Risk factors for incidence and severity of white spot lesions during treatment with fixed orthodontic appliances.

Aim
Periodontal diseases (PDs) may play an important role in the effect oral health status has on a person's quality of life (QoL). The objective was to investigate the influence of PDs (gingivitis and periodontitis) on oral health-related QoL (OHRQoL) by systematically reviewing the literature.

Materials and Methods
Studies using clinical periodontal examinations and validated survey instruments were included. Among 1134 citations initially identified through electronic and hand searching, 37 were eligible and data were extracted from full texts. A vote counting method was used for synthesis of the results.

Results
Included studies were published between 2001 and 2014 and revealed considerable heterogeneity in participant selection, clinical assessments, and OHRQoL measures. A significant association between PDs and OHRQoL was reported in 28 studies, of which eight reported increasing impact with greater disease severity or extent.

Conclusions
Within the limits of the available literature, OHRQoL was affected by clinically assessed PDs. There was evidence for increased impairment with greater severity and extent of PDs, and the recognition of the association was increased when full mouth recording protocols were applied.

Are periodontal diseases really silent? A systematic review of their effect on quality of life

The diagnosis of periodontal disease is commonly based on objective evaluations of the patient's medical/dental history as well as clinical and radiographic examinations. However, periodontal disease should also be evaluated subjectively through measures that quantify its impact on oral health-related quality of life. The aim of this study was to evaluate the impact of periodontal disease on quality of life among adolescents, adults and older adults. A systematic search of the literature was performed for scientific articles published up to July 2015 using electronic databases and a manual search. Two independent reviewers performed the selection of the studies, extracted the data and assessed the methodological quality. Thirty-four cross-sectional studies involving any age group, except children, and the use of questionnaires for the assessment of the impact of periodontal disease on quality of life were included. Twenty-five studies demonstrated that periodontal disease was associated with a negative impact on quality of life, with severe periodontitis exerting the most significant impact by compromising aspects related to function and esthetics. Unlike periodontitis, gingivitis was associated with pain as well as difficulties performing oral hygiene and wearing dentures. Gingivitis was also negatively correlated with comfort. The results indicate that periodontal disease may exert an impact on quality of life of individuals, with greater severity of the disease related to greater impact. Longitudinal studies with representative samples are needed to ensure validity of the findings.

Impact of periodontal disease on quality of life: a systematic review

– Objective:  Despite a marked improvement in oral health of Australian children over the last 30 years, severe early childhood caries (S-ECC) affects up to 17% of 2- to 3-year-old children with some requiring hospitalization and invasive treatment. This provided a compelling rationale to develop and test an oral health promotion programme which aimed to reduce this unnecessary suffering. The purpose of this study was to test the efficacy of an oral health promotion programme for the parents of infants, starting during the pregnancy, using a randomized controlled trial.

Methods:  A programme was developed around the provision of anticipatory guidance to nulliparous women (women expecting their first child) in Adelaide. Mothers in the test group received oral health promotion information during pregnancy, and later when the child reached 6 and 12 months of age. After the second round of information the test group mothers were randomized again. The information was reinforced in one of the test subgroups through a telephone consultation. There was no contact with mothers in the control group after enrolment. At the age of 20 ± 2.5 months all test and control group children were examined by a dentist. The case definition of an incidence of S-ECC was one or more upper incisor teeth being carious at the level of a cavitated or noncavitated lesion. The differences in S-ECC incidence between the test and control groups, and the test subgroups were analysed.

Results:  Of 649 women enroled in the programme (test group 327, control group 322), 441 had their child examined at follow-up. The incidence of S-ECC in the test group was 1.7% and in the control group 9.6% (P < 0.001).

Conclusion:  An oral health promotion programme based on repeated rounds of anticipatory guidance initiated during the mother’s pregnancy was successful in reducing the incidence of S-ECC in these very young children.

Efficacy of an oral health promotion intervention in the prevention of early childhood caries.

The objective this study was to investigate the influence of clinical conditions, socioeconomic status, home environment, subjective perceptions of parents and schoolchildren about general and oral health on schoolchildren's oral health-related quality of life (OHRQoL). A sample of 515 schoolchildren, aged 12 years was randomly selected by conglomerate analysis from public and private schools in the city of Juiz de Fora, Brazil. The schoolchildren were clinically examined for presence of caries lesions (DMFT and dmft index), dental trauma, enamel defects, periodontal status (presence/absence of bleeding), dental treatment and orthodontic treatment needs (DAI). The SiC index was calculated. The participants were asked to complete the Brazilian version of Child Perceptions Questionnaire (CPQ11-14) and a questionnaire about home environment. Questions were asked about the presence of general diseases and children's self-perception of their general and oral health status. In addition, a questionnaire was sent to their parents inquiring about their socioeconomic status (family income, parents' education level, home ownership) and perceptions about the general and oral health of their school-aged children. The chi-square test was used for comparisons between proportions. Poisson's regression was used for multivariate analysis with adjustment for variances. Univariate analysis revealed that school type, monthly family income, mother's education, family structure, number of siblings, use of cigarettes, alcohol and drugs in the family, parents' perception of oral health of schoolchildren, schoolchildren's self perception their general and oral health, orthodontic treatment needs were significantly associated with poor OHRQoL (p < 0.001). After adjusting for potential confounders, variables were included in a Multivariate Poisson regression. It was found that the variables children's self perception of their oral health status, monthly family income, gender, orthodontic treatment need, mother's education, number of siblings, and household overcrowding showed a strong negative effect on oral health-related quality of life. It was concluded that the clinical, socioeconomic and home environment factors evaluated exerted a negative impact on the oral health-related quality of life of schoolchildren, demonstrating the importance of health managers addressing all these factors when planning oral health promotion interventions for this population.

