Clinical, social and psychosocial factors associated with self-rated oral health in Brazilian adolescents.
ABSTRACT The objective of this study is to investigate the main social, psychosocial and clinical factors associated with poor self-rated oral health in adolescents.
A cross-sectional survey was carried out in two cities of the Distrito Federal, Brazil. Data were collected by clinical examinations and by self-administered questionnaires from 1302 adolescents aged 14- 15 years in 39 schools. Data analysis was carried out using a Poisson regression model taking into account the cluster sample.
Adjusting for social, psychosocial and clinical factors, results showed that poor self-rated oral health was significantly associated (P < 0.001) with sex (males) [prevalence ratio (PR) = 0.8, 95% confidence interval (95% CI): 0.7-0.9]; low social class (PR =1.4, 95% CI: 1.2-1.6); poor self-rated general health (PR = 2.6, 95% CI: 2.3-3.1); mouth appearance (PR = 1.9, 95% CI: 1.6-2.2) and with presence of untreated dental decay (PR = 1.4, 95% CI: 1.3-1.6).
The single question on self-rated oral health appears to be a simple and easy way to collect dental health information in adolescents. Assessment and understanding of self-rated oral health should take into account social, psychosocial and oral factors.
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ABSTRACT: Although the use of removable dentures can improve oral function and esthetics for elderly people, compared to those who do not wear removable dentures, those wearing removable dentures could have worse oral health related-quality of life (OHRQoL). Additional information is required to assess which factors related to denture wearing influence the OHRQoL of elderly individuals. The purpose of this study is to evaluate the association between denture wearing and OHRQoL in a sample of elderly individuals in Taiwan. The study population included 277 elderly people wearing removable dentures (mean age = 76.0 years). Using face-to-face interviews, we collected data on the participants' socio-demographic characteristics, dental care service usage (regular dental checkups, treatment during toothache, dental visits in the last year), and factors related to denture wearing (perceived oral pain, perceived loose denture, perceived oral ulcer, perceived halitosis, perceived dry mouth, and perceived total denture satisfaction scores). OHRQoL was measured using the Taiwanese version of the Geriatric Oral Health Assessment Index (GOHAI-T). The location and number of remaining natural teeth and the type of denture were also recorded. Hierarchical multiple regression analysis was performed using GOHAI-T scores as the dependent variable. All the predictors together accounted for 50% of the variance in GOHAI-T scores. Further, education level, number of natural teeth, denture status, perceived loose denture, perceived oral ulcer, and perceived total denture satisfaction scores had statistically significant influences on OHRQoL. When compared with other variables, factors related to denture wearing, especially perceived total denture satisfaction scores, had the greatest impact on GOHAI-T scores. Of the factors analyzed in this study, denture satisfaction was the strongest predictor of OHRQoL. This suggests that denture satisfaction is useful for assessing the effect of denture treatment on the OHRQoL of elderly individuals wearing removable dentures.BMC Oral Health 01/2015; 15(1):1. DOI:10.1186/1472-6831-15-1 · 1.15 Impact Factor
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ABSTRACT: Investigate the individual and contextual variables related to caries in underprivileged adolescents, and the disparity in distribution of the disease. Cross-sectional analytical study, conducted in the city of Piracicaba, SP, Brazil, in 2012. The probabilistic sample was composed of 1,179 adolescents from 15-19 years of age, randomly selected from 21 state schools and 34 Primary Health Units - Family Health (PHU-FH). The dependent variables studied were number of decayed teeth and caries experience (DMFT). The independent variables were classified into individual (clinical, sociodemographic, psychosocial, self-perception, impact on oral health, access to services, and quality of life) and contextual (social exclusion index, total number of residents in suburb, literacy rate, and the following variables given in percentages: residences in the home ownership category, provision of domestic sewerage, trash collection, families with income of over 1 minimum wage per month, and families without monthly income) variables. The multilevel regression model was estimated by the PROC GLIMMIX (Generalized Linear Models-Mixed) procedure, considering the individual variables as Level 1 and the contextual variables of the suburbs as Level 2. Adjustment of the model was evaluated by -2 Res Log Likelihood with alpha = 0.05. As regards the individual variables, adolescents who declared having a prison inmate in the Family and resided in homes with a larger number of persons, showed a higher number of decayed teeth. There were a larger number of decayed teeth, a higher DMFT value, and worse self-perception as regards the health of their teeth and mouth. Other variables, such as being of the female gender, age and time since last visit to the dentist were related to the DMFT index. As regards the contextual variables, the DMFT was lower in suburbs with greater access to domestic sewage, and the number of decayed teeth was higher in suburbs with the worst social exclusion indices. Individual and contextual variables were associated with the presence of caries and DMFT index in underprivileged adolescents, indicating that they must be taken into consideration in the formulation of policies directed towards oral health promotion and prevention activities in this group.BMC Oral Health 01/2015; 15(1):6. DOI:10.1186/1472-6831-15-6 · 1.15 Impact Factor
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ABSTRACT: Objective The aim of this study was to investigate the association between intermediary social determinants, namely social support and social network with dental caries in adolescents.Methods An adapted version of the WHO social determinants of health conceptual framework was used to organize structural and intermediary social determinants of dental caries into six blocks including perceived social support and number of social networks. A cross-sectional study was conducted with a representative sample of 542 students between 12 and 14 years of age in public schools located in the city of Dourados, Brazil in 2012. The outcome variables were caries experience (DMFT ≥ 1) and current dental caries (component D of DMFT ≥ 1) recorded by a calibrated dentist. Individual interviews were performed to collect data on perceived social support and numbers of social networks from family and friends and covariates. Multivariate Poisson regressions using hierarchical models were conducted.ResultsThe prevalence of adolescents with caries experience and current dental caries was 55.2% and 32.1%, respectively. Adolescents with low numbers of social networks and low levels of social support from family (PR 1.47; 95% CI = 1.01–2.14) were more likely to have DMFT ≥ 1. Current dental caries was associated with low numbers of social networks and low levels of social support from family (PR 2.26; 95% CI = 1.15–4.44).Conclusion Social support and social network were influential psychosocial factors to dental caries in adolescents. This finding requires confirmation in other countries but potentially has implications for programmes to promote oral health.Community Dentistry And Oral Epidemiology 11/2014; DOI:10.1111/cdoe.12139 · 1.80 Impact Factor