[Show abstract][Hide abstract] ABSTRACT: IntroductionTo quantify average angular measurements that define the soft tissue profiles of 12-year-old southern Chinese and to determine gender differences.Materials and methodsA random population sample of 514 12-year-old children was recruited (about 10% of a Hong Kong Chinese birth cohort). Photographs were taken in natural head posture and 12 soft tissue landmarks were located on the photos to measure 12 angular measurements using ImageJ (V1.45s) for Windows. Approximately 10% of photographs were reanalyzed and method error was calculated. Angular norm values for the 12 parameters were determined and gender differences were assessed using 2 sample T-test with 95% confidence interval.ResultsThe response rate was 54.1% (278/514). Norm values for the 12 angular measurements were generated. The greatest variability was found for the nasolabial (Cm-Sn-Ls) and labiomental (Li-Sm-Pg) angles. Gender differences were found in 4 angular parameters: vertical nasal angle (N-Prn/TV)(p¿<¿0.05), cervicomental angle (G-Pg/C-Me)(p¿<¿0.001), facial convexity angle (G-Sn-Pg)(p¿<¿0.01) and total facial convexity angle (G-Prn-Pg)(p¿<¿0.01).Conclusion
Norm values for 12 angular measurements among 12-year-old southern Chinese children were provided and some variability noted. Gender differences were apparent in several angular measurements. This study has implications in developing norm values for southern Chinese and for comparison with other ethnic groups.
Head & Face Medicine 12/2014; 10(1):1. · 0.87 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To describe and compare the oral health behaviors of preschool children with and without cerebral palsy (CP), and to assess the oral health knowledge and attitudes of their primary caregivers (PCGs). Seventy‐two preschool children with CP were recruited from 23 Special Child Care Centers in Hong Kong. An age‐ (±3 months) and gender‐matched sample of children from mainstream preschools was recruited as a “control group.” Assessment of children's oral health behaviors and the PCGs' oral health knowledge and attitudes was conducted using questionnaires. Preschool children with CP were less likely to have ever attended a dentist (p p > 0.05), but PCGs of children with CP more frequently reported provision of tooth brushing assistance to their children (p p > 0.05). Difference in oral health behaviors existed between preschool children with and without CP. PCGs of children with and without CP had similar oral health knowledge and attitudes.
[Show abstract][Hide abstract] ABSTRACT: Current studies on the aetiology of developmental defects of enamel (DDE) are subject to recall bias because of the retrospective collection of information. Our objective was to investigate potential risk factors associated with the occurrence of DDE through a prospective cohort study.
PLoS ONE 10/2014; 9(10):e109351. · 3.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives: To investigate associations between dental-problems during early childhood and child health, primary-caregivers (PCG) health, and child/PCG relationships.
Methods: Data were derived from the Growing Up in Ireland study, involving a nationally representative sample of 9-month-old children (N=11,134) in 2007/2008, followed-up at age 3 (N=9,793). Data analysed, included reported dental-problems, information on child health, PCG health, and child/PCG relationships at both time points. Standardized measures were used to assess infant, child and PCG health employing the Strengths and Difficulties Questionnaire (SDQ), the Parental Stress Scale and the Child-Parent Relationship Scale (CPR-S Pianta). Reported dental-problems in early childhood were categorized as: (i) no problems; (ii) problems at 9-months only; (iii) problems at age 3 only; (iv) problems at both time points. Bivariate and regression analyses were carried out on statistically reweighted data to determine associations between reported dental-problems during early childhood [i-iv] and subsequent child health, PCG health, and child/PCG relationship at age 3, controlling for socio-demographics.
Results: During early childhood dental-problems were reported among 7.5% (736) of children (at least once); 2.7% (302) at 9-months and 5.0% (493) at age 3. Reported dental-problems were associated with Child health: SDQ Total difficulties scores (P<0.01); PCG health: Parental stress scores (P<0.01); and PCG/child relationships: Pianta CPR-S scores (P<0.01). Those reported to experience dental-problems at both time points generally fared the worst. Controlling for socio-demographic factors in regression analyses, reported dental-problems remained significantly associated with child health, PCG health, and child/PCG relationships.
