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Special Issue "Social and Environmental Determinants of Oral Health"

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 January 2015)

Special Issue Editor

Guest Editor
Prof. Dr. Mauro Henrique Nogueira Guimarães de Abreu (Website)

Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte - Minas Gerais, 31270, Brazil
Interests: oral health epidemiology; quantitative methodology; dental public health

Special Issue Information

Dear Colleagues,

The oral health status of populations involves a complex network of determination. There is evidence in the scientific literature on the importance of social determinants of health and specifically in oral health. The investigation of environmental factors on oral health needs to further progress. Knowledge of these determinants allows us to propose strategies for overcoming inequalities in oral health. This is one of the challenges of today's world. This special issue will examine studies of social and environmental determinants of oral health.

Prof. Dr. Mauro Henrique Nogueira Guimarães de Abreu
Guest Editor

Submission

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs).

Keywords

  • socioeconomic factors
  • oral health
  • environmental health

Published Papers (17 papers)

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Research

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Open AccessArticle Changes in Socioeconomic Inequalities in the Use of Dental Care Following Major Healthcare Reform in Chile, 2004–2009
Int. J. Environ. Res. Public Health 2015, 12(3), 2823-2836; doi:10.3390/ijerph120302823
Received: 5 November 2014 / Revised: 1 December 2014 / Accepted: 5 February 2015 / Published: 4 March 2015
Cited by 1 | PDF Full-text (694 KB) | HTML Full-text | XML Full-text
Abstract
The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004–2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, [...] Read more.
The study examines changes in the distribution and socioeconomic inequalities of dental care utilization among adults after the major healthcare reform in Chile, 2004–2009. We evaluated the proportion of people who visited the dentist at least once in the previous two years, and the mean number of visits. These outcome variables were stratified by sex, age (20–39, 40–59, 60–63; ≥64 years), educational level (primary, secondary, higher), type of health insurance (public, private, uninsured), and socioeconomic status (quintiles of an asset-index). We also used the concentration index (CIndex) to assess the extent of socioeconomic inequalities in the use of dental care, stratified by age and sex as a proxy for dental care needs. The use of dental care significantly increased between 2004 and 2009, especially in those with public health insurance, with lower educational level and lower socioeconomic status. The CIndex for the total population significantly decreased both for the proportion who used dental care, and also the mean number of visits. Findings suggest that the use of dental care increased and socioeconomic-related inequalities in the utilization of dental care declined after a Major Health Reform, which included universal coverage for some dental cares in Chile. However, efforts to ameliorate these inequalities require an approach that moves beyond a sole focus on rectifying health coverage. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Dental Caries and Periodontal Disease in Brazilian Children and Adolescents with Cerebral Palsy
Int. J. Environ. Res. Public Health 2015, 12(1), 335-353; doi:10.3390/ijerph120100335
Received: 10 September 2014 / Accepted: 9 December 2014 / Published: 29 December 2014
Cited by 1 | PDF Full-text (714 KB) | HTML Full-text | XML Full-text
Abstract
The aim of the present study was determine the prevalence and factors associated with dental caries and periodontal disease in Brazilian children and adolescents with cerebral palsy (CP). This is a cross-sectional study conducted with 80 patients ranging in age from 2 [...] Read more.
The aim of the present study was determine the prevalence and factors associated with dental caries and periodontal disease in Brazilian children and adolescents with cerebral palsy (CP). This is a cross-sectional study conducted with 80 patients ranging in age from 2 to 18 years old. Oral exams were conducted by an examiner with records of DMFT, dmft, Gingival Bleeding Index (GBI) and Community Periodontal Index (CPI). The statistical analysis used Poisson Regression with robust variance estimation (α = 0.05). The prevalence of dental caries was 59.3%, with DMFT and mean dmft of 1.71 ± 2.42 and 2.22 ± 3.23, respectively. The mean GBI was 22.44%, and in the CPI, the prevalence of gingival bleeding, calculus, shallow and deep pockets were 94.73%, 79.62%, 12.90% and 3.22%, respectively. The caregiver’s educational level of less than eight years were associated with the dental caries experience (PR = 1.439; 95%CI = 1.09–1.89). The periodontal alterations were associated with female sex (PR = 0.82; 95%CI = 0.69–0.97), caregiver’s educational level of less than eight years (PR = 1.15; 95%CI = 1.03–1.29), poor oral perception (PR = 0.89; 95%CI = 0.80–0.98), serious communication problem (PR = 0.87; 95%CI = 0.76–0.99) and athetoid type of CP (PR = 0.85; 95%CI = 0.75–0.97). The patients with CP presented high dental caries experience and periodontal alterations, which were associated with their demographic, socioeconomic, oral health perception and systemic information. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Counseling Role of Primary Care Physicians in Preventing Early Childhood Caries in Children with Congenital Heart Disease
