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This systematic review aimed to evaluate the effectiveness of psychological behavioral therapies to improve behaviors of autistic children during dental visits. Screening, data extraction, risk-of-bias assessment, and evaluation of certainty of evidence were performed by two independent reviewers. Eighteen studies were ultimately included. On average 56% (95% confidence interval, 33.95–78.29) and 64% (95% confidence interval 47.24–81.80) of autistic children can cooperate with dental examination with an oral mirror in the first and second visits, respectively. Visual pedagogy did not improve the proportion of autistic children who can accept dental examinations. Inconsistent results were also identified for Treatment and Education of Autistic and related Communication-handicapped CHildren, Picture Exchange Communication System, Applied Behavior Analysis, video modeling, distractions, and other conventional behavioral management techniques. Many studies were of small sample size, lacked a control group, did not account for autism spectrum disorder severity, comorbidities, previous dental experience or other confounders, and had a high risk of bias. The evidence supporting the use of psychoeducation techniques to improve the dental experience of autistic children is limited and of very low certainty. Further research with larger scale studies and appropriate control groups is needed to enhance the certainty of evidence in this field. This research review looked at how well different psychological behavioral therapies help improve the behavior of autistic children during dental visits. The researchers studied 18 different studies and found that, on average, about 56% of autistic children were able to cooperate with a dental exam using an oral mirror during their first visit. The number increased to about 64% during their second visit. However, using visual pedagogies or teaching aids did not seem to make a big difference in how many children could accept the dental exams. The results for other psychological behavioral techniques were also inconsistent, including Treatment and Education of Autistic and related Communication-handicapped CHildren, Picture Exchange Communication System, Applied Behavior Analysis, video modeling, and distractions. Many of the studies were small and did not include a comparison group. They also did not consider factors like how severe the autism was, other conditions the children had, or their previous dental experiences. Because of these limitations, the evidence supporting the use of psychological behavioral techniques to improve dental visits for autistic children is limited and uncertain. More research with larger studies and proper control groups is needed to better understand this topic. [ABSTRACT FROM AUTHOR]

Fluoride hesitancy is a growing public health challenge and interventions to address it may need to be tailored for minoritized subgroups to address oral health inequities. The goals of this qualitative study were to investigate the extent to which an existing conceptual model on topical fluoride hesitancy is applicable to Latino parents and whether applicability differed between Spanish-speaking Latino (SL) and English-speaking Latino (EL) parents. We conducted semi-structured one-on-one interviews with non-Latino English-speaking parents (N = 50), SL parents (n = 8), and EL parents (n = 8). We coded the transcripts deductively and compared our findings both qualitatively and quantitatively to an existing model on topical fluoride hesitancy comprising 21 categories classified into six domains. We compared frequencies across model domains and categories for Latino versus non-Latino parents as well as for SL versus EL parents. Latino parents were represented across all six domains and 21 categories of the conceptual model. Comparing Latino and non-Latino parents, representation was similar across Domains 1 to 3 (necessity, chemicals, and harm); Latino parents were more highly represented in Domains 4 to 6 (uncertainty, pressure, and choice) compared with non-Latino parents. A larger proportion of EL parents thought a healthy diet was more important than fluoride (Category 1d) and a larger proportion of SL parents felt they did not know enough about fluoride (Category 4a). An existing conceptual model on topical fluoride hesitancy was generally a good fit for SL and EL parents. However, differential representation across model categories suggests that fluoride-related communication and intervention approaches may need to be tailored to Latino parents based on language preference. [ABSTRACT FROM AUTHOR]

Aim: No comprehensive synthesis of dental anxiety (DA), dental utilization (DU), oral health-related quality of life (OHRQoL), and their relationships have been examined despite various systematic investigations being done on their prevalence and interventions individually. Therefore, this review aims to systematically review the status and relationship between DA, DU, and OHRQoL among adult groups. Materials and Methods: Data collection spanned 6 months, from 1 July to 31 December 2023, involving eight databases. Only cross-sectional (CS) studies with adult participants aged 15-64 years, conducted globally, published in English, and available as full-text articles by December 31, 2023, were included. Two reviewers screened the titles and abstracts and assessed the full-text articles. All studies were CS. The risk of bias was evaluated using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical CS studies. The quality of evidence for each measured factor was assessed using the Grading of Recommendations Assessment, Development, and Evaluation methodology. Results: The initial search yielded 3333 studies. The 22 final studies included 13 highquality studies with over 80% and nine fair studies with 50% and 79% scored. None of the studies scored below 50%. A negative link between DA and DU was identified in 15 of 16 studies with 35,846 participants aged 22.19-50.21 years. Six studies on DA, DU, and OHRQoL included 22,845 participants aged 15-55 years, mostly in their late and mid-fifties. Four of six verified Berggren and Meynert's (1984) vicious cycle theory's high association between DA, DU, and OHRQoL. Conclusions: A 22-study review reveals a strong association between DA, DU, and OHRQoL. Most moderate to high-quality studies emphasized a negative correlation between DA and DU, which affected OHRQoL.PROSPERO registration number CRD42023455219. [ABSTRACT FROM AUTHOR]

Muhammad Ashraf Nazir,1 Salman Alghamdi,2 Mohammed Sallout,2 Salman Bubshait,2 Amal Asiri3 1Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Muhammad Ashraf Nazir, Email manazir@iau.edu.saPurpose: The purpose of the study was to assess the sense of coherence and its relationship with oral health and other study variables among adult patients at university dental hospital.Patients and Methods: This cross-sectional study included adult patients visiting the Dental Hospital of the College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam. Sense of coherence was determined by Antonovsky’s Sense of Coherence scale (SOC-13), which consists of 13 items on a 7-point Likert. DMFT index, plaque index, gingival index, and simplified oral hygiene index were used to evaluate the oral health of study participants. Bivariate and multivariable analyses were performed, and 0.05 level of significance was used in the study.Results: The study included the data of 558 participants with a mean age of 32.19± 10.11 years. The mean score of SOC was 52.77± 13.11, which was significantly higher in high-income participants (P < 0.001), participants without a medical condition (P=0.021), non-smokers (P < 0.001), and those who visited the dentist in less than one year (P=0.028). Bivariate analysis showed statistically significant negative correlations between SOC and DMFT index (P=0.002), SOC and plaque index (P < 0.001), SOC and gingival index (P=0.002), and SOC and simplified oral hygiene index (P=0.001). Multivariable analysis also showed that SOC was significantly correlated with DMFT index (P=0.001), plaque index (P < 0.001), gingival index (P < 0.001), and oral hygiene index (P=0.004) after controlling for age, gender, education, and monthly income.Conclusion: This study found that high-income and healthy participants, non-smokers, and those who visited the dental office during the last one year demonstrated significantly higher SOC. In addition, there was a statistically significant correlation between SOC and oral health. These study findings highlight the importance of raising awareness about SOC to improve oral health outcomes in adult patients.Keywords: sense of coherence, oral health, dental visits, smoking

Objectives: To learn about the use patterns of dental hygienist services, by the 65+ age group in Israel and to identify the main barriers facing different population groups. Methods: Telephone interviews with a representative sample of 512 older adults aged 65 and over were conducted from February to April 2020. Results: About 50% of the older adults aged 65 and over visited a dentist (2.9 visits on average) and 35% visited a dental hygienist in the year preceding the interviews. 17% reported never visiting a dentist and 45% never received care from a dental hygienist. Dental care use rates are lower in the outlying areas of the country, among non‐Jews and among those who find it difficult to cover monthly household expenses. Those who regularly visit a dental hygienist maintain a preventive oral health routine, including tooth brushing and visits to the dentist for periodic preventive check‐ups. They are aware of the harmful effects of eating sweets in between meals. Most of the older adults aged 65 and over are unaware of the reform under which hygienist' care was included in the basket of services provided by health plans. Conclusions: There is underutilization of dental hygienist services and lack of awareness of proper oral health behaviour in the lower socioeconomic group. As less than 50% of older adults are aware of the legal rights for dental care, there is a need to raise awareness of the reform and the services provided under it. [ABSTRACT FROM AUTHOR]

The complexity and high dimensionality of healthcare data present substantial challenges in building machine learning (ML) models, given the large number of variables such as patient demographics and medical history. Effective feature selection is crucial to address issues such as increased computational resource, longer training times, overfitting, and reduced model interpretability, etc. This study evaluates a range of feature selection methods to identify the most impactful features for predicting dental expenditures using publicly available Medical Expenditure Panel Survey (MEPS) data. Sixteen ML models are assessed to determine the top performing model, after which state-of-the-art filter, wrapper, embedded, and hybrid feature selection techniques are applied to optimize the feature set. The highest performance, in terms of coefficient of determination ( $R^{2}$ ), is achieved using a hybrid feature selection method that combines the mutual information filter with the embedded features from the CatBoost regressor. The results indicate that the proposed system is suitable for real-time deployment even with reduced features, providing potential benefits such as minimizing the need for irrelevant and difficult-to-obtain features. Moreover, automated feature selection significantly enhances model performance, yielding a $R^{2}$ score of 0.86, compared to the score 0.73 achieved with carefully selected manual features. Additionally, to enhance the interpretability of the top-performing ML model, explanatory visualizations are employed to examine the influence of key features on predicting dental expenditures.