Conclusions: Findings from the Growing up in Ireland study identified that reports of dental-problems were common in early childhood (affecting ~ 1 in 13 children). Significant associations between reported dental-problems in early childhood and child health (behavioural difficulties) and PCG health (parental stress) were evident. Furthermore, negative aspects of the child/PCG relationships were also associated with reported dental-problems in early childhood.
[Show abstract][Hide abstract] ABSTRACT: Objective: To investigate the relationship between reported dental problems in infancy (at age 9 months) and early childhood (at age 3 years) and infant, child, and primary caregivers’ health.
Method: Data were derived from the longitudinal infant cohort of the Growing Up in Ireland study, involving a nationally representative sample of 9-month olds (N=11,134) in 2007/2008, followed-up at age 3 years (N=9,793) in 2010/2011. Data analysed, included reported dental problems, information on child health and primary caregivers’ health (PCG) when children were 9-months and 3-years of age. Standardised, valid and reliable measures were used to assess for infant/child/PCG health including the Infant Characteristics Questionnaire (ICQ), Strengths and Difficulties Questionnaire (SDQ), Parental Stress Scale and the Parental Depression Scale. Bivariate and regression analyses were carried out on statistically reweighted data to determine associations between reported dental problems and infant/child health and PCG health, controlling for socio-demographics (gender of child, gender of PCG and receipt of social welfare benefits as a proxy for socio-economic status).
Result: PCG’s reported that 302 infants (2.7%) at 9-months of age and 493 children (5.0%) at 3-years of age experienced ‘dental problems’. Reported dental problems at 9-months of age were associated with infant health - ICQ fussy-difficult score (p<0.01) and PCG health - Parental Stress Score (p<0.05) and Parental Depression (p<0.01). Reported dental problems at age 3, were associated with child health - SDQ Total Difficulties Score (p<0.05) and PCG health - Parental Stress Score PCG (p<0.01). Controlling for socio-demographic factors in regression analyses reported dental problems remained significantly associated with infant health, child health and PCG health.
Conclusion: Dental problems were reported among more than 1 in 50 infants at 9-months old, and among 1 in 20 children at age 3. Reported dental problems were associated with infant, child and PCG health.
[Show abstract][Hide abstract] ABSTRACT: Purpose: To identify and review the psychometric properties of instruments available for measuring oral health literacy. Materials and Methods: A comprehensive computerised search was carried out using six databases. The final papers were rated for level of evidence and scientific quality. Results: A total of 621 potentially relevant articles were retrieved in the primary search. Twenty-nine studies using 13 oral health literacy instruments were included in the final analysis. After applying an international standards framework, all included studies were categorised as evidence level '2c'. Qualities of evidence were rated with STROBE guidelines. Psychometric analysis indicated various levels of validity and reliability across the instruments. Conclusions: As an emerging field, the number and reliability of oral health literacy instruments is rapidly growing, although many are in preliminary stages of testing. The majority of these focus on functional literacy and were developed in English for North American contexts. Further work is indicated to measure oral health literacy as a wider construct across diverse populations.
Oral health & preventive dentistry 09/2014; · 0.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives
The objective of this study was to review orofacial functional impairments among patients following stroke, including objective and subjective assessment.MethodsA structured search strategy was applied to three electronic databases (Pubmed, Embase, and Web of Science) to identify effective papers. Relevant data regarding subjects, method, outcomes, and key findings were extracted from the effective papers and the results were summarized.ResultsThe initial search yielded 5227 papers, and 18 effective papers (Kappa: 0.971) were in accordance with the inclusion criteria. The patients with stroke consistently showed a decreased lip force, salivary flow rate, and chewing performance compared to the healthy controls. Due to equivocal results gained from the effective papers, the qualitative assessments regarding whether there was any change in masticatory force on the affected side and oral health-related quality of life were inconclusive.Conclusions
Existing evidence highlights a number of compromised orofacial functions experienced by patients following stroke. These impairments appear to be sustained, with spontaneous recovery unlikely to occur. While rehabilitative approaches may have the potential to improve orofacial function and quality of life following stroke, there is currently a lack of evidence-based interventions available to inform the development of comprehensive rehabilitation protocols.This article is protected by copyright. All rights reserved.
