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This study explored the association between history of orthodontic treatment and changes in self-esteem among British adolescents. Birth cohort study. United Kingdom. Data from 2600 participants of the British Cohort Study were analysed. Participants completed the Lawrence Self-Esteem Questionnaire (LAWSEQ) at the ages of 10 and 16 years. The change in LAWSEQ score over six years was the outcome. Participants were divided into two groups according to parental reports of orthodontic treatment at the same ages. The association between history of orthodontic treatment and six-year changes in LAWSEQ score was tested in linear regression models adjusting for demographic factors (adolescents' sex and ethnicity), family socioeconomic status (parental social class and mothers' education), perceived orthodontic treatment need and baseline LAWSEQ score. According to parental reports, 8% of participants had a history of orthodontic treatment. The mean LAWSEQ score at baseline was 13.7 (95% confidence interval [CI] 13.6–13.9) and increased significantly over time by 1.7 units (95% CI 1.5–1.9). Orthodontic treatment history was positively, albeit not significantly, associated with change in LAWSEQ score (coefficient: 0.08, 95% CI –0.56 to 0.72). The direction of the association reversed but remained non-significant after adjustment for all confounders (coefficient: –0.19; 95% CI –0.68 to 0.30). Improvements in self-esteem were positively associated with mothers' education (coefficient: 0.85; 95% CI 0.09–1.61) and negatively associated with self-esteem at baseline (coefficient –0.79; 95% CI –0.82 to –0.75). This six-year longitudinal study provided no evidence for an association between history of orthodontic treatment and changes in self-esteem during adolescence. [ABSTRACT FROM AUTHOR]

Aim To determine whether wearing orthodontic appliances was associated with eating difficulty and lower sugars intake among British adolescents. Methods This study analysed data from 4116 12- and 15-year-olds who participated in the 2013 Children's Dental Health Survey in the UK. Information on eating difficulties in the past 3 months and usual intake of six sugary items was collected through self-administered questionnaires. The presence and type of orthodontic appliances (fixed or removable) were assessed during clinical examinations. Logistic regression was used to evaluate the association between wearing orthodontic appliances and eating difficulty whereas linear regression was used to evaluate the association between wearing orthodontic appliances and sugars intake. Regression models were adjusted for socio-demographic, behavioural, and clinical characteristics of adolescents. Results 12.9 per cent of the 4116 adolescents wore orthodontic appliances (10.1 per cent fixed and 2.8 per cent removable), 21.0 per cent reported eating difficulties and the mean daily intake of sugars was 5.3 times/day (SD: 3.7, range: 0–20). Adolescents with fixed appliances had 4.02 (95% CI: 3.03, 5.33) greater odds of reporting eating difficulty than those with no appliances, but no differences were found between adolescents wearing removable and no appliances. No association was found between wearing orthodontic appliances and daily sugars intake either [coefficients of 0.20 (95% CI: –0.27, 0.66) and –0.30 (95% CI: –0.96 to 0.36) for adolescents wearing fixed and removable appliances, respectively]. Conclusion Wearing fixed orthodontic appliances were associated with greater odds of reporting eating difficulty, but not with lower sugars intake among British adolescents. [ABSTRACT FROM AUTHOR]