Int. J. Environ. Res. Public Health 2014, 11(12), 12716-12725; doi:10.3390/ijerph111212716
Received: 20 November 2014 / Revised: 4 December 2014 / Accepted: 4 December 2014 / Published: 9 December 2014
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Abstract
The dental health of preschool children with congenital heart disease (CHD) is usually poor, which may contribute to the development of infective endocarditis (IE). Primary care physicians play an important role in providing access to preventive dental services, particularly for preschool children. [...] Read more.
The dental health of preschool children with congenital heart disease (CHD) is usually poor, which may contribute to the development of infective endocarditis (IE). Primary care physicians play an important role in providing access to preventive dental services, particularly for preschool children. The object of this study was to provide epidemiologic evidence for the impact of primary care physicians’ (PCP’s) counseling role on early childhood caries in children with CHD in Guangzhou, China, which might guide future caries prevention to decrease the risk of IE in children with CHD. A hospital-based, case-control study was performed, which contained 100 children with newly diagnosed early childhood caries and 100 matched (sex and age) children without dental caries. All of the subjects were diagnosed with CHD at birth and recruited from Guangdong Cardiovascular Institute from 2012 through 2013. A conditional multivariate logistic-regression model was used to assess the associations between PCPs’ role and early childhood caries with a significance level of 5%. Our findings revealed that mother’s education level (OR = 0.36, CL = 0.14–0.92) and knowledge, being educated on the relationship between CHD and infective endocarditis (OR = 0.48, CL = 0.25–0.94) and the impact of oral health on infective endocarditis (OR = 0.37, CL = 0.18–0.79) by the PCP were associated with early childhood caries. PCPs played an important role in preventing early childhood caries among preschool children with CHD in Guangzhou, China. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Oral Health Behaviour and Social and Health Factors in University Students from 26 Low, Middle and High Income Countries
Int. J. Environ. Res. Public Health 2014, 11(12), 12247-12260; doi:10.3390/ijerph111212247
Received: 22 September 2014 / Revised: 19 November 2014 / Accepted: 20 November 2014 / Published: 26 November 2014
Cited by 3 | PDF Full-text (686 KB) | HTML Full-text | XML Full-text
Abstract
Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. [...] Read more.
Poor oral health is still a major burden for populations throughout the world, particularly in developing countries. The aim of this study was investigate oral health behaviour (tooth brushing and dental attendance) and associated factors in low, middle and high income countries. Using anonymous questionnaires, data were collected from 19,560 undergraduate university students (mean age 20.8, SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas. Results indicate that 67.2% of students reported to brush their teeth twice or more times a day, 28.8% about once a day and 4.0% never. Regarding dental check-up visit, 16.3% reported twice a year, 25.6% once a year, 33.9% rarely and 24.3% never. In a multivariate logistic regression analysis, being a male, coming from a wealthy or quite well off family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, depression and PTSD symptoms, tobacco use and frequent gambling, low physical activity, and low daily meal and snacks frequency were associated with inadequate tooth brushing (<twice daily). Further, being a male, older age, coming from a not well off or poor family background, living in low income or lower middle income, weak beliefs in the importance of regular tooth brushing, PTSD symptoms, illicit drug use, low physical activity, and low daily snacks frequency, skipping breakfast and inadequate fruit and vegetables consumption were associated with less than one annual dental care visit. Oral health behaviour among the students was found to be low. Various risk factors identified can be used to guide interventions to improve oral health behaviour among university students. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Dental Caries Experience and Use of Dental Services among Brazilian Prisoners