[Show abstract][Hide abstract] ABSTRACT: Objective: We investigated the prevalence of erosive tooth wear (ETW), juice/drink consumption and associated factors in adults in the United States.
Methods: We used the National Health and Nutrition Examinations Survey data for 2003-2004. ETW is defined as erosive tooth wear on at least one surface of at least one examined tooth. Drink/juice consumption collected via a Food Frequency Questionnaire was processed with DietCalc software to obtain average daily consumption frequency for all queried drinks and juice categories including milk. Survey-weighted descriptive and multivariable analyses with interaction terms were performed.
Results: Our study sample consisted of 3773 adults (20 years and above) and 80% had evidence of erosive tooth wear. We found significant difference in the percent of ETW for age (lowest in 20-24 year old 63%), gender (lowest in female 76%) and race/ethnicity (lowest in African American 65%). Among those with and without ETW, consumption of soft drink was highest and that of tomato/vegetable juice was lowest. There was a significant difference in the consumption of fruit juice, milk and tomato/vegetable juices among those with and without ETW (p<0.005). After adjustment for demographic factors, drink/juice consumption was not predictive of ETW.
Conclusion: We found substantial levels of erosive tooth wear in adults that is affected by demographic factors in a complex way. Drink/juice consumption in adults were not associated with ETW after adjusting for demographics.
[Show abstract][Hide abstract] ABSTRACT: Objective: The objective of this study was to review clinical, microbiological, and immunological aspects of oral health, as well as oral health related behaviors among patients following stroke.
Method: A structured search strategy was applied to three electronic databases to identify effective papers. Outcomes regarding tooth condition, periodontal condition, oral hygiene status, and dental attendance were extracted. Comprehensive Mete Analysis 2.0 software was used to pool those outcomes which were suitable for meta-analysis. Narrative summaries of key findings were provided for those outcomes which were not amenable to be synthesized.
Result: The initial search yielded 19927 papers, 60 potentially effective studies (Kappa: 0.974) and 23 effective papers (Kappa: 0.965) in accordance with the inclusion criteria. The standardized differences in mean values of the parameters (fixed effect, random effect model) for patients with stroke compared to control groups were: number of remaining teeth (-0.325, -0.271), DMFT index (0.246, 0.246), plaque index (0.305, 0.356), gingival index (0.716, 0.653), periodontal health status- clinical attachment loss (0.437, 0.490) and probing depth (0.470, 0.579). In addition, a lower chance of dental attendance was observed among patients with stroke (odds ratio: 0.493, 0.480). Qualitative assessments were inconclusive.
Conclusion: There is an increasing interest in oral health of patients with stroke. Patients with stroke had a poorer clinical oral health status across a range of parameters (tooth loss, dental caries experience, and periodontal status). Coupled with this, their dental attendance was less frequent. Further studies employing standardized assessments of oral health/oral health behaviors are needed to confirm these oral health disparities.
[Show abstract][Hide abstract] ABSTRACT: Objective: To systematically review all clinical, population and psychometric data on the use of the Oral Health Impact Profile (OHIP) since its development 20 years ago in 1994.
Method: A systematic literature search was carried out using four databases (PubMed, Web of Science, Embase and Scopus) of publications from 1994 to 2014. Abstracts and articles that described the use of OHIP were considered by two independent readers using predefined exclusion criteria. Selected studies were grouped by category and reviewed.