ABSTRACT: Introduction: Rates of dental visits of older adults in the United States, particularly in Tennessee, are rapidly increasing, coupled with the growing complexity of older adults’ dental treatment. Notably, increased dental visits help detect and treat dental disease and offer opportunities for preventive care. This longitudinal study aimed to examine the prevalence and determinants of dental care visits amongst Tennessee seniors. Methods: This observational study combined multiple cross-sectional studies. Five even years of Behavioral Risk Factor Surveillance system data were used, including 2010, 2012, 2014, 2016, and 2018. Our data were limited to Tennessee seniors (60 years or older). Weighting was conducted to account for the complex sampling design. Logistic regression analysis was performed to determine the factors associated with dental clinic visits. A P value < .05 was considered statistically significant. Results: The current study comprised 5362 Tennessee seniors. Older individuals visiting dental clinics within 1 year gradually decreased from 76.5% in 2010 to 71.2% in 2018. The majority of participants were female (51.7%), White (81.3%), and located in Middle Tennessee (43.5%). Logistic regression showed that those more likely to visit dentists or dental clinics included females (odds ratio [OR], 1.4; 95% confidence interval [CI], 1.1–1.8), never-smokers and former smokers (OR, 2.2; 95% CI, 1.5–3.4), individuals with some college education (OR, 1.6; 95% CI, 1.1–2.4), college graduates (OR, 2.7; 95% CI, 1.8–4.1), and those with high incomes (eg, >$50,000; OR, 5.7; 95% CI, 3.7–8.7). Conversely, Black participants (OR, 0.6; 95% CI, 0.4–0.8), participants with fair/poor health (OR, 0.7; 95% CI, 0.5–0.8), and those who have never married (OR, 0.5; 95% CI, 0.3–0.8) were less likely to report dental visits. Conclusions: Rates of Tennessee seniors visiting dental clinics within 1 year have gradually decreased from 76.5% in 2010 to 71.2% in 2018. Several factors were associated with seniors seeking dental treatment. Effective interventions to improve dental visits should take the identified factors into account.

Parents of children usually understand the importance of getting primary care pediatric well-child checkups during certain stages of childhood, yet few know the importance of early routine dental visits to proactively incorporate good oral hygiene and relate the connection of oral care to overall systemic physical health. The purpose was to determine the impact of integrating oral health screening, intervention, and referral into the pediatric well-child visit. Children (aged 0–18 years) received oral health screening, oral photographs, fluoride varnish, oral health education, and referral during well-child visits. Forty-two percent of our population had never had a dental examination. Fifty-eight percent had no established dental home, and 73% drank sugar-sweetened beverages weekly. The overall impact of this model was providing comprehensive oral health care to children who have never been to the dentist and providing a smooth transition between medical and dental, increasing access to care. [ABSTRACT FROM AUTHOR]

Introduction: Early school-aged children are in a transitional phase from primary to permanent dentition. Established dietary and oral hygiene habits will influence the condition of the oral cavity in the future. Aim: This study aimed to evaluate alterations in early school children's dietary and oral hygiene practices during the COVID-19 pandemic and to anticipate potential long-term health implications. Material and Methods: This cross-sectional online study involved guardians of Polish children aged 6–10 years, living in Western Poland, who were socially isolated at home during the COVID-19 pandemic. A total of 180 guardians were invited to participate in this study. The questionnaire included 17 questions divided into four different sections—the child's anthropometric data, dietary habits, oral health, and attitude to dental visits. Results: The survey was completed by 106 guardians. The mean (standard deviation) age of the children was 8.12 (0.93) years (range 6–10 years). Overall, 24.5% of the surveyed individuals reported buying healthy products (fresh vegetables, fruit) more frequently during the pandemic. Furthermore, 35.8% admitted to snacking between meals more frequently and 16.0% less frequently. Almost one-quarter of the parents acknowledged that their children were less motivated to maintain oral hygiene during the pandemic and 28.3% declared a lower frequency of visits to the dentist from the outbreak of the pandemic for two main reasons: a fear of coronavirus transmission and economic reasons. Conclusions: In the group studied, the results of the assessment indicate that the COVID-19 pandemic had some effects on oral health that may lead to an increased risk of oral disease development, such as tooth decay in children. None of the respondents noticed an increase in their child's motivation about good oral hygiene despite spending more time at home. The irregularity of follow-up visits for one-third of the respondents hindered preventive measures and the continuation of dental treatment. [ABSTRACT FROM AUTHOR]

Background: Oral health is a vital component of overall health and well-being and is an important indicator of healthy living and quality of life. According to the Global Burden of Disease Study 2019, approximately 3.5 billion people worldwide have oral diseases. Objective: This study assessed the level of oral hygiene in a rural community in North India. Materials and Methods: This community-based cross-sectional study included randomly chosen men and women from a rural area of the Ludhiana district of Punjab from August 2021 to February 2022 using the World Health Organization (WHO) Oral Health Questionnaire. Results: This study included 405 participants, comprising 205 (50.6%) men and 200 (49.4%) women, with a mean age of 44.5 + 16.7 years. It was found that only 17.3% of the participants had good status of their gums and teeth, without caries, compared with 17.8% who had poor or extremely poor status. In addition, 54.2% of the participants reported experiencing pain and discomfort in their gums and teeth due to poor oral hygiene. Conclusion: Only a small percentage of our rural cohort had good oral hygiene, indicating a need for increased awareness initiatives.

Background: The aim of this research was to investigate the factors associated with postponing dental attendance amongst Japanese workers during the coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted an internet-based survey in Japan from November 24 to 29, 2021. The participants were selected from people registered with an online research company. The inclusion criteria for this study were full-time or part-time workers aged 20 to 69 years. Participants filled out a questionnaire about their oral health, behaviour, and working conditions. Results: A total of 1840 participants were included in the analysis. Three hundred ninety-eight participants (21.5%) answered that they postponed dental attendance due to COVID-19. Multiple logistic regression showed that women were more likely to postpone dental attendance (odds ratio [OR], 1.74; 95% confidence interval, 1.33–2.26). Moreover, employment status, household income, changes in income, working at home, interdental cleaning device use, regular dental attendance, awareness of untreated teeth, and dental pain were also associated with postponing dental attendance. The results of decision tree analysis showed that regular dental attenders with dental pain were the most likely to postpone dental attendance. Conclusions: The characteristics of postponed dental visits for Japanese workers differ depending on whether one is a regular dental attender or not. Amongst regular dental attenders, worsening oral health due to interruptions in dental attendance is concerning. Meanwhile, untreated teeth might be neglected amongst nonregular dental attenders. Preventing patients from refraining from dental attendance, regardless of whether or not they are regular dental attenders, is important during the COVID-19 pandemic.