/pdf/the-influence-of-oral-health-conditions-socioeconomic-status-44qx03ey1w.pdf

The influence of oral health conditions, socioeconomic status and home environment factors on schoolchildren's self-perception of quality of life

A cross-sectional dental questionnaire census survey was conducted in classrooms of 17,280 students aged 13-18 years in Skaraborg County, Sweden. The overall response rate, based on school attendance on the test day, was 91% with no gender differences at the senior level, and 86% (boys 87%, girls 85%) at the upper secondary level. The aim was to examine gender differences in knowledge, attitude, behavior and perceived oral health. A retest study showed good agreement. Thirty-one percent of the girls and 21% of the boys flossed regularly. Eleven percent reported daily candy consumption, with no significant gender difference. Girls, however, more often than boys considered their own consumption to be too high. This gender difference in attitude was most pronounced among older daily consumers (odds ratio (OR) = 5.8 [3.7-9.2]). Oral health was regarded as important by a majority of the students (95%). Girls considered sound teeth to be more important than did boys, both among the younger (OR = 1.7 [1.4-2.1]) and the older (OR = 2.4 [1.9-3.1]) adolescents. It is concluded that most adolescents had a positive dental attitude and perceived their own oral health to be good. Poorer knowledge and behaviors concerning oral health were demonstrated. Gender differences existed in most issues. Girls scored more favorably on behavioral measures, showed more interest in oral health, and perceived their own oral health to be good to a higher degree than did boys.

Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents

In western Sweden, the aim was to study the associations between oral health variables and total and central adiposity, respectively, and to investigate the influence of socio-economic factors (SES), lifestyle, dental anxiety and co-morbidity. The subjects constituted a randomised sample from the 1992 data collection in the Prospective Population Study of Women in Gothenburg, Sweden (n = 999, 38- > =78 yrs). The study comprised a clinical and radiographic examination, together with a self-administered questionnaire. Obesity was defined as body mass index (BMI) > =30 kg/m2, waist-hip ratio (WHR) > =0.80, and waist circumference >0.88 m. Associations were estimated using logistic regression including adjustments for possible confounders. The mean BMI value was 25.96 kg/m2, the mean WHR 0.83, and the mean waist circumference 0.83 m. The number of teeth, the number of restored teeth, xerostomia, dental visiting habits and self-perceived health were associated with both total and central adiposity, independent of age and SES. For instance, there were statistically significant associations between a small number of teeth (<20) and obesity: BMI (OR 1.95; 95% CI 1.40-2.73), WHR (1.67; 1.28-2.19) and waist circumference (1.94; 1.47-2.55), respectively. The number of carious lesions and masticatory function showed no associations with obesity. The obesity measure was of significance, particularly with regard to behaviour, such as irregular dental visits, with a greater risk associated with BMI (1.83; 1.23-2.71) and waist circumference (1.96; 1.39-2.75), but not with WHR (1.29; 0.90-1.85). Associations were found between oral health and obesity. The choice of obesity measure in oral health studies should be carefully considered.

/pdf/oral-health-and-obesity-indicators-3xqtdvbjrd.pdf

Oral health and obesity indicators

Accounts of self-perceptions of oral health have hitherto been rare, although they are of great interest for strategies in health promotion. The objective of this study was to increase our knowledge of adolescents' perceptions of oral health and influencing factors. Semi-structured interviews of 17 Swedish adolescents were performed. Criteria for strategic sampling were age (15, 18 years), gender (male, female), and dental health (healthy, unhealthy). Data were analyzed according to the constant comparative method. Areas of focus were general oral health, personal oral health, dental care, and life-style issues. Oral health awareness was generally low among the informants. Two categories of oral health were identified: action (the physical things we do to effect the condition of our mouths) and condition (the physical status of the mouth). Conditional aspects were most frequent in evaluations of personal oral health. The informants considered their possibilities to influence oral health limited. Perceptions of influences on oral health were related to personal and professional care, social support and impact, and external factors. 'Concern for oral health' was derived as the core category in perceived influence on oral health. The study indicates that it is important to find factors that enhance adolescents' awareness of their own resources and to seek mechanisms that govern internalization. There is a need to find strategies to convey such knowledge to the intermediaries: dental personnel and parents.

Adolescents' perceptions of oral health and influencing factors: a qualitative study

Periodontal health status in Swedish adolescents : an epidemiological, cross-sectional study

Periodontal health status in Swedish adolescents: an epidemiological, cross-sectional study.

Objective To investigate the associations between dental attitudes and behaviours, and self-perceived oral health from a gender perspective in an adolescent population. Design A census survey. Self ...

Anna-Lena Östberg

Papers

Gender differences in knowledge, attitude, behavior and perceived oral health among adolescents

Oral health and obesity indicators

Adolescents' perceptions of oral health and influencing factors: a qualitative study

Periodontal health status in Swedish adolescents: an epidemiological, cross-sectional study.

A gender perspective of self-perceived oral health in adolescents : associations with attitudes and behaviours