Result: An initial search identified 3262 papers, 1348 ‘potentially effective publications’ were screnned (Kappa >0.80) and 656 publications fulfilled the inclusion criteria - ‘effective’ publications for the review (Kappa >0.80). OHIP has been translated into over 40 different languages and employed in over 60 different countries, but evidence of cross-cultural validation is scant. The validity and reliability of OHIP have been widely reported; and mostly, it performs well. Various short-form measures exist (at least eight), with OHIP-14 being the most common version employed (376 out of 656 studies); however, issues of content validity and responsiveness of OHIP-14 in certain contexts are evident. Increasingly, OHIP is being employed in prospective studies to assess outcomes from clinical interventions (176 of the 656 reports), but few studies have interpreted or measured ‘change’ that is meaningful for a clinical or population health prospective.
Conclusion: OHIP is widely used globally and has generally performed well in terms of psychometrics, albeit that there are cross-cultural concerns. The use of the short-form OHIP-14 is particularly popular, but it may not be the most appropriate measure to use in some particular contexts. Increasingly, OHIP is being used in prospective studies; however, the challenge remains to interpret what ‘change’ in OHIP scores actually means, and to determine its value and use in routine clinical practice as a patient-reported outcome measure (PROM). Happy Birthday OHIP!
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to review clinical, microbiological, and immunological aspects of oral health, as well as oral health related behaviors among patients following stroke.
Journal of Dentistry 06/2014; · 2.84 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Introduction
To date, evidence of the effectiveness of endodontic treatment and criteria of success have mainly been considered in terms of clinical outcome, and there is a lack of information of treatment outcomes from patients' perspectives. This study aimed to assess changes in quality of life after endodontic treatment and to determine if changes in quality of life were associated with changes in patient-perceived oral health and clinical assessments of success.
This longitudinal study involved 279 subjects. Patient-reported outcome measures based on oral health–related quality of life was assessed using the short form of the Oral Health Impact Profile (OHIP-14). The patients completed the assessments before endodontic treatment and 1 month and 6 months after root canal obturation. A global oral health transition assessment was ascertained by a single (global) item rating of oral health improvement and clinical assessment mainly based on the Periapical Index (PAI) of periapical radiographs.
There were significant changes in OHIP-14 scores over the study period after conventional orthograde endodontic treatment (from pretreatment–6 months postobturation) (P < .001). The magnitude of statistical change (effect size) was moderate (0.61) in the short-term (after 1 month) and large (0.71) in the longer-term (after 6 months). Changes in the OHIP-14 was associated with changes in patient self-rating oral health status (P < .001), which was also associated with changes in PAI scores (P < .05).
Endodontic treatment improves quality of life. The OHIP-14 measure is both sensitive and responsive to endodontic treatment and is likely to be useful in understanding patients' perspectives of outcomes from endodontic care.
Journal of Endodontics 06/2014; · 2.79 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Chronic orofacial pain (OFP) is common in general adult populations worldwide. High levels of psychological distress and impaired coping abilities are common among Western people with chronic OFP but limited information was found in southern Chinese people. This study aimed to explore the perceptions and experiences of community dwelling elderly people with chronic OFP symptoms and their treatment seeking behaviour in Hong Kong.
An exploratory qualitative interview study was conducted. Elderly people experiencing chronic OFP symptoms were invited to take part in an individual semi-structured interview. A total of 25 semi-structured interviews were performed for 25 participants.
Pertinent issues relating to the treatment seeking behaviour emerged from the interviews, many of which were inter-related and overlapping. They were organized into three major themes: (i) Impact of chronic OFP on daily life; (ii) Personal knowledge and feeling of chronic OFP; (iii) Management of chronic OFP. The participants were found to have the intention to seek professional treatment, but there were barriers which discouraged them continuing to seek professional treatment. They also received complementary treatment for chronic OFP, such as acupuncture, massage and "chi kung". Moreover, a wide range self-management techniques were also mentioned. On the other hand, those who did not seek professional treatment for the chronic OFP claimed that they had accepted or adapted to the pain as part of their lives.