Background: Maintenance of oral health of children with special needs requires the involvement of caregivers who are also responsible for ensuring adherence to professional recommendations, including dental visits. Aim: This study aimed at exploring the correlates of dental visits of children with hearing loss (CWHL) in Indonesia using the theory of planned behaviour (TPB). Design: This cross‐sectional study involved purposive sampling methods, conducted via an online survey administered to mothers of CWHL who were aged 5–12 years. Constructs of the TPB model were collected, including the mother's attitudes, subjective norms, perceived behaviour control (PBC) and intention towards dental visits for CWHL. Dental visits were measured by asking whether their children had a dental visit within the last 12 months. Data were analysed using SPSS for descriptive and bivariate analyses. The significance level was set as p <.05. Partial least square structural equation modelling (PLS‐SEM) was used to analyse measurement and structural TPB models. Results: A total of 254 mothers participated in this study. The final TPB model explained 35.4% and 9.2% of the variance in mothers' intention and behaviour towards their children's dental visits, respectively. Of all the included constructs from the TPB model, only PBC was significantly associated with intention and behaviour (p <.05). The mother's attitude and subjective norms did not significantly predict intention (p >.05). Intention did not significantly predict the mother's behaviour towards children's dental visits (p >.05). Conclusion: The TPB model revealed a construct associated with dental visit intention and behaviour in CWHL. This study suggested that effective promotion intervention should focus on the mother's PBC to increase parents' adherence to preventive dental visits in CWHL in Indonesia. [ABSTRACT FROM AUTHOR]

Background: Oral health is a vital component of overall health and well-being and is an important indicator of healthy living and quality of life. According to the Global Burden of Disease Study 2019, approximately 3.5 billion people worldwide have oral diseases. Objective: This study assessed the level of oral hygiene in a rural community in North India. Materials and Methods: This community-based cross-sectional study included randomly chosen men and women from a rural area of the Ludhiana district of Punjab from August 2021 to February 2022 using the World Health Organization (WHO) Oral Health Questionnaire. Results: This study included 405 participants, comprising 205 (50.6%) men and 200 (49.4%) women, with a mean age of 44.5 + 16.7 years. It was found that only 17.3% of the participants had good status of their gums and teeth, without caries, compared with 17.8% who had poor or extremely poor status. In addition, 54.2% of the participants reported experiencing pain and discomfort in their gums and teeth due to poor oral hygiene. Conclusion: Only a small percentage of our rural cohort had good oral hygiene, indicating a need for increased awareness initiatives. [ABSTRACT FROM AUTHOR]

Health and social factors show large heterogeneity across regional cultural geographies and influence oral health as well. The purpose of this study is to confirm associations between county-level general health, behaviors, social factors, and oral health indicators and to further analyze the patterns of distribution of oral health indicators across dominant regional cultures in the United States (US) as defined by the American Nations model. We calculated a Lifestyle Health Index (LHI) from the 2023 PLACES database using county-level, age-adjusted health data and merged it with (a) 2020 Social Vulnerability Index (SVI) database, (b) dominant regional cultures from Nationhood Lab's American Nations model, (c) dentist visits and teeth lost data from the 2023 PLACES database, and (d) access to dentistry data from the County Health Rankings database. Correlation coefficients between the LHI (and sub scores), SVI (and sub scores), and dental variables showed strong associations. ANOVA post-hoc test results revealed significant differences for dental visits and teeth lost for LHI, SVI and access to dentists. Prevalence of dental visits and teeth lost showed clear heterogeneity across regional cultures. Oral health is strongly linked to lifestyle health factors, social vulnerability, access to dentistry, and cultural norms and belief systems. Within the US, significant heterogeneity exists in the distribution of oral health indicators across dominant regional cultural geographies. Oral health communications and policy solutions focused on health-related behaviors (e.g., tobacco, diet), disease-specific considerations (e.g., diabetes), and the social environment (e.g., poverty, housing) should be tailored to regional cultures rather than a single US-based culture to improve dental care and oral health outcomes. [ABSTRACT FROM AUTHOR]

Introduction: : Access to oral care during pregnancy is important for the maintenance of optimal oral health. Objective: : The aim of this study was to estimate dental anxiety (DA) and its association with previous dental visits and sociodemographic factors amongst pregnant women. Methods: : A cross-sectional study was conducted (June through August 2019) amongst pregnant women (N = 825) attending hospitals and health centres in Dhahran, Khobar, and Dammam cities in the Eastern province of Saudi Arabia. The Modified Dental Anxiety Scale (MDAS) was used to assess DA and the World Health Organization Oral Health Survey for Adults was administered to evaluate patterns of dental attendance. Results: : DA was found in 90.9% of the pregnant women. The mean DA score of the sample was 12.53 ± 5.33 (range, 5 to 25) and it was significantly higher amongst non-Saudi (13.21 ± 5.24) vs Saudi women (12.15 ± 5.34) (P = .006), those who had negative dental experience (13.99 ± 5.62) vs those without such experience (12.2 ± 5.21) (P < .001), and those with dental pain or discomfort (13.18 ± 5.46) vs without pain or discomfort (11.94 ± 5.14) (P = .001). The study found a significant relationship between DA and reasons for dental attendance before pregnancy (P = .002) and time since the last dental visit (P = .009). Multiple logistic regression analysis showed significantly increased odds (OR, 1.69; 95% CI, 1.25 to 2.27) of experiencing moderate to extreme DA amongst pregnant women who visited the dentist after a year/never visited compared to those who visited in less than a year. Similarly, participants with negative dental experience were significantly more likely to have moderate to extreme DA (OR, 1.49; 95% CI, 1.02 to 2.20) than those without negative experience after adjusting for sociodemographic factors. Conclusions: : DA was highly prevalent amongst pregnant women, which was significantly associated with negative dental experience, dental pain or discomfort, and reasons for and time since the last dental visit.

Abstract Background Dental visits can provide education, prevention and treatment measures for teenagers, and help to form correct oral health knowledge and attitude. The purpose of this study was to evaluate the effects of socio-demographic factors, dental status, oral health literacy, and health-related behaviors on dental visits in early 12-year-old adolescents. Methods 953 subjects aged 12 in Longhua district of Shenzhen were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Shenzhen adolescents' dental visits. Results A total of 27.6% of the participants had not been to a dentist. After the multiple factors binary logistic regression analysis, it confirmed that the following variables: Shenzhen Hukou (OR 2.133, 95% CI 1.429–3.185), moderate caries (OR 1.404, 95% CI 1.022–1.928) and severe caries (OR 2.546, 95% CI 1.461–4.437), Angle Class II malocclusion (OR 1.703, 95% CI 1.134–2.556), sometimes or never toothbrushing (OR 2.985, 95% CI 1.491–5.975), dental floss usage (OR 1.829, 95% CI 1.250–2.677), having had a toothache within the last 12 months (OR 1.469, 95% CI 1.086–1.986), high knowledge attitude level (OR 1.570, 95% CI 1.106–2.229), moderate knowledge attitude level (OR 1.534, 95% CI 1.073–2.193), were associated factors for dental visit experience. Conclusions The dental visits of 12-year-old children in Longhua district of Shenzhen is affected by multi-dimensional factors. It is suggested that oral health education should be strengthened, good oral hygiene habits should be cultivated, and the needs and utilization of oral health services for non-Shenzhen Hukou adolescents should be paid attention to, so as to effectively improve the overall oral health level of adolescents.

Objectives: The aims of this scoping review are to assess the literature investigating the association between cash transfer programs and oral health; and to identify the theoretical frameworks applied to guide this literature. Methods: A search strategy to identify studies published until December 2020 was applied to a range of databases. Observational and interventional studies that had cash transfer programs as exposure/intervention and oral health as outcome were considered. Dental health services utilization, as well as access to dental health services, were considered secondary outcomes. Cash transfer programs were considered programs based on conditional or unconditional cash transfer carried out as part of national social protection schemes, and interventional studies on the impact of cash transfer on oral health were also considered eligible. Data charting was performed in two steps and a narrative synthesis was conducted. Results: Of 6344 articles identified, four articles were included. These articles investigated three different conditional cash transfer programs, Universal Child Allowance (Argentina), Bolsa Família (Brazil) and Family Rewards (USA). Inconsistencies were identified in findings on the effect of conditional cash transfer programs on the prevalence of dental caries and these differences may be due to the comparison group selected for each study. Concerning dental visits, the results point in different directions, which makes these findings still inconclusive. No explicit theoretical framework was reported in the articles to guide the expected association. Conclusion: Although cash transfers play an important role in improving certain health outcomes, there is limited evidence to suggest an association between cash transfers and oral health. [ABSTRACT FROM AUTHOR]