Int. J. Environ. Res. Public Health 2014, 11(12), 12118-12128; doi:10.3390/ijerph111212118
Received: 28 July 2014 / Revised: 11 November 2014 / Accepted: 11 November 2014 / Published: 25 November 2014
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Abstract
This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, [...] Read more.
This ross-sectional study involving 127 male prisoners evaluates the use of dental services and dental caries among Brazilian inmates. Data were collected by interview and clinical examination. Sociodemographic and sentencing information as well as use of dental services, self-reported dental morbidity, self-perception, and oral health impacts were investigated. The mean DMFT index value was 19.72. Of the components, the decayed component showed the highest mean value (11.06 ± 5.37). Statistically significant association was found between DMFTs with values from 22 to 32 and oral health satisfaction (p = 0.002), difficulty speaking (p = 0.024), shame of talking (p = 0.004) and smiling (p < 0.001). Regarding the use of dental services, 80% had their last dental appointment less than one year ago, with most visits occurring in prison (80%), with restorative treatment (32%), followed by dental pain (26.4%), being the main reasons for such appointments. Most prisoners used dental services provided by the prison. Although restorative treatment has been the main reason for the use of dental services, “decayed” and “missing” components contributed to the high mean DMFT index. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Prevalence of Loss of All Teeth (Edentulism) and Associated Factors in Older Adults in China, Ghana, India, Mexico, Russia and South Africa
Int. J. Environ. Res. Public Health 2014, 11(11), 11308-11324; doi:10.3390/ijerph111111308
Received: 14 July 2014 / Revised: 8 October 2014 / Accepted: 14 October 2014 / Published: 30 October 2014
Cited by 3 | PDF Full-text (503 KB) | HTML Full-text | XML Full-text
Abstract
Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from [...] Read more.
Little information exists about the loss of all one’s teeth (edentulism) among older adults in low- and middle-income countries. This study examines the prevalence of edentulism and associated factors among older adults in a cross-sectional study across six such countries. Data from the World Health Organization (WHO’s) Study on global AGEing and adult health (SAGE) Wave 1 was used for this study with adults aged 50-plus from China (N = 13,367), Ghana (N = 4724), India (N = 7150), Mexico (N = 2315), Russian Federation (N = 3938) and South Africa (N = 3840). Multivariate regression was used to assess predictors of edentulism. The overall prevalence of edentulism was 11.7% in the six countries, with India, Mexico, and Russia has higher prevalence rates (16.3%–21.7%) than China, Ghana, and South Africa (3.0%–9.0%). In multivariate logistic analysis sociodemographic factors (older age, lower education), chronic conditions (arthritis, asthma), health risk behaviour (former daily tobacco use, inadequate fruits and vegetable consumption) and other health related variables (functional disability and low social cohesion) were associated with edentulism. The national estimates and identified factors associated with edentulism among older adults across the six countries helps to identify areas for further exploration and targets for intervention. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Sociobehavioral Factors Associated with Caries Increment: A Longitudinal Study from 24 to 36 Months Old Children in Thailand
Int. J. Environ. Res. Public Health 2014, 11(10), 10838-10850; doi:10.3390/ijerph111010838
Received: 12 August 2014 / Revised: 11 October 2014 / Accepted: 14 October 2014 / Published: 17 October 2014
Cited by 6 | PDF Full-text (684 KB) | HTML Full-text | XML Full-text
Abstract
The aim of this study is to investigate sociobehavioral risk factors from the prenatal period until 36 months of age, and the caries increment from 24 to 36 months of the child in Thailand. The data utilized in this study come from [...] Read more.
The aim of this study is to investigate sociobehavioral risk factors from the prenatal period until 36 months of age, and the caries increment from 24 to 36 months of the child in Thailand. The data utilized in this study come from the prospective cohort study of Thai children (PCTC) from prenatal to 36 months of the child in Mueang Nan district, Northern Thailand. The total sample size recruited was 783 infants. The sample size with dental caries data was 603 and 597, at 24 months and at 36 months, respectively. The sample size of having two assessment points with a dental examination (at 24 months and at 36 months) was 597. Results indicate that the caries increment was 52.9%, meaning from 365 caries free children at 24 months 193 had developed dental caries at 36 months. The prevalence of dental caries was 34.2% at 24 months (n = 206) and 68.5% at 36 months of age (n = 409). In bivariate analysis, higher education of the mother, lower household income, bottle feeding of the infant, frequent sweet candy consumptions, and using rain or well water as drinking water were associated with dental caries increment, while in multivariate conditional logistic regression analysis lower household income, higher education of the mother, and using rain or well water as drinking water remained associated with dental caries increment. In conclusion, a very significant increase in caries development was observed, and oral health may be influenced by sociobehavioural risk factors. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Factors Associated with No Dental Treatment in Preschoolers with Toothache: A Cross-Sectional Study in Outpatient Public Emergency Services
Int. J. Environ. Res. Public Health 2014, 11(8), 8058-8068; doi:10.3390/ijerph110808058
Received: 3 June 2014 / Revised: 28 July 2014 / Accepted: 29 July 2014 / Published: 8 August 2014
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Abstract
Many parents rely on emergency services to deal with their children’s dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency [...] Read more.
Many parents rely on emergency services to deal with their children’s dental problems, mostly pain and infection associated with dental caries. This cross-sectional study analyzed the factors associated with not doing an oral procedure in preschoolers with toothache attending public dental emergency services. Data were obtained from the clinical files of preschoolers treated at all nine dental emergency centers in Goiania, Brazil, in 2011. Data were children’s age and sex, involved teeth, oral procedures, radiography request, medications prescribed and referrals. A total of 531 files of children under 6 years old with toothache out of 1,108 examined were selected. Children’s mean age was 4.1 (SD 1.0) years (range 1–5 years) and 51.6% were girls. No oral procedures were performed in 49.2% of cases; in the other 50.8%, most of the oral procedures reported were endodontic intervention and temporary restorations. Primary molars were involved in 48.4% of cases. With the exception of “sex”, the independent variables tested in the regression analysis significantly associated with non-performance of oral procedures: age (OR 0.7; 95% CI 0.5–0.8), radiography request (OR 3.8; 95% CI 1.7–8.2), medication prescribed (OR 7.5; 95% CI 4.9–11.5) and patient referred to another service (OR 5.7; 3.0–10.9). Many children with toothache received no oral procedure for pain relief. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Maternally Perceived Barriers to and Facilitators of Establishing and Maintaining Tooth-Brushing Routines with Infants and Preschoolers
Int. J. Environ. Res. Public Health 2014, 11(7), 6808-6826; doi:10.3390/ijerph110706808
Received: 17 March 2014 / Revised: 24 June 2014 / Accepted: 25 June 2014 / Published: 2 July 2014
Cited by 4 | PDF Full-text (391 KB) | HTML Full-text | XML Full-text
Abstract
Establishing effective toothbrushing routines using fluoridated toothpaste in infancy has been suggested as important to dental health throughout childhood and into adulthood. However, previous studies have revealed a number of potential barriers to, and facilitators of caregivers ability to establish early dyadic [...] Read more.
Establishing effective toothbrushing routines using fluoridated toothpaste in infancy has been suggested as important to dental health throughout childhood and into adulthood. However, previous studies have revealed a number of potential barriers to, and facilitators of caregivers ability to establish early dyadic toothbrushing routines with pre-schoolers. However, as yet no qualitative research has been conducted to ascertain potential barriers and facilitators of the earliest dyadic toothbrushing in infancy, and nor has any previous research specifically focused on how novice mothers of first-born infants and preschoolers manage this task. This study therefore outlines findings from a qualitative interview study with first-time mothers of children aged 24–30 months (n = 16) exploring perceived barriers to and facilitators of early dyadic toothbrushing routines with infants and preschoolers. A number of key themes were identified from interview transcripts and an ‘ecological’ approach conceptualised maternally perceived barriers to and facilitators of dyadic toothbrushing. Proximal influences were found to be located within the caregiver-child relationship (‘micro-system’), including parental cognitions (e.g., PSE), parental behaviours (e.g., parenting practices) and infant and preschooler temperament and behaviours (e.g., tantrums). Distal factors were also identified as relevant to the establishment and maintenance of these routines, such as social support (‘exosystem’) and family history of tooth-brushing (‘chronosystem’). Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle A Survey of the Perception of Comprehensiveness among Dentists in a Large Brazilian City