Objective: To explore the association between long‐term pattern of dental attendance and tooth retention among British adults. Methods: This study analysed data from 2970 dentate adults who participated in the Adult Dental Health Survey. Data were collected through home interviews and clinical examinations. Individuals were categorized into four trajectories according to their responses to three questions on dental attendance over their life span. The four trajectories were always, current, former and never regular attenders. Tooth retention was measured as the number of natural teeth retained and having a functional dentition (20 or more teeth). Associations were examined in regression models adjusted for demographic (sex, age and country of residence), socioeconomic (education, equivalized household income and social class) and clinical factors (untreated caries and periodontal disease). Results: Never and former regular attenders had fewer teeth retained (rate ratios with 95% confidence interval: 0.93 [0.89‐0.97] and 0.97 [0.96‐0.99], respectively) and lower odds of having functional dentition (odds ratios with 95% CI: 0.36 [0.22‐0.60] and 0.53 [0.34‐0.83], respectively) than always regular attenders after adjusting for demographic, socioeconomic and clinical characteristics. However, no differences in number of teeth retained or having a functional dentition were found between always and current regular attenders. Conclusion: Long‐term regular dental attendance was associated with greater tooth retention. Never and former regular attenders had fewer teeth retained than always regular attenders. No difference in tooth retention was found between always and current regular attenders. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To assess the interrelationship between ethnicity, migration status and dental caries experience among adults in East London. Methods: We analysed data from 1910 adults (16‐65 years) representing 9 ethnic groups, who took part in a community‐based health survey in East London. Participants completed a supervised questionnaire and were clinically examined by trained dentists. Dental caries was assessed with the number of decayed, missing and filled teeth (DMFT). The association of ethnicity, nativity status and migration history with DMFT was assessed in negative binomial regression models controlling for demographic, socioeconomic and behavioural factors. Results: White migrants had greater DMFT than UK‐born adults, whereas every Asian and Black migrant group had lower DMFT than adults of the same ethnic group born in the UK (albeit significant only for Black Caribbean and Asian Others). Among foreign‐born adults, age at arrival (Rate Ratio: 1.03; 95% Confidence Interval: 1.01‐1.05) and length of residence (1.04; 95% CI: 1.02‐1.06) were positively associated with DMFT. A significant interaction between both factors was also found, with more pronounced differences between older and younger migrants at longer stay in the UK for White Others, Black Caribbean and Asian Others. Conclusion: Large inequalities in caries experience were found between foreign‐ and UK‐born adults, with considerable variation across ethnic groups. Looking beyond cultural explanations, in favour of social and environmental factors, may help to explain those inequalities. [ABSTRACT FROM AUTHOR]

Objective To evaluate the contribution of dental anxiety to social gradients in different oral health outcomes and whether social gradients in oral health persist once dental anxiety is removed from the population examined. Methods Data from 9035 British adults were analysed. Participants' socioeconomic position ( SEP) was measured through education and household income. Dental anxiety was measured with the Modified Dental Anxiety Scale. Poor subjective oral health, oral impacts on quality of life and edentulism among all adults and the number of teeth, the number of decayed, missing and filled surfaces (DMFS) and sextants with pocketing among dentate adults were the oral health outcomes. The contribution of dental anxiety to absolute and relative social inequalities in each oral health outcome (measured with the Slope and Relative Index of Inequality [ SII and RII], respectively) was estimated from regression models without and with adjustment for dental anxiety and quantified with the percentage attenuation. Interactions between each SEP indicator and dental anxiety were used to test what would happen if dental anxiety were removed from the whole population. Results The largest contribution of dental anxiety to explaining oral health inequalities was found for education gradients in perceived outcomes (11%-13%), but dental anxiety explained <4% of social gradients in edentulism. Among dentate adults, dental anxiety accounted for <5% and <7% of education and income gradients, respectively. Only four of the 24 interactions tested were statistically significant. Hence, the education- and income-based SII and RII for oral impacts were nonsignificant among anxiety-free adults but were significant at higher levels of dental anxiety. Conclusions Little support was found for the role of dental anxiety in explaining social inequalities in various perceived and clinical oral health measures. Oral health inequalities were found among both nondentally anxious and anxious participants. [ABSTRACT FROM AUTHOR]