Objectives: Dental check‐ups at the workplace provide the opportunity for early detection of dental diseases. Dental check‐ups during working hours could reduce the number of days of absence from work due to visits to dental clinics outside the workplace. Although health check‐ups are provided to workers in Japan, dental check‐ups is not mandatory. This study aimed to determine the association between the place of dental check‐ups and absenteeism due to visits to the dental clinic. Methods: This cross‐sectional study used data from an online self‐reported worker survey conducted for 2 weeks in March 2017. We applied linear regression analysis with robust variance to determine the association between the place of dental check‐ups and absenteeism due to dental clinic visits while adjusting for sociodemographic, health, and oral health covariates. Results: The average age of the 3930 participants was 43.3 ± 11.7 years, and 52.3% were male. The number of days of absenteeism due to dental clinic visits in the past year for those who received check‐ups only at the dental clinic and at the workplace were 0.57 ± 2.67 days and 0.21 ± 1.20 days, respectively. After adjusting for covariates, it was found that those who received dental check‐ups at the workplace had 0.35 (95% CI, 0.12–0.58) fewer days of absence than those who received dental check‐ups at the dental clinic. Conclusion: Workers who received dental check‐ups at the workplace were associated with fewer days of absence due to dental visits than those who received at the dental clinic. [ABSTRACT FROM AUTHOR]

Background: Dental caries is a chronic, infectious and preventable disease that is very common around the world. It has been observed that dental caries affect not only the majority of adults but also 60% to 90% of children. Permanent first molars (PFM) are the most commonly decayed teeth observed in children. Aim: The aim of this study is to evaluate the decayed, missing filled teeth (DMFT) scores of PFMs in the early post-eruptive stage, within the scope of the United Nations Agenda for 2030 Sustainable Development Goals, thereby raising awareness for the prevention and treatment of permanent tooth decay. Methods: This descriptive cross-sectional epidemiological study was conducted in Erzurum between the years 2015–2016 by collecting data from children aged 7–10 years (17,208). In addition to the decayed, filled and missing data of the students' 6-year-molars, their ages, genders, frequencies of both tooth brushing and dental office visits were evaluated. The relationship between the variables was analyzed with chi-square. Result: The present study analyzed the data of a total of 11,457 children, 5704 girls and 5753 boys with a mean age of 8.74 ± 1.18. There was a statistically significant difference between the PFMs 16, 26, 36 and 46 regarding the number of healthy, decayed, missing and restored teeth (p < 0.001). Conclusion: In this study, the prevalence of caries in the PFMs of children aged 7–10 years was 15.9% and the mean DMFT was 0.79 ± 1.39. This result showed that PFMs might develop carious lesions and even be lost within three years in the early post-eruptive stage. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of childhood dental attendance pattern on self-rated oral health in middle adulthood among the British population., Methods: Data from the 1970 British Cohort Study involving participants born in England, Scotland, and Wales were used. Self-rated oral health was assessed at age 46. Childhood dental attendance patterns, derived from follow-up surveys at ages 5, 10, and 16, were classified as 'always', 'sometimes', or 'never' regular. Logistic regression was performed to estimate the effect of childhood dental attendance on adult oral health. Subgroup analyses by education level and oral hygiene practices examined potential variations across these factors., Results: This study analyzed data from 4699 participants. An association was found between childhood dental attendance pattern and self-rated oral health in middle adulthood. The odds of reporting poor oral health were higher among those with 'sometimes' and 'never' regular dental attendance patterns than 'always' regular attenders. However, this association became insignificant after adjusting for covariates. Subgroup analyses revealed that 'sometimes' and 'never' regular attendance patterns were associated with higher odds of reporting poor oral health among participants who brushed less than twice daily and those with lower parental academic qualifications., Conclusion: This study suggests that childhood dental attendance is associated with perceived adult oral health, though this relationship diminished after adjusting for covariates. However, the association persisted among those who brushed less than twice daily and had lower parental academic qualifications. It underscores the importance of both demographic factors and health-related behaviors in determining long-term oral health outcomes., (© 2025 The Author(s). Journal of Public Health Dentistry published by Wiley Periodicals LLC on behalf of American Association of Public Health Dentistry.)

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic has been concomitant to a number of alterations in children's dental health. The indoor activities and intermittent eating during the COVID-19 pandemic lockdown had an impact on oral hygiene practices and behavioural change in children. Aim: To assess the impact of the COVID-19 pandemic lockdown on oral health and behaviour change among children in the eastern province of Saudi Arabia. Materials and Methods: This cross-sectional study was conducted in Department of Paediatric Dentistry, Dammam Specialised Dental Center, Dammam, Eastern Province, Saudi Arabia, from 6th October 2021 to 8th March 2022, among 510 children. A well-structured questionnaire consisting of 24 closed-end items related to socio-demographic data, children's behavioural change during lockdown and oral health practices in the eastern province of Saudi Arabia was tailored. All parents or legal guardians of children aged between 6 and 12 years old were asked to sign a written informed permission to complete a questionnaire voluntarily. Statistical analysis was executed by using Statistical Package for Social Sciences version 22.0 (IBM Product, USA). Results: Of 510 children to be evaluated for the impact of the COVID-19 pandemic lockdown, 284 (55.7%) mothers, 209 (41%) fathers, and 17 (3.3%) caregivers were the respondents. Although one-half of the children 273 (53.5%) had no change in oral health attention, 72 (14.1%) had increased, while 165 (32.5%) had decreased oral health attention during the COVID-19 pandemic lockdown. There were three significant predictors of children's oral health behaviour during the COVID-19 pandemic lockdown including frequency of tooth brushing increased (OR=18.7), decreased brushing (OR=28.3), consumption of sugary meals (OR=4.6), and noticing of caries, toothache, bad breath, bleeding/swelling of the gingiva (OR=3.1). Conclusion: Study findings demonstrated that the COVID-19 pandemic caused considerable behavioural and psychological alterations in children. The frequency of brushing, dental visits, and sugar consumption all decreased significantly. [ABSTRACT FROM AUTHOR]

Patient–provider cost conversations can minimize cost-related barriers to health, while improving treatment adherence and patient satisfaction. The authors sought to identify factors associated with the occurrence of cost conversations in dentistry. This was a cross-sectional study using data from an online, self-administered survey of US adults who had seen a dentist within the past 24 months at the time of the survey. Multivariable hierarchical logistic regression analysis was used to identify patient and provider characteristics associated with the occurrence of cost conversations. Of the 370 respondents, approximately two-thirds (68%) reported having a cost conversation with their dental provider during their last dental visit. Cost conversations were more likely for patients aged 25 through 34 years (odds ratio [OR], 2.84; 95% CI, 1.54 to 5.24), 35 through 44 years (OR, 3.35; 95% CI, 1.50 to 7.51), and 55 through 64 years (OR, 3.39; 95% CI, 1.38 to 8.28) than patients aged 18 through 24 years. Cost conversations were less likely to occur during visits with dental hygienists than during visits with general or family dentists (OR, 0.25; 95% CI, 0.11 to 0.58). In addition, respondents from the South (OR, 1.90; 95% CI, 1.04 to 3.48) and those screened for financial hardship were more likely to report having cost conversations with their dental providers (OR, 6.70; 95% CI, 2.69 to 16.71). Within the study sample, cost conversations were common and were facilitated via financial hardship screening. Modifying oral health care delivery processes to incorporate financial hardship screening may be an effective way to facilitate cost conversations and provision of patient-centered care. [ABSTRACT FROM AUTHOR]