Int. J. Environ. Res. Public Health 2014, 11(4), 4249-4261; doi:10.3390/ijerph110404249
Received: 26 February 2014 / Revised: 10 April 2014 / Accepted: 11 April 2014 / Published: 16 April 2014
Cited by 1 | PDF Full-text (294 KB) | HTML Full-text | XML Full-text
Abstract
Objectives: To quantitatively identify the perception of dentists regarding comprehensiveness and its domains of “patient welcoming”, “bonding” and “quality of care” in primary dental care settings of a large Brazilian city. Methods: A questionnaire was administered to all dentists comprising the primary [...] Read more.
Objectives: To quantitatively identify the perception of dentists regarding comprehensiveness and its domains of “patient welcoming”, “bonding” and “quality of care” in primary dental care settings of a large Brazilian city. Methods: A questionnaire was administered to all dentists comprising the primary health care service to Belo Horizonte with tenured jobs and 40 work hours per week, totalling a population of 207 professionals. The response rate was 90.34%. A pilot test was conducted with 44 dentists working in primary care for at least two years and who did not participate in the main study. Descriptive statistical analysis involved calculating proportions. No confidence intervals were calculated because this was a census study. Results: In most items (79.0%), professionals’ perceptions about the comprehensiveness were overwhelmingly positive. When we stratified the analysis by domain and checked those items about which dentists had a less favourable perception, 22.7% were in the patient welcoming domain, 25.0% were in the bonding domain and 12.5% were in quality of care. Conclusions: Comprehensiveness, as an approach in health care practice, needs to be enhanced, and there is evidence that these dentists are aware of its importance. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Health Insurance, Socio-Economic Position and Racial Disparities in Preventive Dental Visits in South Africa
Int. J. Environ. Res. Public Health 2013, 10(1), 178-191; doi:10.3390/ijerph10010178
Received: 27 October 2012 / Revised: 25 December 2012 / Accepted: 25 December 2012 / Published: 2 January 2013
Cited by 3 | PDF Full-text (226 KB) | HTML Full-text | XML Full-text
Abstract
This study sought to determine the contributions of socio-economic position and health insurance enrollment in explaining racial disparities in preventive dental visits (PDVs) among South Africans. Data on the dentate adult population participating in the last South African Demographic and Health Survey [...] Read more.
This study sought to determine the contributions of socio-economic position and health insurance enrollment in explaining racial disparities in preventive dental visits (PDVs) among South Africans. Data on the dentate adult population participating in the last South African Demographic and Health Survey conducted during 2003–2004 (n = 6,312) was used. Main outcome measure: Reporting making routine yearly PDVs as a preventive measure. Education, material wealth index and nutritional status indicated socio-economic position. Multi-level logistic regression analysis was conducted to determine the predictors of PDVs. A variant of Blinder-Oaxaca decomposition analysis was also conducted. Health insurance coverage was most common among Whites (70%) and least common among black Africans (10.1%) in South Africa. Similarly, a yearly PDV was most frequently reported by Whites (27.8%) and least frequently reported among black Africans (3.1%). Lower education and lower material wealth were associated with lower odds of making PDVs. There was significant interaction between location (urban/rural) and education (p = 0.010). The racial and socio-economic differences in PDVs observed in urban areas were not observed in rural areas. In the general dentate population, having health insurance significantly increased the odds of making PDVs (OR = 4.32; 3.04–6.14) and accounted for 40.3% of the White/non-White gap in the probability of making PDVs. Overall, socio-economic position and health insurance enrollments together accounted for 55.9% (95% CI = 44.9–67.8) of the White/non-White gap in PDVs. Interventions directed at improving both socio-economic position and insurance coverage of non-White South Africans are likely to significantly reduce racial disparities in PDVs. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
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Open AccessArticle Social Vulnerability and Traumatic Dental Injury among Brazilian Schoolchildren: A Population-Based Study
Int. J. Environ. Res. Public Health 2012, 9(12), 4278-4291; doi:10.3390/ijerph9124278
Received: 31 August 2012 / Revised: 9 November 2012 / Accepted: 13 November 2012 / Published: 22 November 2012
Cited by 6 | PDF Full-text (187 KB) | HTML Full-text | XML Full-text
Abstract
The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo [...] Read more.