This qualitative study observed that elderly people affected by chronic OFP symptoms in Hong Kong sought many different ways to manage their pain including traditional and complementary approaches. The role of the dentist in dealing with chronic OFP is unclear. Multiple barriers exist to accessing care for chronic OFP. The findings may be used to inform future chronic OFP management strategies in Hong Kong.
BMC Oral Health 01/2014; 14(1):8. · 1.15 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To assess the oral health-related quality of life (OHRQoL) of young adults in Hong Kong and its relationships with oral health status. A survey was conducted in a representative sample of Hong Kong adults aged 18 years. OHRQoL was measured by the short form Oral Health Impact Profile (OHIP-14, Chinese version). Clinical examinations were taken to assess the oral health status using DMFT index and Community Periodontal Index (CPI) according to WHO criteria. Information on socioeconomic status, self-perceived oral health status and treatment need was also collected. Totally 324 young adults (male: 177 and female: 147) were examined. The mean and median OHIP-14 score were 6.3 (SD = 5.8, range = 0–26) and 5, respectively. Half of the subjects (50.6 %) reported some negative impacts. Good internal consistency (Cronbach’s alpha = 0.87) and construct validity in relation to perceived oral health status, perceived dental treatment need and perceived oral health impact on daily life were established. Neither socio-demographic background nor oral health status showed a significant association with OHIP-14 score (p > 0.05). The findings indicated that the impact of oral health on quality of life appeared to be low in the young Hong Kong adults. Chinese version of OHIP-14 had good reliability and validity in measuring OHRQoL of young Chinese adults. Neither socio-demographic background nor oral health status had an influence on their OHRQoL in this low impact population.
Applied Research in Quality of Life 01/2014; · 0.74 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Internet social media offers a rich source for soliciting the public's views on health issues. This qualitative research, using You-Tube as a platform, aimed to explore the public's perspectives on management of dental fear and anxiety (DFA) in pediatric patients.
Using three keywords ("dental fear," "dental phobia," and "dental anxiety"), YouTube videos were searched. Twenty-seven videos related to DFA in children and adolescents were reviewed by three investigators, including a nondental layperson. Inductive thematic analysis was adopted for interpreting the data.
Several strategies were considered useful for controlling DFA in pediatric patients, including: verbal and nonverbal communication to establish closeness and effective guidance (explanation, permission-seeking, reassurance, and negotiation); desensitization to dental settings and procedures; tell-show-do; positive reinforcement; distraction by imagination and thoughtful designs of clinic; and parental presence and support. Some self-coping strategies adopted by patients alleviated their DFA, such as self-reasoning and trust-building through long-term connection. Dentists' clinical competence, favorable treatment outcomes, and state-of-the-art devices and technologies (dental lasers, intraoral camera, and adapted anaesthesia method) contributed to reducing DFA.
Authentic testimonials in YouTube videos endorsed and interpreted a variety of strategies adoptable by patients, parents, and dental professionals for managing children's and adolescents' dental fears and anxieties.
[Show abstract][Hide abstract] ABSTRACT: Objectives: To explore the influence of socio-demographic and clinical oral health factors on oral health-related quality of life (OHRQoL) in patients after stroke, and to monitor OHRQoL outcomes following the provision of an in-hospital oral health intervention programme.Design: OHRQoL was measured before and after randomization and provision of oral health promotion interventions in a prospective clinical trial.Subjects: Eighty-one patients admitted to a stroke rehabilitation ward.Methods: OHRQoL was assessed using the Oral Health Impact Profile-14 (OHIP-14) and Oral Health Transition Scale upon admission and 3 weeks later following provision of an oral health promotion programme. Potential factors were examined for their association with OHRQoL outcomes.Results: Lack of a regular daily brushing habit was significantly associated with 6 of 8 transition scale items (pp Conclusion: OHRQoL is compromised following stroke and may be influenced by the lack of a regular daily brushing habit during hospitalization. The early re-establishment of an oral hygiene protocol is a priority in stroke rehabilitation wards in order to improve clinical oral health and OHRQoL.
Historical Journal Of Film Radio and Television 01/2014; 46(6).