Muhammad Nazir,1 Khalid S Almulhim,2 Ziyad AlDaamah,3 Salman Bubshait,3 Mohammed Sallout,3 Salman AlGhamdi,3 Jehan Alhumaid1 1Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Eastern Province, Saudi Arabia; 2Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Eastern Province, Saudi Arabia; 3College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, 31441, Eastern Province, Saudi ArabiaCorrespondence: Muhammad Nazir Tel +966-543569615Email manazir@iau.edu.saPurpose: Dental fear is associated with the avoidance of dental visits and negative oral health outcomes. It is important to assess distribution of dental fear and preference for emergency dental treatment among adult population during COVID-19. Therefore, the purpose of this study was to evaluate dental fear and emergency dental treatment among adults in COVID-19 quarantine centers in Greater Dammam, Saudi Arabia.Materials and Methods: Male and female adults (N=606) in quarantine centers for COVID-19 participated in this cross-sectional study (June–July 2020). Dental Fear Survey was used to collect data on dental fear. The participants also provided their responses about emergency dental treatment/dental attendance patterns in addition to demographic information.Results: The mean DFS score of the sample was 39.08 ± 19.47, and 23.1% of the participants were a little fearful and 22.6% were highly fearful. About 36.8% reported that they would prefer to visit a dental office in case of dental emergency mostly for dental pain and fractured tooth during the COVID-19 pandemic. Only 10.4% of the participants reported visiting a dentist in less than 3 months, 35.8% in less than 6 months, 52.5% between 6 and 12 months and more, and 1.3% never visited the dentist. DFS scores significantly differed among participants who visited the dentist in less than 3 months (31.86 ± 14.57), less than 6 months (37.70 ± 18.57), between 6 and 12 months and more (40.78 ± 20.23), and never visited the dentist (65.75 ± 14.74) (P < 0.001). The timing of last dental visit (P < 0.001), female gender (P 0.039), and dental pain (P < 0.001) were the significant predictors of dental fear.Conclusion: Dental fear was common among adults with a predilection for the female gender. Increased dental fear was significantly related to dental pain and reduced dental attendance. Only one-third of adults were willing to perform emergency dental visits.Keywords: dental anxiety, emergency treatment, dental visits, pandemic

Background: Regular dental visits are essential for the prevention, early detection and treatment of worldwide highly prevalent oral diseases. Personality traits were previously associated with treatment compliance, medication adherence and regular doctor visits, however, the link between personality traits and regular dental visit attendance remains largely unexplored. Thus, the objective of this study is to clarify this link. Methods: Data (wave 7) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, focusing on Germany (n = 2822). Personality was assessed using the 10-item Big Five Inventory (BFI-10). Regular dental visits were assessed. Multiple logistic regressions were used, adjusting for various covariates. Results: Majority of the participants (84%) reported to attend regular dental visits during lifetime. Regularity of lifetime dental visit attendance was positively and significantly associated with increased extraversion [OR 1.13, 95% CI (1.01–1.26)], increased conscientiousness [OR 1.26, 95% CI (1.10–1.44)], and increased openness to experience [OR 1.12, 95% CI (1.01–1.26)]. However, there was a lack of association with agreeableness and neuroticism. Moreover, the outcome measure was positively associated with younger age, being female, born in Germany, being married, higher education, being retired (compared to being homemaker), whereas it was not associated with obesity or chronic diseases. Conclusions: Identification of personality traits that are associated with regular dental visits can support prevention, screening and clinical management of oral diseases. Further research in this field may facilitate the development and increase the incorporation of individualized concepts to enhance patient compliance and attendance, and thus the provision of oral and dental care services. [ABSTRACT FROM AUTHOR]

Introduction We investigated changes in tobacco product use and receipt of cessation counseling among smokers within 50 US states and the District of Columbia between 2010/2011 and 2014/2015 among adults aged ≥18 years. Methods Data were from the Tobacco Use Supplement to the Current Population Survey, a household-based survey designed to yield representative estimates at the state and national levels (n=153725 for 2010/2011 and n=163920 for 2014/2015). Tobacco product use was estimated for all adults. We calculated receipt of cessation counseling among current cigarette smokers who visited a dentist (data available for 2010/2011 only) or a medical doctor (data available for both 2010/2011 and 2014/2015). Betweenyear changes were assessed with chi-squared tests. Results Between 2010/2011 and 2014/2015, declines occurred in 22 states for combustible tobacco smoking, and in 13 states for any tobacco use. Among current cigarette smokers who visited a medical doctor, 13 states had an increase in the receipt of advice or assistance to quit between 2010/2011 and 2014/2015. State-specific estimates of receipt of advice during 2014/2015 ranged from 58.7% (Arkansas) to 80.7% (Wisconsin). During 2010/2011, 31.2% of current cigarette smokers who visited a dentist were advised to quit smoking, and only 7.6% were assisted to quit. By state, the proportion receiving dentist advice to quit ranged from 21.4% (Montana) to 38.9% (Alaska). These estimates were lower than those from physicians in each state. Conclusions Wide variability in delivery of cessation counseling existed across states, and dentists were less likely to deliver cessation counseling than physicians.

Aim: This study determined the prevalence and risk factors associated with hepatitis B and C among the low-socioeconomic population. Materials & methods: A total of 1004 participants were screened for hepatitis B/C infection and risk factors from six different localities of Islamabad, Pakistan Results: The prevalence rate of hepatitis B and C was 1 and 4%, respectively. Chi-square test showed hepatitis B/C infection was related with marital status, hepatitis B vaccination, blood recipients and family income. Multivariable analysis showed hepatitis B vaccination, exposure to therapeutic injections, dental visits, exposure to HCV patients and age of participants were independently associated with hepatitis C infection. Conclusion: The risk of hepatitis B/C infection is multifactorial and the population needs to be vaccinated at a larger scale to avoid outbreaks. [ABSTRACT FROM AUTHOR]

Background: During the early days a child's development and oral health habits are predisposed and shaped by parents. For the betterment of the oral health of their children, parents should have a positive attitude toward oral health. To evaluate parent's knowledge, attitudes, and practices toward oral health of their children a study was conducted. Materials and Methods: Parents of 340 children who visited the Department of Dentistry, Shaheed Hasan Khan Mewati Government Medical College Nuh, Haryana, were included in this cross-sectional study. A self-validated questionnaire containing two parts was delivered on a face-to-face interview basis. The first part involved demographic data of parents and the second part had 15 multiple-choice questions related to knowledge, attitude, and practices toward dental health of their children. Results: The results revealed the majority of the parents (50%) were not aware of the importance of primary dentition. The first dental visit was planned after the history of pain or swelling in the child's mouth by most of the respondents. Regular and supervised brushing was ignored by 79.9% of the caretakers. Conclusion: In the present study, it was concluded that there is a little level of awareness regarding knowledge, attitude, and practices among parents toward the oral health of children. It is thus suggested to educate the parents on the significance of oral health and periodic dental check-ups. [ABSTRACT FROM AUTHOR]

Background: Dental visits can provide education, prevention and treatment measures for teenagers, and help to form correct oral health knowledge and attitude. The purpose of this study was to evaluate the effects of socio-demographic factors, dental status, oral health literacy, and health-related behaviors on dental visits in early 12-year-old adolescents. Methods: 953 subjects aged 12 in Longhua district of Shenzhen were investigated. The questionnaire and clinical examination were applied in schools, and two-level logistic regression models were constructed to interpret the effect of individual and contextual factors on Shenzhen adolescents' dental visits. Results: A total of 27.6% of the participants had not been to a dentist. After the multiple factors binary logistic regression analysis, it confirmed that the following variables: Shenzhen Hukou (OR 2.133, 95% CI 1.429–3.185), moderate caries (OR 1.404, 95% CI 1.022–1.928) and severe caries (OR 2.546, 95% CI 1.461–4.437), Angle Class II malocclusion (OR 1.703, 95% CI 1.134–2.556), sometimes or never toothbrushing (OR 2.985, 95% CI 1.491–5.975), dental floss usage (OR 1.829, 95% CI 1.250–2.677), having had a toothache within the last 12 months (OR 1.469, 95% CI 1.086–1.986), high knowledge attitude level (OR 1.570, 95% CI 1.106–2.229), moderate knowledge attitude level (OR 1.534, 95% CI 1.073–2.193), were associated factors for dental visit experience. Conclusions: The dental visits of 12-year-old children in Longhua district of Shenzhen is affected by multi-dimensional factors. It is suggested that oral health education should be strengthened, good oral hygiene habits should be cultivated, and the needs and utilization of oral health services for non-Shenzhen Hukou adolescents should be paid attention to, so as to effectively improve the overall oral health level of adolescents. [ABSTRACT FROM AUTHOR]

Introduction Utilization of dental services is recognized as important for the prevention and management of dental diseases. Community-based studies on dental service utilization patterns are sparse in African countries like Nigeria. This study describes factors influencing dental service utilization patterns among adult residents in Lagos, Nigeria. Methods Based on a cross-sectional design and utilizing a multi-stage sampling approach, 400 rural and urban participants participated in this study. Data collection was via interviewer administered questionnaires. Factors assessed included predisposing, enabling and need factors. Data management and analysis were carried out using SPSS version 23. The outcome of interest was dental service utilization. Pearson’s chi-squared and logistic regression analyses ascertained associations. Results The mean (±SD) age of the participants was 35.51 (±11.16) years. We observed that 60.8% (95% CI: 55.8–65.6%) of the respondents had never utilized dental health services, 28.5% (95% CI: 24.1–33.2%) had their last dental visit >12 months preceding the study, while 10.8% (95% CI: 7.9–14.2) had a last dental visit ≤12 months preceding the study. Respondents aged ≥56 years and clerical workers/skilled artisans as well as unskilled artisans/manual laborer’s had lower odds of utilization. For enabling factors, urban dwelling was associated with significantly lower odds of non-utilization of dental services (OR=0.06; 95% CI: 0.04–0.10); while for need factors, having had an extraction done (OR=1.48; 95% CI: 1.23–2.07) and having a dental complaint in the previous year (OR=16.56; 95% CI: 10.03–27.34) were significantly associated with higher odds of non-utilization. Conclusions Our study highlights the disparities in oral health access for the aged, rural residents, the financially deprived, unskilled workers, with a low education level, and those that had oral health complaints. Institution of policies should focus on increasing access to preventive oral health care in rural areas, increasing public oral health funding, and the inclusion of primary oral health components in the existing primary healthcare system.