The aim of the present study was to test the association between social vulnerability and the prevalence of traumatic dental injury (TDI). A population-based cross-sectional study was carried out with 1,556 schoolchildren aged 11 to 14 years in the city of Belo Horizonte, Brazil. The participants were examined for TDI using Andreasen’s criteria and those diagnosed with TDI were interviewed to determine the history of the injury. The Social Vulnerability Index (SVI) was used for socioeconomic classification, which addresses environmental, cultural, economic, legal and security/survival dimensions. The Poisson regression model was used for the multivariate analysis, with the significance level set at 5%. The prevalence of TDI was 14.1%; 59.3% of the participants with TDI did not seek a dentist after the incident. Poorer environmental, economic and legal conditions were statistically associated with the occurrence of untreated TDI (p < 0.05) and all the five SVI dimensions were associated with seeking a dentist due to TDI (p < 0.006). The prevalence of untreated TDI was higher among boys (PR: 1.42; 95%CI: 1.11–1.81) and those in situations of greater social vulnerability (PR: 2.27; 95%CI: 1.11–4.61). In conclusion, the male gender and high social vulnerability proved to be associated with the occurrence of TDI. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Socio-Environmental Factors Associated with Self-Rated Oral Health in South Africa: A Multilevel Effects Model
Int. J. Environ. Res. Public Health 2012, 9(10), 3465-3483; doi:10.3390/ijerph9103465
Received: 24 July 2012 / Revised: 17 September 2012 / Accepted: 25 September 2012 / Published: 2 October 2012
Cited by 3 | PDF Full-text (145 KB) | HTML Full-text | XML Full-text
Abstract
Aim: This study examined the influence of the social context in which people live on self-ratings of their oral health. Method: This study involved a representative sample of 2,907 South African adults (≥16 years) who participated in the 2007 South [...] Read more.
Aim: This study examined the influence of the social context in which people live on self-ratings of their oral health. Method: This study involved a representative sample of 2,907 South African adults (≥16 years) who participated in the 2007 South African Social Attitude Survey (SASAS). We used the 2005 General Household Survey (n = 107,987 persons from 28,129 households) to obtain living environment characteristics of SASAS participants, including sources of water and energy, and household cell-phone ownership (a proxy measure for the social network available to them). Information obtained from SASAS included socio-demographic data, respondents’ level of trust in people, oral health behaviors and self-rated oral health. Results: Of the respondents, 76.3% self-rated their oral health as good. Social context influenced women’s self-rated oral health differently from that of men. Good self-rated oral health was significantly higher among non-smokers, employed respondents and women living in areas with higher household cell-phone ownership. Furthermore, trust and higher social position were associated with good self-rated oral health among men and women respectively. Overall, 55.1% and 18.3% of the variance in self-rated oral health were explained by factors operating at the individual and community levels respectively. Conclusion: The findings highlight the potential role of social capital in improving the population’s oral health. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Oral Care during Pregnancy: Attitudes of Brazilian Public Health Professionals
Int. J. Environ. Res. Public Health 2012, 9(10), 3454-3464; doi:10.3390/ijerph9103454
Received: 6 August 2012 / Revised: 25 September 2012 / Accepted: 25 September 2012 / Published: 28 September 2012
Cited by 2 | PDF Full-text (106 KB) | HTML Full-text | XML Full-text
Abstract
There is little information about health professionals’ behavior regarding oral health care during pregnancy. We evaluated attitudes of obstetricians/gynecologists, nurses, and dentists working at a public community service towards pregnant women’s oral health. Health professionals responded to a self-applied questionnaire. Cluster analysis [...] Read more.
There is little information about health professionals’ behavior regarding oral health care during pregnancy. We evaluated attitudes of obstetricians/gynecologists, nurses, and dentists working at a public community service towards pregnant women’s oral health. Health professionals responded to a self-applied questionnaire. Cluster analysis identified two clusters of respondents; Chi-square, Student’s t test, and logistic regression were used to compare the two clusters in terms of the independent variables. Respondents were categorized into cluster 1 ‘less favorable’ (n = 159) and cluster 2 ‘more favorable’ (n = 124) attitudes. Professionals that had attended a residency or specialization program (OR = 2.08, 95% CI = 1.15–3.77, p = 0.016) and worked exclusively at the public service (OR = 2.15, 95% CI = 1.10–4.20, p = 0.025) presented more favorable attitudes. Obstetricians/gynecologists (OR = 0.22, 95% CI = 0.09–0.54, p = 0.001) and nurses (OR = 0.50, 95% CI = 0.29–0.86, p = 0.013) showed less favorable attitudes than dentists. Health care providers’ attitudes regarding pregnant women’s oral health were related to their occupation, qualification, and dedication to the public service. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