Aim To explore ethnic inequalities in periodontal disease among British adults, and the role of socioeconomic position ( SEP) in those inequalities. Methods We analysed data on 1925 adults aged 16-65 years, from the East London Oral Health Inequality ( ELOHI) Study, which included a random sample of adults living in an ethnically diverse and socially deprived area. Participants completed a questionnaire and were clinically examined for the number of teeth with periodontal pocket depth ( PPD)≥4 mm and loss of attachment ( LOA)≥4 mm. Ethnic inequalities in periodontal measures were assessed in negative binomial regression models before and after adjustment for demographic (gender and age groups) and SEP indicators (education and socioeconomic classification). Results Compared to White British, Pakistani, Indian, Bangladeshi and Asian Others had more teeth with PPD≥4 mm whereas White East European, Black African and Bangladeshi had more teeth with LOA≥4 mm, after adjustments for demographic and SEP measures. The association of ethnicity with periodontal disease was moderated by education, but not by socioeconomic classification. Stratified analysis showed that ethnic disparities in the two periodontal measures were limited to more educated groups. Conclusion This study showed considerable ethnic disparities in periodontal disease between and within the major ethnic categories. [ABSTRACT FROM AUTHOR]

Aim: To explore the association between alcohol consumption at age 11-12 years and traumatic dental injuries (TDI) at age 15-16 years.Methods: Data of 635 adolescents who participated in phases I and III of the Research with East London Adolescents Community Health Survey (RELACHS), a longitudinal school-based survey of a representative sample of adolescents from East London, were used for this study. Information on socio-demographic characteristics and alcohol consumption was obtained from questionnaires in phase I when adolescents were 11-12 years of age. Data on TDI and clinical characteristics (incisor overjet and lip coverage) were taken from clinical examination in phase III when adolescents were 15-16 years of age. The association between (lifetime and last month) alcohol consumption and TDI was assessed in crude and adjusted logistic regression models.Results: Overall, 14.5% of adolescents had ever consumed alcohol and 3.5% had consumed alcohol the month before the baseline survey, whereas 17% of adolescents had experienced TDI by age 15-16 years. No significant association of alcohol consumption with TDI was seen in these adolescents for either lifetime (adjusted odds ratio [OR]: 0.87; 95% confidence interval [CI]: 0.45-1.67) or last month consumption of alcohol (adjusted OR: 0.86; 95% CI: 0.28-2.69).Conclusion: This study did not support the association between alcohol use and TDI in adolescents. [ABSTRACT FROM AUTHOR]

Aim The aim of this study was to explore the association between long-term pattern of dental attendance and periodontal disease among British adults. Methods We used data from 3272 adults who participated in the 1998 Adult Dental Health Survey in the UK. Participants were classified into four trajectories (current, always, former and never regular attenders) based on their responses to three questions on lifetime dental attendance patterns. The numbers of teeth with pocket depth ( PD) ≥4 mm and loss of attachment ( LOA) ≥4 mm were the outcome measures. The association between dental attendance patterns and each periodontal measure was assessed in crude and adjusted models using negative binomial regression. Results Never and former regular attenders had more teeth with PD ≥4 mm (Rate Ratios with 95% Confidence Interval: 1.58 [1.28-1.95] and 1.34 [1.12-1.60] respectively) and LOA ≥4 mm (1.34 [1.04-1.72] and 1.37 [1.07-1.75] respectively) than always regular attenders, after adjustments for demographic (sex, age and country of residence) and socioeconomic factors (education and social class). However, no differences in periodontal measures were found between always and current regular attenders. Conclusion This analysis of national cross-sectional data shows that adults with different long-term patterns of dental attendance have different periodontal health status. [ABSTRACT FROM AUTHOR]

Objectives This study aimed to characterize trajectories of intergeneration mobility from birth to age 33 years and to assess the influence of these trajectories on adult oral health. Methods Repeated data on occupational social class (birth and 7, 11, 16, 23 and 33 years) and two subjective oral health indicators (lifetime and past-year prevalence of persistent trouble with gums or mouth) measured at age 33 years, from the 1958 National Child Development Study, were used for this analysis. Latent class growth analysis ( LCGA) was used to identify different trajectories of exposure to manual social class over time. Binary logistic regression was then used to explore the association between these trajectories and each oral health indicator, adjusting for participants' sex. Results Latent class growth analysis showed that a four trajectory model provided the best fit to the data. The four trajectories that emerged were identified as stable manual, stable nonmanual, late steep increase (those who were likely to be in the manual social class until age 16 years but ended up in the nonmanual social class afterwards) and steady increase (those whose likelihood of leaving the manual social class increased gradually over time). Lifetime and past-year prevalence of persistent trouble with gums or mouth was significantly higher in the stable manual trajectory than in all other trajectories. No differences were found between the stable nonmanual, late steep increase and steady increase trajectories. Conclusion Although four distinctive trajectories were identified in the 1958 NCDS, only those who remained in the manual social class over time reported worse oral health by age 33 years. Proximal socioeconomic experiences may be more relevant to adult oral health than early life experiences. [ABSTRACT FROM AUTHOR]