Aim: This study aimed to explore whether income inequality exists in dental visits among children when children/parents were informed they had caries., Methods: This study used data from a prior longitudinal study carried out in Liaoning Province, China, involving 772 children under the age of five from local kindergartens. Children were clinically assessed for dental caries at baseline, data on dental visits were collected a year later. Logistic regression model was used to analyze the association between dental caries and household income at baseline and dental visits at follow-up, a year later., Results: In the logistic regression analysis accounting for age and sex, the results showed that household income and dental caries had significant association with dental visits among Chinese children. Lower household income was negatively associated with dental visits, with those at the lowest income level having lower odds ratio (OR) of 0.27 (95% confidence interval (CI): 0.16, 0.47), and the second lowest income level, with OR of 0.39 (95% CI: 0.22, 0.71) compared to highest-income group. There was a statistically significant association between dental caries at baseline and dental visits in the following year (OR: 1.08, 95% CI: 1.02, 1.15)., Conclusion: There were income inequalities in dental visits among children in China, even when they were diagnosed with dental caries. Socioeconomic inequality appears to be a major barrier to dental visits among Chinese children with dental needs., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Ethics Committee of King’s College London (KCL) issued approval HR-15/16-2901. Shenyang Dental Hospital also gave oral consent (Ministry of Health of People’s Republic of China). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, He et al.)

BACKGROUND. The effect of COVID-19 on various facets such as physical, psychological, financial, social, and so on has been investigated extensively. However, the wariness influencing the decision to visit the dentist during this pandemic has received relatively little attention in Indian scenario. The study sought to investigate the general public's anxiety regarding visiting a dentist during the COVID-19 pandemic, including the factors that possibly contribute towards this apprehension among Indian nationals. METHODS. Structured questionnaire based cross sectional observational study. Completed responses were received from 259 individuals. Information was collected on demographic details, medical history, history of COVID-19 infection, history of dental problems, anxiety associated with dental visit and reason for dental visit during the pandemic, whether vaccinated and expecting the dentist to be vaccinated. Apprehension or concerns regarding dental visits were acquired via nine closed-ended questions with dichotomous responses. RESULTS. During the pandemic, 25.9% had dental problems, 24.7% visited the dentist and 81% were anxious about dental visits. 72.6% were concerned about contracting infection from the clinic, 81.5% were concerned about contracting infection in the waiting area, and 87.3% were concerned about whether the clinicians/assistants would meticulously follow standard operating protocols, 88% were concerned about disinfection between patients and 75.7% expressed concern on higher treatment charges due to the pandemic. CONCLUSIONS. The general public is concerned about disease transmission in the dentist's office and increased treatment costs, both of which could have a negative impact on the use of dental services during this COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Dental caries is a chronic, infectious and preventable disease that is very common around the world. It has been observed that dental caries affect not only the majority of adults but also 60% to 90% of children. Permanent first molars (PFM) are the most commonly decayed teeth observed in children. Aim: The aim of this study is to evaluate the decayed, missing filled teeth (DMFT) scores of PFMs in the early post-eruptive stage, within the scope of the United Nations Agenda for 2030 Sustainable Development Goals, thereby raising awareness for the prevention and treatment of permanent tooth decay. Methods: This descriptive cross-sectional epidemiological study was conducted in Erzurum between the years 2015–2016 by collecting data from children aged 7–10 years (17,208). In addition to the decayed, filled and missing data of the students’ 6-year-molars, their ages, genders, frequencies of both tooth brushing and dental office visits were evaluated. The relationship between the variables was analyzed with chi-square. Result: The present study analyzed the data of a total of 11,457 children, 5704 girls and 5753 boys with a mean age of 8.74 ± 1.18. There was a statistically significant difference between the PFMs 16, 26, 36 and 46 regarding the number of healthy, decayed, missing and restored teeth (p < 0.001). Conclusion: In this study, the prevalence of caries in the PFMs of children aged 7–10 years was 15.9% and the mean DMFT was 0.79 ± 1.39. This result showed that PFMs might develop carious lesions and even be lost within three years in the early post-eruptive stage.

This study analyzed the trend in self‐reported dentate status over 30 years (1987–2017) among Danish adults, the self‐reported frequencies of preventive dental visits undertaken annually during the period 1987–2013, and the self‐reported use of the 2016 recall scheme for preventive dental check‐ups. The impact of social determinants (education, employment, civil status, and ethnic background) on these dental outcome variables in 2017 was explored. Questionnaire data were obtained from the Danish Health and Morbidity Surveys conducted from 1987–2017, and they were analyzed by tri‐variate frequency distributions and multivariate analyses. The prevalence of complete tooth loss was 17.7% in 1987 but 3.4% in 2017. The frequency of adults having 20 or more teeth grew markedly from 1987 (65.9%) to 2017 (85.1%). Educational inequality in dentate status persisted over the period. The frequency of preventive dental visits at least annually increased from 1987 to 2013, although visits were less frequent for young people. In 2017, preventive dental check‐ups were reported in intervals: less than 12 months (56.4%), 12–18 months (18.9%), 19–24 months (4.8%), and more than 24 months (5.2%). In 2017, dentate status and preventive dental check‐ups varied profoundly by social determinants. In conclusion, social policies should be implemented to tackle the persistent inequities in dentate status and public health policies should target Universal Health Coverage. [ABSTRACT FROM AUTHOR]

Abstract Background Universal coverage for dental care is a topical policy debate across Canada, but the impact of dental insurance on improving oral health-related outcomes remains empirically unexplored in this population. Methods We used data on individuals 12 years of age and older from the Canadian Community Health Survey 2013–2014 to estimate the marginal effects (ME) of having dental insurance in Ontario, Canada’s most populated province (n = 42,553 representing 11,682,112 Ontarians). ME were derived from multi-variable logistic regression models for dental visiting behaviour and oral health status outcomes. We also investigated the ME of insurance across income, education and age subgroups. Results Having dental insurance increased the proportion of participants who visited the dentist in the past year (56.6 to 79.4%, ME: 22.8, 95% confidence interval (CI): 20.9–24.7) and who reported very good or excellent oral health (48.3 to 57.9%, ME: 9.6, 95%CI: 7.6–11.5). Compared to the highest income group, having dental insurance had a greater ME for the lowest income groups for dental visiting behaviour: dental visit in the past 12 months (ME highest: 17.9; 95% CI: 15.9–19.8 vs. ME lowest: 27.2; 95% CI: 25.0–29.3) and visiting a dentist only for emergencies (ME highest: -11.5; 95% CI: − 13.2 to − 9.9 vs. ME lowest: -27.2; 95% CI: − 29.5 to − 24.8). Conclusions Findings suggest that dental insurance is associated with improved dental visiting behaviours and oral health status outcomes. Policymakers could consider universal dental coverage as a means to support financially vulnerable populations and to reduce oral health disparities between the rich and the poor.