Open AccessArticle Effects of Smoking and Genotype on the PSR Index of Periodontal Disease in Adults Aged 18–49
Int. J. Environ. Res. Public Health 2012, 9(8), 2839-2850; doi:10.3390/ijerph9082839
Received: 3 July 2012 / Revised: 27 July 2012 / Accepted: 30 July 2012 / Published: 10 August 2012
Cited by 6 | PDF Full-text (125 KB) | HTML Full-text | XML Full-text
Abstract
Studies have found both genetic and environmental influences on chronic periodontitis. The purpose of this study was to examine the relationships among previously identified genetic variants, smoking status, and two periodontal disease-related phenotypes (PSR1 and PSR2) in 625 Caucasian adults (aged 18–49 [...] Read more.
Studies have found both genetic and environmental influences on chronic periodontitis. The purpose of this study was to examine the relationships among previously identified genetic variants, smoking status, and two periodontal disease-related phenotypes (PSR1 and PSR2) in 625 Caucasian adults (aged 18–49 years). The PSR Index was used to classify participants as affected or unaffected under the PSR1 and PSR2 phenotype definitions. Using logistic regression, we found that the form of the relationship varied by single nucleotide polymorphism (SNP): For rs10457525 and rs12630931, the effects of smoking and genotype on risk were additive; whereas for rs10457526 and rs733048, smoking was not independently associated with affected status once genotype was taken into consideration. In contrast, smoking moderated the relationships of rs3870371 and rs733048 with affected status such that former and never smokers with select genotypes were at increased genetic risk. Thus, for several groups, knowledge of genotype may refine the risk prediction over that which can be determined by knowledge of smoking status alone. Future studies should replicate these findings. These findings provide the foundation for the exploration of novel pathways by which periodontitis may occur. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)
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Open AccessArticle Toothaches in the Daily Lives of Brazilian Adults
Int. J. Environ. Res. Public Health 2012, 9(8), 2587-2600; doi:10.3390/ijerph9082587
Received: 23 May 2012 / Revised: 5 July 2012 / Accepted: 12 July 2012 / Published: 25 July 2012
Cited by 3 | PDF Full-text (307 KB) | HTML Full-text | XML Full-text
Abstract
The aim of the present study was to estimate the prevalence of toothaches and to evaluate its effects on the daily lives of adults living in an industrialised region of southeastern Brazil. A questionnaire was administered to a sample of 744 individuals. [...] Read more.
The aim of the present study was to estimate the prevalence of toothaches and to evaluate its effects on the daily lives of adults living in an industrialised region of southeastern Brazil. A questionnaire was administered to a sample of 744 individuals. The variables related to toothache were grouped into three components: access to dental service, pain severity, and social/functional impacts. The present study found that 68.0% of the subjects had limited access to oral health care, 39.7% presented high toothache severity, and 47.3% reported that toothache greatly affected their daily lives. Nervousness (87.2%) and chewing difficulty (72.6%) were the most commonly reported toothache-related effects. Through correspondence analysis, four groups with separate profiles for toothache and associated factors were identified. Two groups reported greater effects of toothaches in their daily lives. One group consisted of individuals who had less access to dental services (women and individuals who were multiracial, married, had a middle school education, or a low family income). The other group consisted of individuals who reported a high toothache severity and high degree of social/functional impacts (individuals who were 40 to 44 years old, married or widowed, black or multiracial, and had a middle school education). The other two groups were those whose daily lives were less affected by toothaches. One group consisted of individuals who had greater access to dental services (men and individuals who were divorced, had a college degree, or had incomes greater than R$ 300.01). The final group consisted of individuals who had low toothache severity and a low degree of associated social/functional impacts (individuals who were 35 to 39 years old, white, single, or had a high school education). Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)