There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long-term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular-attenders) based on their responses to three questions on lifetime dental-attendance patterns. The association between dental-attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth ( DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio-economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long-term dental attendance and caries experience was found in adjusted models. Former and never regular-attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular-attenders. No differences in DMFT or its components were found between current and always regular-attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses. [ABSTRACT FROM AUTHOR]

This study assessed trends in social inequalities in tooth loss in the United Kingdom between 1988 and 2009. Data from 20,126 adults who participated in the latest three national Adult Dental Health Surveys in England, Wales and Northern Ireland were used. Social class was determined using the 6-point Registrar General’s Social Class. Three indicators of tooth loss were analysed; the proportion of edentate people among all adults and the number of teeth and the proportion with functional dentition (defined as having 20+ teeth) among dentate adults. Trends were modelled within an age, period and cohort framework using partial least squares regression (PLSR). Confidence intervals for PLSR estimates were obtained using non-parametric bootstrapping. The Slope and Relative Index of Inequality (SII and RII) were used to quantify social inequalities in tooth loss. Between 1988 and 2009, absolute inequalities in total tooth loss narrowed (SII changed from −28.4% to −15.3%) while relative inequalities widened (RII from 6.21 to 20.9) in the whole population. On the other hand, absolute and relative social inequality in tooth loss remained fairly stable over time among dentate adults. There was an absolute difference of 2.5–2.9 in number of teeth and 22–26% in the proportion with functional dentition between the lowest and highest social classes. In relative terms, the highest social class had 10–11% more teeth and 25–28% higher probability of having functional dentition than the lowest social class. The findings show pervasive inequalities in tooth loss by social class among British adults despite marked improvements in tooth retention in recent years and generations. In the whole adult population, absolute inequalities in tooth loss have narrowed while relative inequalities have increased steadily. Among dentate adults, absolute and relative inequalities in number of teeth and proportion of people with functional dentition have remained significant but unchanged over time. [ABSTRACT FROM AUTHOR]

Objectives. We assessed the relative influences of age, period, and cohort effects on trends in caries experience of permanent teeth in 4 different populations. Methods. We used data from England and Wales, United States, Japan, and Sweden in which numerous cross-sectional, nationally representative surveys have been conducted periodically since the early 1960s. For each country, trends in caries experience (measured by DMFT index—the number of decayed, missing, and filled permanent teeth) were analyzed in an age, period, and cohort (APC) analysis using partial least square regression. Results. A strong effect of age manifested in caries experience, period and cohort effects aside. Caries levels increased through to adolescence; thereafter, there was a larger increase in DMFT in adulthood. Compared with the aging effect, period and cohort effects on caries experience were small. Population DMFT scores decreased over time in all countries except Japan. Cohort effects on caries experience displayed a nonlinear pattern in all 4 countries, with slightly lower caries levels among the oldest and most recent generations. Conclusions. Despite marked recent declines in caries among children, caries levels increase with age and remain problematic in adults. [ABSTRACT FROM AUTHOR]