Abstract Background The first aim was to present descriptive data on the frequency of dental visits among older adults in Germany. The second aim was to identify the determinants of the number of dental visits using a longitudinal approach. Methods Longitudinal data were derived from the German Ageing Survey, which is a nationally representative sample of community-dwelling individuals ≥40 years in Germany. The frequency of dental visits in the past 12 months was recorded in the years 2002, 2008 and 2011. In order to control for time-constant unobserved heterogeneity, Poisson fixed effects regressions were used. Results While the mean number of dental visits was 2.3 (SD: 2.0) in 2002, it was 2.0 (SD: 1.7) in 2008 and 2.1 (SD: 1.7) in 2011. The frequency of dental visits declined with age (total sample and women), transitions from normal weight to overweight (total sample), changes from divorced/widowed/single/married, living separated from spouse to ‘married, living together with spouse’ in women and with a decrease in the number of physical illnesses (total sample and men). Conclusions The frequency of dental visits declines with age in older adults. While some of the determinants of frequency are non-modifiable (e.g., ageing and worsening of general health), others are modifiable (e.g., change in weight category).

Background: Oral health care of older adults is of rising importance due to ongoing demographic changes. There is a lack of studies examining the determinants of dental treatment avoidance in this age group. Therefore, the objective of this study was to identify those determinants. Methods: Cross-sectional data were drawn from the second wave (year 2002) of the German Ageing Survey which is a population-based sample of community-dwelling individuals ≥ 40 years in Germany (n = 3398). Dental treatment avoidance was quantified using the question "Did you need dental treatments in the past twelve months, but did not go to the dentist?" [no; yes, once; yes, several times]. Socioeconomic and health-related determinants were adjusted for in the analysis. Multiple logistic regressions were performed. Results: In terms of need, 6.7% of individuals avoided dental treatment in the preceding twelve months. Multiple logistic regressions revealed that dental treatment avoidance was associated with younger age (total sample [OR 0.978; 95% CI 0.958–0.998] and men [OR 0.970; 95% CI 0.942–0.999]), unemployment (total sample [OR 1.544; 95% CI 1.035–2.302] and men [OR 2.004; 95% CI 1.085–3.702]), lower social strata (women [OR 0.814; 95% CI 0.678–0.977]), increased depressive symptoms (men [OR 1.031; 95% CI 1.001–1.062]), and increased physical illnesses (total sample [OR 1.091; 95% CI 1.006–1.183] and men [OR 1.165; 95% CI 1.048–1.295]). The outcome measure was not associated with income poverty, marital status and physical functioning. Conclusions: The present study highlights the association between dental treatment avoidance and different socioeconomic and health-related factors. These results suggest that it is necessary to promote the importance of dental visits. [ABSTRACT FROM AUTHOR]

INTRODUCTION We investigated changes in tobacco product use and receipt of cessation counseling among smokers within 50 US states and the District of Columbia between 2010/2011 and 2014/2015 among adults aged =18 years. METHODS Data were from the Tobacco Use Supplement to the Current Population Survey, a household-based survey designed to yield representative estimates at the state and national levels (n=153725 for 2010/2011 and n=163920 for 2014/2015). Tobacco product use was estimated for all adults. We calculated receipt of cessation counseling among current cigarette smokers who visited a dentist (data available for 2010/2011 only) or a medical doctor (data available for both 2010/2011 and 2014/2015). Betweenyear changes were assessed with chi-squared tests. RESULTS Between 2010/2011 and 2014/2015, declines occurred in 22 states for combustible tobacco smoking, and in 13 states for any tobacco use. Among current cigarette smokers who visited a medical doctor, 13 states had an increase in the receipt of advice or assistance to quit between 2010/2011 and 2014/2015. State-specific estimates of receipt of advice during 2014/2015 ranged from 58.7% (Arkansas) to 80.7% (Wisconsin). During 2010/2011, 31.2% of current cigarette smokers who visited a dentist were advised to quit smoking, and only 7.6% were assisted to quit. By state, the proportion receiving dentist advice to quit ranged from 21.4% (Montana) to 38.9% (Alaska). These estimates were lower than those from physicians in each state. CONCLUSIONS Wide variability in delivery of cessation counseling existed across states, and dentists were less likely to deliver cessation counseling than physicians. [ABSTRACT FROM AUTHOR]

Abstract Background Regular/frequent dental visits, at least annually, can aid in reducing the public health burden of head and neck cancers (HNCs) by facilitating earlier detection of the disease. The aim of this study was to conduct a quantitative assessment of any independent association between past dental visits/check-ups and incidence of cancers of HN/upper aerodigestive tract (UADT) and oral cavity worldwide. Methods PubMed, CINAHL, and Cochrane databases were searched for all observational studies published until August 2017 in any language that assessed an association of past dental visits/dental check-ups among the incident cases of HNC/UADT cancers. Screening and quality assessment of the articles was performed by two independent reviewers. Three different meta-analyses were conducted: two based on the incident cancer reported in the studies (HNCs/cancers of UADT and oral cavity); another included all studies irrespective of the type of cancer reported with the frequency of past dental visits as subgroups. Results Searches retrieved 3164 titles: after removing duplicates, 1377 remained. Of these, 62 were reviewed in full, but only 38 were eligible for inclusion. Under the random effects model, odds of past never/irregular/not frequent dental visits were greater in HNC cases and oral cancer cases as compared to the hospital-based/population-based controls [HNCs-unadjusted odds ratio (OR) 2.24; 95% confidence interval (CI) 1.89 to 2.65) and (oral cancers—OR 1.93; 95% CI 1.47 to 2.52]. Similar results were observed for all cancers with frequency of past dental visits as subgroup analysis (OR 2.01; 95% CI 1.76 to 2.30). Meta-regression findings indicate that none of the subgroup influenced the effect estimates for incidence of cancers. There was no publication bias in our study. Conclusion This systematic review and meta-analysis indicates that individuals with never/irregular/not frequent dental visits are more likely to be incident cases of HNCs/UADT cancers.

Background: Children with seizure disorders are faced with different oral conditions from lack of personal care, side effects of medications, and injuries from poor neuromuscular controls. Aims: This study aims to assess the oral health characteristics of children diagnosed with seizure disorders. Settings and Design: A cross-sectional survey was carried out among children aged 0–16 years who attended the outpatient neurology clinic of the Department of Paediatrics, Lagos University Teaching Hospital and an age- and gender-matched control group. Materials and Methods: Data were collected through interviewer-administered questionnaires to their parents/caregivers and oral examinations of the children. Statistical Analysis Used: Data entry was done using Statistical Package for Social Sciences version 20, and statistical analysis was performed using Chi-square test, and the level of significance was set at P < 0.05. Results: Two groups of 101 children each with seizure disorders and without seizure disorders aged between10 months and 16 years participated in the study. Majority of the participants with seizures –92 (91.1%) had never visited the dentist. The Decayed, Missing, Filled Teeth for participants with seizure disorders and control were 0.56 + 1.89 and 0.15 + 0.50, respectively. With regard to gingival hyperplasia, anterior open bite, proclined teeth, and fractures of teeth, patients with seizures showed significantly worse conditions compared with the control group. Conclusions: Result from this study showed that children who have seizures had poorer oral health and dental visit behavior than those without seizures. There is therefore a need for oral health care to be incorporated into recommended health care of these groups of patients to improve their quality of life.

Background: There is a lack of studies investigating the impact of postponed dental visits due to financial constraints on quality of life. Aims: The aim of this study was to identify whether these factors are associated longitudinally. Methods: Data were derived from waves 5 and 6 of the "Survey of Health Ageing and Retirement in Europe" (SHARE). The analysis focused on Germany (n = 7506). The widely used CASP-12 was used to quantify the quality of life. Postponed dental visits for financial reasons in the preceding 12 months (no, yes) were used as the main explanatory variable. Socioeconomic and health-related covariates were included in regression analysis. Results: Gender stratified regression analysis showed that quality of life decreased with the presence of postponed dental visits due to financial reasons in men. Furthermore, quality of life decreased with the worsening of self-rated health in both men and women. The outcome measure was not associated with age, marital status, income, and chronic diseases in both sexes. Discussion: Study findings suggest that postponing dental visits due to financial constraints contributes to a decreased quality of life among older men. Conclusion: Efforts to avoid these circumstances might help to maintain the quality of life in older men. [ABSTRACT FROM AUTHOR]

