https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(12)61680-8.pdf

Common values in assessing health outcomes from disease and injury: disability weights measurement study for the Global Burden of Disease Study 2010.

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Applied Longitudinal Data Analysis Modeling Change And Event Occurrence

Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia

Summary
Background : The impact of irritable bowel syndrome, a gastrointestinal motility disorder, is underestimated and poorly quantified, as clinicians may see only a minority of sufferers.

Aim : To determine the prevalence, symptom patterns and impact of irritable bowel syndrome in the US.

Methods : This two-phase community survey used quota sampling and random-digit telephone dialling (screening interview) to identify individuals with medically diagnosed irritable bowel syndrome or individuals not formally diagnosed, but fulfilling irritable bowel syndrome diagnostic criteria (Manning, Rome I or II). Information on irritable bowel syndrome symptoms, general health status, lifestyle and impact of symptoms on individuals’ lives was collected using in-depth follow-up interviews. Data were also collected for healthy controls identified in the screening interviews.

Results : The total prevalence of irritable bowel syndrome in 5009 screening interviews was 14.1% (medically diagnosed: 3.3%; undiagnosed, but meeting irritable bowel syndrome criteria: 10.8%). Abdominal pain/discomfort was the most common symptom prompting consultation. Most sufferers (74% medically diagnosed; 63% undiagnosed) reported alternating constipation and diarrhoea. Previously diagnosed gastrointestinal disorders occurred more often in sufferers than non-sufferers. Irritable bowel syndrome sufferers had more days off work (6.4 vs. 3.0) and days in bed, and reduced activities to a greater extent than non-sufferers.

Conclusions : Most (76.6%) irritable bowel syndrome sufferers in the US are undiagnosed. Irritable bowel syndrome has a substantial impact on sufferers’ well-being and health, with considerable socioeconomic consequences.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1365-2036.2005.02463.x

Irritable bowel syndrome in the United States: prevalence, symptom patterns and impact.

Mail and telephone surveys: The total design method.

The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of "high" and 6 of "medium" quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.

Oral Conditions and Health-Related Quality of Life: A Systematic Review.

Background
While the majority of dental care in Australia is provided in the private sector those patients who attend for public care remain a public health focus due to their socioeconomic disadvantage. The aims of this study were to compare dental service profiles provided to patients at private and public clinics, controlling for age, sex, reason for visit and income.

/pdf/dental-service-patterns-among-private-and-public-adult-1l5vp9aek0.pdf

Dental service patterns among private and public adult patients in Australia

Middle-aged and older adults are retaining teeth and avoiding dentures, which should impact quality of life. The aims of our study were to investigate tooth loss and chewing ability and their association with oral- and general-health-related quality of life and life satisfaction. A random sample of 45- to 54-year-olds from Adelaide, South Australia, was surveyed by self-complete questionnaire in 2004–2005 (n = 879, response rate = 43.8%). Health-related quality of life was measured with the Oral Health Impact Profile 14-item version and EuroQol Visual Analogue Scale instruments and life satisfaction by the Satisfaction with Life Scale. Functional tooth units were recorded at oral examinations performed by calibrated dentists on 709 persons (completion rate = 80.7%). Number of functional teeth was positively associated with chewing ability (β = 0.31, P < 0.01). In multivariate analyses, controlling for number of functional teeth and other explanatory variables spanning dental visit pattern, dental behaviour, socio-demographics and socio-economic status, chewing ability was negatively associated with oral-health-related impacts (β = −0.37, P < 0.01) and positively associated with general health (β = 0.10, P < 0.05) and well-being (β = 0.16, P < 0.01). Chewing ability was related to oral-health-related quality of life and general health, possibly reflecting the impact of chewing on food choice and enjoyment of meals and diet, and also indicated the importance of oral health to general well-being.

Tooth loss, chewing ability and quality of life.