Review

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Open AccessReview A Systematic Review of Socioeconomic Indicators and Dental Caries in Adults
Int. J. Environ. Res. Public Health 2012, 9(10), 3540-3574; doi:10.3390/ijerph9103540
Received: 28 May 2012 / Revised: 10 September 2012 / Accepted: 2 October 2012 / Published: 10 October 2012
Cited by 22 | PDF Full-text (246 KB) | HTML Full-text | XML Full-text
Abstract
Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough [...] Read more.
Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough review of the literature. Seven databases were systematically searched: Pubmed, Cochrane, Web of Science, Bireme, Controlled Trials, Clinical Trials and the National Institute for Health and Clinical Excellence. No restrictions were placed on the language or year of publication. The search yielded 41 studies for systematic review. Two independent reviewers screened the studies for inclusion, extracted data and evaluated quality using the Newcastle-Ottawa scale. The following socioeconomic indicators were found: educational level, income, occupation, socio-economic status and the community index. These indicators were significantly associated with a greater occurrence of dental caries: the subject’s education, subject’s income, subject’s occupation and the Gini coefficient. A high degree of heterogeneity was found among the methods. Quality varied across studies. The criteria employed for socioeconomic indicators and dental caries should be standardized in future studies. The scientific evidence reveals that educational level, income, occupation and the Gini coefficient are associated with dental caries. Full article
(This article belongs to the Special Issue Social and Environmental Determinants of Oral Health)

Planned Papers

The below list represents only planned manuscripts. Some of these manuscripts have not been received by the Editorial Office yet. Papers submitted to MDPI journals are subject to peer-review.

Title: On the Absence of Regulations of Adult Dental Services in Norway: A Critical Discourse Analysis
Author: Birgit Abelsen
Affiliation: Northern Research Institute Alta as, Box 1463, N-9506 Alta, Norway; E-Mail: birgita@norut.no; Tel.: +47 78 45 71 14; Fax: +47 78 45 71 01
Abstract: In most countries in which health care is distributed according to the principle of equal access for equal need, we observe extensive public involvement in financing as well as the regulation of providers. In Norway, there is a remarkable contrast when it comes to dentistry. This article inquires as to health policy reasoning to explain why free pricing and free establishment rights remain characteristic features of Norwegian adult dentistry. The public debate following recent suggestions of establishment and pricing regulations is analysed using a critical discourse analysis perspective. This analysis takes into account official documents involved in this specific policy debate as well as the sociocultural context in which these texts are produced and consumed, and the discourse practice level which guides this text’s production and consumption. The analysis shows that free market logic, dentists’ professional status and autonomy arguments came first when the Norwegian government opposed the proposed regulations, while the argument for patient benefit was lost in the process. The powerful positioning of the dentist within the Norwegian oral health care system is seen as being an important factor in explaining the outcome of this debate.

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