Aim: To explore the association between periodontal disease and quality of life in British adults, independently of demographic factors, socioeconomic position and other common oral conditions. Materials and Methods: This is a cross-sectional study of 3122 dentate adults who participated in the 1998 Adult Dental Health Survey in the United Kingdom. The short-form oral health impact profile (OHIP-14) was used to assess oral health-related quality of life. Periodontal disease was defined as having at least two proximal sites with loss of attachment ⩾4mm and one proximal site with pocket depth ⩾4 mm, not necessarily on the same tooth. The association between periodontal disease and the OHIP-14 score was assessed in unadjusted, partially adjusted and fully adjusted models. Results: Periodontal disease was associated with the OHIP-14 score (rate ratio: 1.26, 95% CI: 1.16-1.38), even after adjustment for demographic factors (sex, age and English region or country), socioeconomic position (educational attainment and household income) and clinical conditions (number of teeth, partial denture use, dental caries, traumatic dental injuries and tooth wear). Conclusion: Periodontal disease was associated with quality of life, independent of socio-demographic characteristics and other conditions present in the mouth. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the prevalence of condition-specific impacts on daily performances attributed to malocclusion in British adolescents. Two hundred 16- to 17-year-old adolescents were randomly selected from 957 children attending a public college in London, UK. During interviews, participants provided information about demographic variables and socio-dental impacts on quality of life attributed to malocclusions, using the Condition-Specific form of the Oral Impacts on Daily Performances (CS-OIDP) index. Adolescents were also clinically examined using the Index of Orthodontic Treatment Need. Statistical comparison by covariates was performed using chi-squared test and chi-squared test for trends. The prevalence of oral impacts on daily performances attributed to any oral condition was 26·5% whereas the prevalence of CS-OIDP attributed to malocclusion was 21·5%. There was no statistically significant difference by sex, age, ethnicity or orthodontic treatment status of schoolchildren in the prevalence of CS-OIDP attributed to malocclusion ( P ≥ 0·243 for all cases). However, there was a linear trend for the prevalence of CS-OIDP attributed to malocclusion, by level of normative orthodontic treatment need ( P = 0·042). The prevalence of such impacts increased from 16·8% for adolescents with no/slight need for orthodontic treatment, to 31·7% for those with definite need for orthodontic treatment. Although findings support the idea that malocclusion has physical, psychological and social effects on quality of life of these adolescents, the inconsistencies in findings between the self-reports of impacts of malocclusion and the assessment of normative needs highlight the shortcomings of using only clinical indexes to estimate orthodontic treatment needs. [ABSTRACT FROM AUTHOR]

Current methods to determine the energy efficiency of buildings generally require on-site visits of certified energy auditors which makes the process slow, costly, and geographically incomplete. To accelerate the identification of promising retrofit targets on a large scale, we propose to estimate building energy efficiency from widely available and remotely sensed data sources only, namely street view, aerial view, footprint, and satellite-borne land surface temperature (LST) data. After collecting data for almost 40,000 buildings in the United Kingdom, we combine these data sources by training multiple end-to-end deep learning models with the objective to classify buildings as energy efficient (EU rating A–D) or inefficient (EU rating E–G). After evaluating the trained models quantitatively as well as qualitatively, we extend our analysis by studying the predictive power of each data source in an ablation study. We find that the end-to-end deep learning model trained on all four data sources achieves a macro-averaged F1 score of 64.64% and outperforms models trained on building energy consumption data by 9.78%. As industry experts use building energy consumption data to approximate a building's energy efficiency prior to a potential on-site inspection, this work shows the potential and complementary nature of remotely sensed data in predicting energy efficiency and opens up new opportunities for future work to integrate additional data sources. • Fast, scalable, and non-intrusive method to estimate building energy efficiency. • End-to-end deep learning (DL) model fuses remotely sensed data sources. • K-Means clustering of street view embeddings speeds up data cleaning significantly. • Integrated gradients method enables qualitative analysis of end-to-end DL model. • Comprehensive ablation study underscores the complementary nature of data sources. [ABSTRACT FROM AUTHOR]

The article discusses a study on the use of data from the "Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) to analyze health conditions in Great Britain. It describes British health loss patterns and the top preventable risks behind some of the patterns. Ways in which British health outcomes compare with comparable countries in 1990 and 2010 are addressed. Great Britain's performance in terms of premature mortality is also cited.