Objective: This study examined the associations between edentulism, dental care service utilization, and cognitive functioning trajectories among older adults. Method: Longitudinal data from the Health and Retirement Study (2006-2014) were employed to examine individuals aged 51 and older who were identified as having normal cognition at baseline (N = 12,405). Cognitive functioning was measured with a modified version of the Telephone Interview for Cognition Status. Edentulism was self-reported as total tooth loss at baseline. Dental care service utilization was measured by self-report of having visited a dentist at least once during the previous 2 years. Results: The results indicated that edentulism and dental care service utilization were independently associated with cognitive decline during the observation period. Findings also showed that dental care service utilization moderated the association between edentulism and cognitive decline. Discussion: The findings suggested that providing access to dental services may promote cognitive health and potentially reduce health care expenditures. [ABSTRACT FROM AUTHOR]

Background: This study examines last dental visit (visiting within the last 12 months, having a last visit 5 or more years ago, attending a private dental practice) and usual visit (usually visiting for a check-up, having a dentist they usually attend).Methods: Explanatory variables include age, gender, region, income, area-based SES and dental insurance. The data were collected in the Interview in NSAOH 2017-18.Results: There was a dental visiting gradient by region, with lower percentages visiting in the last 12 months in remote (44.9%) and regional areas (50.8%) than major cities (58.7%). A higher percentage of the higher-income tertile made visits (63.8%) than the middle (53.7%) and lower tertiles (49.9%). There was a visiting gradient by area-based SES, with higher percentages in the higher (63.8%) and middle SES tertiles (55.2%) than the lower tertile (50.2%). Uninsured persons had lower percentages visiting (43.3%) than insured (69.7%).Conclusions: Persons in remote locations, those with low socioeconomic status and those uninsured were disadvantaged in terms of access. They had lower percentages visiting in the last 12 months, usually visiting for a check-up, having a dentist they usually attend and higher percentages visiting 5 or more years ago. [ABSTRACT FROM AUTHOR]

Background: This paper examines oral hygiene behaviours (tooth brushing, mouthwash use and dental floss) by a range of explanatory variables.Methods: Explanatory variables included age, sex, region, income, area-based SES, dental insurance and visiting pattern. The data reported were collected in the interview survey in NSAOH 2017-18.Results: A higher percentage of females brushed with toothpaste at least daily (98.0%) and used floss in the last week (62.6%) than males (94.6% and 48.5% respectively). There was an income gradient in tooth brushing. Higher percentages brushed in the high income (96.8%) than middle (96.2%) and low-income tertiles (93.6%). A higher percentage of the high-income tertile (58.2%) flossed than the lower tertile (53.3%). Those with unfavourable visit patterns had lower percentages who brushed daily (92.7%) than the intermediate (96.7%) or favourable (98.2%) groups. There was a gradient in flossing by visiting, with a lower percentage flossing for the unfavourable visiting group (38.5%) than for the intermediate (52.8%) or favourable groups (67.6%).Conclusions: Oral hygiene behaviours were associated with gender, socioeconomic status and dental visiting. A higher percentage of women brushed and flossed than men. Lower socioeconomic status and those with unfavourable visiting patterns had lower frequencies of brushing and flossing. [ABSTRACT FROM AUTHOR]

Introduction: The objectives of this study were to describe trends of children being given dental checkup advice by primary care providers (PCPs) and having dental visits and to assess factors associated with being given dental checkup advice and having a dental visit.Methods: Data were from the annual, cross-sectional Medical Expenditure Panel Survey (MEPS) from 2001 to 2016. The sample included 126,773 children ages 2-17 years. We used predictive margins to estimate the probability of being given dental checkup advice and having a dental visit. We examined time trends of the proportion of children being given dental checkup advice from PCPs, as well as trends in the proportion of children having a dental visit from 2001 to 2016. Multiple logistic regression was used to assess the association between being given dental checkup advice and having a dental visit.Results: Overall, the proportion of children being given dental checkup advice increased from 31.4% in 2001 to 51.8% in 2016 (Trend P < 0.001). No significant increasing trend was found for having a dental visit among those being given dental checkup advice (Trend P > 0.05). Children being given dental checkup advice were more likely to have a dental visit (AOR = 1.54, P < 0.001).Conclusions: Although there was an increase in the proportion of children being given advice to have dental checkups by PCPs from 2001 to 2016, there was no significant increase in having a dental visit among children being given the advice. More research is needed to better understand how dental care advice from a PCP can effectively motivate and facilitate dental care for children. [ABSTRACT FROM AUTHOR]

Purpose: The Index of Dental Anxiety and Fear (IDAF-4C+) constitutes a theory-grounded, reliable and valid instrument, which, due to its modular structure, allows different uses such as assessing dental anxiety levels, establishing preliminary dental phobia diagnoses and identifying feared stimuli. This study aimed to develop a Spanish version of the original IDAF-4C+ and evaluate its psychometric properties. Materials and Methods: A sample of 231 Spanish undergraduate students (70.6% female; mean age 21.4 years) completed a questionnaire comprising the Spanish version of the IDAF-4C+ and other measures related to dental anxiety. The structure, reliability and validity of the adapted IDAF-4C+ were analysed. Results: The adapted IDAF-4C fear module yielded a single-factor structure and demonstrated good internal consistency (Cronbach's alpha) and test-retest reliability. It shared a greater amount of variance with phobia diagnoses than the Modified Dental Anxiety Scale (MDAS) and a single-item measure of dental fear (SIDF). Moreover, the IDAF-4C was moderately to highly correlated with the MDAS and the SIDF measure, as well as with variables connected with dental anxiety such as negative dental thoughts, having had a negative dental experience and negative affect. The frequency of dental visits was also linked to IDAF-4C scores, and IDAF-stimulus items involving cognitive vulnerability, interpersonal and cost concerns were associated with dental attendance. Conclusion: The Spanish version of IDAF-4C+ presents similar psychometric properties to the original version which, considering the advantages of this instrument, qualifies the adapted one for its use in different research and applied contexts. [ABSTRACT FROM AUTHOR]

Purpose: The present study investigated the effects of dental anxiety and dental visits on oral hygiene practices, which included brushing, lossing and amount of time brushing. Materials and Methods: The study included a dental questionnaire developed to measure aspects of dental visits, oral hygiene and dental anxiety. A demographic questionnaire included questions pertaining to age, ethnicity and citizenship. Participants included 77 undergraduate students attending a diverse southern United States university enrolled in psychology courses. Results: Linear regression was conducted to explore the association between dental anxiety and oral hygiene practices. Results revealed the model explained a significant proportion of variance in oral hygiene practices, R2 = 0.141, F(1,76) = 12.441, P < 0.001. Specifically, higher dental anxiety was associated with poorer oral hygiene practices. A correlation was conducted to investigate the association between dental visits and oral hygiene practices. Results revealed a correlation between dental visits and brushing r(75) = 0.342, P = 0.002, and lossing frequency r(75) = 0.294, P = 0.009. There was no association between visits to the dentist and time spent brushing teeth. Conclusion: Results indicate that dental anxiety is associated with oral hygiene practices. Additionally, those who visit the dentist more often have somewhat better oral hygiene practices. The present study indicates that there may be a learned association between dental anxiety and oral hygiene practices. Methods of education can be developed to disassociate anxieties that may inhibit optimum oral hygiene practices. It may also be beneficial for dental professionals to emphasise the value of the amount of time patients spend brushing their teeth. [ABSTRACT FROM AUTHOR]

Background: Health education advocates regular dental visits to improve oral health. There is a need to verify the outcomes associated with various dental visits patterns. Objective: To assess the relationship of reported and clinically assessed oral health outcomes in Saudi children with their dental visits' pattern. Methods: This cross-sectional study included 6–12-year-old schoolchildren from six cities in the Eastern Province of Saudi Arabia in 2015. Parents responded to a questionnaire about dental visit patterns. Through a clinical examination, the presence of caries, sealants and need for referral was assessed. Univariate and multivariate regression was used to assess the association between dental visit patterns and pain in the past 6 months, presence of untreated caries and need for referral after controlling for confounders. Results: Of the 3000 questionnaires distributed, 2306 (76.9%) parents responded. Significantly higher odds of pain were associated with visiting when in dental pain (odds ratio = 6.81) and never visiting a dentist (odds ratio = 3.44), whereas significantly lower odds were associated with regular checkups (odds ratio = 0.28). No significant association was observed with visits after recall by dentists. Conclusion: Regular checkups initiated by parents are associated with better reported oral health outcomes in terms of pain, while recall by dentists has no impact on oral health.