Background:Previousstudieshaveshownvariationinlong-termdentalvisitingbut little is known about the oral health outcomes of such variation. Objective: The objective of this study is to determine the association of different dental visiting trajectories with dental clinical and oral health-related quality of life (OHRQoL) indicators. Methods: This study utilized data from the Dunedin Multidisciplinary Health and Development Study, a continuing longitudinal study of 1,037 babies born in Dunedin (New Zealand) betweenApril 1,1972 and March 31,1973.Data presented here were collected at ages 15,18,26,and 32 years.Three categories of dental attendance were identified in earlier research, namely: regulars (n = 285, 30.9 percent of the cohort), decliners (441, 55.9 percent), and opportunistic users (107, 13.1 percent). Results: There was a statistically significant association between opportunistic dentalvisitingbehavioranddecayedmissingandfilledsurfacesscore(Beta = 3.9)as well as missing teeth because of caries (Beta = 0.7). Nonregular dental visiting trajectories were associated with higher Oral Health Impact Profile (OHIP-14) scores (Beta = 2.1) and lower self-rated oral health scores (prevalence ratio = 0.8). Conclusion: Long-term, postchildhood dental attendance patterns are associated with oral health in adulthood, whether defined by clinical dental indicators or OHRQoL. Improving dental visiting behavior among low socioeconomic status groups would have the greatest effect on improving oral health and reducing oral health impacts.

Impact of dental visiting trajectory patterns on clinical oral health and oral health-related quality of life.

– Objectives:  Service provision varies by dentist, practice and patient factors. However, limited subsets of these potential influences on service rates have been explored. More comprehensive models could improve our understanding of the factors influencing the pattern of care delivered. The aim of this study was to examine variation in dental services by dentist (treatment choice, practice beliefs, preferences for patients, demographics), practice (type, location, size and volume of practice) and patient (visit, demographic, oral health and socio-economic) characteristics.

Methods:  A random sample of Australian dentists was surveyed in 1997–98 (response rate = 60.3%). Private general practitioners (n = 345) provided dentist and practice data, and service provision and patient variables were collected from a log of a typical clinical day (n = 4,115 patients). Multivariate negative binomial regression models were fitted for diagnostic, preventive, restorative, extraction and prosthodontic services.

Results:  Significant dentist factors included (P < 0.05; RR = rate ratio): lower diagnostic rates (RR = 0.78) for dentists with stronger practice beliefs for giving information about cost and treatment options; preventive rates were lower (RR = 0.74) for male dentists and higher (RR = 1.48) for younger dentists aged 20–29 years; restorative rates were higher (RR = 1.27) for dentists that rated patient preferences more highly in treatment choice and in the dentist age group 30–39 years (RR = 1.25); extraction rates were lower (RR = 0.61) for dentists with stronger preferences for patients that would adhere with treatment but higher (RR = 1.57) for dentists with stronger preferences for sociable patients; and prosthodontic rates were lower (RR = 0.38) for dentists with stronger preferences for adaptable patients who were willing to cooperate when expected to do so. Practice factors included: higher preventive (RR = 1.28) and prosthodontic rates (RR = 2.07) in solo practice; higher preventive (RR = 1.34) but lower prosthodontic rates (RR = 0.42) in capital cities; lower diagnostic (RR = 0.82) and extraction rates (RR = 0.55) in practices with fewer other dentists; higher diagnostic (RR = 1.33) and extraction (RR = 1.62) rates but lower restorative rates (RR = 0.84) in practices with lower patient visits per year. Patient factors included: lower preventive (RR = 0.76) but higher extraction rates (RR = 1.45) for emergency visits; lower extraction rates (RR = 0.60) for the insured; higher diagnostic rates (RR = 1.17) for new patients; higher restorative (RR = 1.31) but lower prosthodontic rates (RR = 0.46) for patients with decayed teeth; higher prosthodontic rates (RR = 2.14) for those with dentures; and lower preventive (RR = 0.66), but higher extraction (RR = 2.22) and prosthodontic rates (RR = 1.82) for patients from lower socio-economic status areas.

Conclusions:  Dental service rates were influenced by large number of small effects from a wide range of dentist, practice and patient factors. Socio-economic and geographic barriers may need broad policy innovations to be addressed, but factors such as insurance and visit type have the potential to be altered to achieve better service outcomes and there is scope for research into clinical outcomes to improve the knowledge upon which treatment decisions are based.

David S. Brennan

Papers

Oral Conditions and Health-Related Quality of Life: A Systematic Review.

Dental service patterns among private and public adult patients in Australia

Tooth loss, chewing ability and quality of life.

Impact of dental visiting trajectory patterns on clinical oral health and oral health-related quality of life.

The role of dentist, practice and patient factors in the provision of dental services.