based on the study findings, recommendations include expanding public dental service coverage, evaluating concession card mechanisms and advocating for regular dental visits to mitigate disparities in dental care access. [ABSTRACT FROM AUTHOR]