[Show abstract][Hide abstract] ABSTRACT: To describe the relationship between caregivers' oral health literacy (OHL) and the oral health status of their children in an Asian population.
A random sample of 301 child/caregiver dyads was recruited from kindergartens in Hong Kong. Two locally-developed and validated OHL assessment tasks were administered to caregivers with Hong Kong Rapid Estimate of Adult Literacy in Dentistry-30 (HKREALD-30) assessing word recognition and Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P) assessing comprehension. Their children's oral health status was assessed [dental caries experience - decayed, missing, filled teeth index - (dmft) and oral hygiene status - Visible Plaque Index (VPI)].
Caregivers' literacy was associated with children's oral health status. The HKOHLAT-P had a stronger association with children's oral health than HKREALD-30. HKOHLAT-P and HKREALD-30 remained associated with dmft in the adjusted negative binomial regression models (accounting for socio-demographics), Incidence Rate Ratio (IRR) 0.97, p=0.02, and 0.96, p=0.03, respectively. In the adjusted model, HKOHLAT-P was associated with VPI (IRR 0.90, p<0.05), but no association between HKREALD-30 and VPI was evident.
The main conclusion of this study was that caregiver oral health literacy was associated with their child's oral health status. A comprehension instrument had a more robust association with children's oral status than a word recognition instrument.
This study has implications for general public health education for designing community-level interventions.
Patient Education and Counseling 11/2013; · 2.60 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study aimed to explore the preferred treatment for pre-school children with caries of different severities in primary teeth among general dental practitioners (GDPs) and specialists in paediatric dentistry (PDs) in Hong Kong, and to determine the difference in practice patterns between the groups.
A random sample of 476 GDPs (approximately 25% of all registered dentists) and all registered PDs (n = 28) were invited to participate in the study. Both groups were asked to select their single most preferred treatment option on eight hypothetical clinical case scenarios in which the severity of dental caries in a single primary molar/incisor of a 4-year-old healthy and cooperative boy differed. The distribution frequency of responses was tabled. Difference in the care approach patterns of GDPs and PDs were examined in bivariate and regression analyses.
The overall response rate of the study was 61.5% (310/504). There were significant differences between the GDPs and PDs on their preferred treatment in six out of eight case scenarios (P < 0.05). PDs favoured comprehensive restorative treatment more than GDPs. Non-interventionist approach, atraumatic restorative technique or extraction were more popular among GDPs. Variation in treatment choices was apparent within both GDPs and PDs, in which spread of treatment options was wider among GDPs.
GDPs and PDs have different dental care approach patterns for pre-school children with dental caries. Wide variation in the views about the best way to treat the child exists within both groups.
International Dental Journal 10/2013; 63(5):273-280. · 1.20 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This paper describes the development of a new literacy assessment instrument, the Hong Kong Oral Health Literacy Assessment Task for Paediatric Dentistry (HKOHLAT-P). Its relationship to literacy theory is analyzed to establish content and face validity. Implications for construct validity are examined by analyzing cognitive demand to determine how "comprehension" is measured.
Key influences from literacy assessment were identified to analyze item development. Cognitive demand was analyzed using an established taxonomy.
The HKOHLAT-P focuses on the functional domain of health literacy assessment. Items had strong content and face validity reflecting established principles from modern literacy theory. Inclusion of new text types signified relevant developments in the area of new literacies. Analysis of cognitive demand indicated that this instrument assesses the "comprehension" domain, specifically the areas of factual and procedural knowledge, with some assessment of conceptual knowledge. Metacognitive knowledge was not assessed.
Comprehension tasks assessing patient health literacy predominantly examine functional health literacy at the lower levels of comprehension. Item development is influenced by the fields of situated and authentic literacy. Inclusion of content regarding multiliteracies is suggested for further research. Development of functional health literacy assessment instruments requires careful consideration of the clinical context in determining construct validity.
Journal of Public Health Dentistry 09/2013; · 1.21 Impact Factor