Dental health attitudes among dentate black and white adults

OBJECTIVES: Blacks and poor persons share a greater burden of oral disease and are less likely to seek dental care on a regular basis. The role of dental attitudes and knowledge of services on this circumstance is unclear. The authors quantified group differences in dental attitudes and knowledge of services and related them to regularity of dental care use. METHODS: As part of the baseline phase of The Florida Dental Care Study, a longitudinal study of oral health, 873 respondents who had at least one tooth and who were 45 years or older participated for an interview and a clinical dental examination. Dental care use, seven dental attitudinal constructs, and knowledge of dental services were queried. RESULTS: Forty-five percent of respondents reported going to a dentist only when they have a problem, and 17% of respondents had not seen a dentist in more than 5 years. Ten percent of respondents reported that they had at least one permanent tooth removed by someone other than a dentist (typically, the respondent himself). Blacks and poor persons had more negative attitudes toward dental care and dental health and were less knowledgeable of dental services. Multivariate analyses suggested that dental attitudes were important to understanding the use of dental care services for this diverse group of adults, and that race and poverty contributed independently to dental care use even with dental attitudes taken into account. CONCLUSIONS: Dental attitudes contribute to race and poverty differences in dental care use among adults. The persistence of race and poverty effects with attitudes taken into account suggests that additional explanatory factors contribute as well. These differences may contribute to more prevalent and severe oral health decrements among the same adults who also are more likely to suffer from other health decrements.     

The oral health of Indiana's independent, disabled adults

This epidemiological study was conducted to measure the oral health and related variables of one of Indiana's special population groups: adults who are developmentally disabled, work in sheltered workshops and do not live in staffed residential facilities. Fifteen sheltered workshops in ten Indiana counties cooperated with this study in which 393 individuals were interviewed and received oral screening. Information was gathered regarding oral health status, history of utilization of dental services, availability of dental insurance or Medicaid and use of tobacco products. This study was conducted by the Indiana Foundation of Dentistry for the Handicapped and was funded by the Indiana State Department of Health.     

Using subjective oral health status indicators to screen for dental care needs in older adults

A study was undertaken to assess the ability of a number of subjective oral health status indicators to identify community-dwelling older adults who need dental treatment. The indicators consisted of a single-item self-rating of treatment need, a 15-item psychosocial impact index and the 49-item Oral Health Impact Profile (OHIP). Data for the study were collected as part of an oral health survey of Canadians aged 50 years and over. The associations between these subjective indicators and clinically defined dental treatment needs were assessed using statistics for determining the predictive power of a diagnostic test. Although there were statistically significant associations between the subjective and clinical measures, values for statistics such as sensitivity, positive predictive values and positive likelihood ratios were low. Although the measures did not perform well as screening tests, they did identify a sub-group of individuals whose clinical conditions impacted significantly on daily life and who would probably benefit the most from dental treatment. In this respect, the subjective measures assessed here can themselves be interpreted as indicators of need which complement conventional clinical measures of needs for dental care.     

Multidimensionality of health-related locus-of-control-scale items.

Examined the factorial structure of the Multidimensional Health Locus of Control Scale in 86 male medical patients (mean age 58 yrs). Results largely confirm the factorial independence of locus-of-control items in 3 separate subscales: Internal, Powerful Others, and Chance. Further refinement and development of the concept is shown to be feasible. (6 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship of oral microflora with oral health status in Parkinson's disease

Parkinson's disease (PD) patients report an increased craving for sweets, which may have an effect on microflora. We compared patients of PD who crave sweets with PD patients who do not. Age- and sex-matched control subjects were used, with 14 subjects in each group. A plaque sample was taken from tooth #18 with a curette and placed into RTF, homogenized, and plated onto selective and non-selective media. Microflora were expressed as % CFU's of total anaerobes. Statistical analysis was performed by ANOVA and Newman-Keuls on log-transformed data. No statistical difference was observed among the three groups for lactobacilli, bacteroides, fusobacteria, veillonella, and actinomyces. S. mutans was lower in controls than in PD patients. Apparently, the craving for sweets in PD patients does not result in a significant increase in % of total anaerobes of certain microflora. PD patients showed a significant increase in mucositis compared with the control groups.     

Continuous improvement of oral health in Europe

The oral health action programmes of the WHO Regional Office for Europe (WHO/EURO) comply with the overall European Health Policy and targets for the improvement of health in Europe by the year 2000 (HFA2000) and focus on promotive and preventive care approaches primarily at the community level. Various activities, including the development of guidelines for local action projects, have been established to support WHO/EURO's Member States in initiating preventive oral health care system and introducing the concept of continuous quality development in oral health care. The main focus for Countries of Central and Eastern Europe (CCEE) is to formulate national goals for oral health and to further develop oral health services in the region. Collection of national data using agreed European quality indicators for oral health will form the basis of appropriate monitoring and development of technologies to improve oral health care services and the oral health status at large. The WHO/EURO action programmes aim to implement oral disease prevention and health promotion activities. Guidelines have been established to support individual Member States who intend to establish community-based programmes in accordance with scientifically sound principles and methods. The ORATEL Project (Telematic System for Quality Assurance in Oral Health Care) is part of the Commission of European Communities (CEC) strategy for harmonization and standardization in health care (CEC) Programme for advanced informatics in medicine--AIM/CEC) and ORATEL is the only AIM/CEC project related to oral health. The ORATEL Project aims to improve the oral health status in the European Region through use of appropriate computerized information systems. The Project will support management and administration of dental clinics and will be an integral part of a quality assurance system to promote a standardized level of quality in the field. Its advanced educational and decision-support tools can be used by professionals at all levels of the system. ORATEL possesses tools for aggregating and transmitting data upwards for monitoring and evaluation purposes at local, national and supranational administrative levels.     

Relationship of masticatory mandibular movements to masticatory performance of dentate adults: a method study

This study evaluated a sieve method for measuring masticatory performance and determined the associations between masticatory performance and masticatory mandibular movements. Ten dentate adults and three complete denture-wearing subjects participated in the study. The masticatory performance indices for these subjects were determined after a 10 s masticatory sequence and another sequence that ended at the swallowing threshold. Almond was used as the test food and almond fragments were sized using a standard 0.65 mm square size brass wire sieve. Masticatory mandibular movements were simultaneously recorded by an optoelectronic device. The reproducibility of the masticatory performance tests was good (r = 0.98 and 0.82 for the 10 s and swallowing threshold test indices, respectively). The masticatory performance indices were markedly different between dentate and denture-wearing subjects. The 10 s masticatory performance index in the dentate subjects, showed moderate to rather strong correlation with all parameters of mandibular velocity (r = 0.6-0.7). The 10 s index also showed a strong negative correlation to the duration of the occlusal level phase and the total duration of the chewing cycle (r = -0.7 to -0.8) in the dentate subjects. This study confirms that masticatory performance levels are relatively stable and associated with the efficacy of specific masticatory mandibular movement parameters.     

Chewing gum and saliva in oral health

The crucial role played by many properties of saliva in preventing dental caries, maintaining the plaque pH and controlling the equilibrium between enamel de- and remineralization has been demonstrated. This has been documented by the effects of salivary dysfunction on caries incidence and by the distribution of sites of caries predilection in areas where saliva presence is restricted. The use of sugar-free chewing gum has been increasingly accepted as one adjunct to oral hygiene procedures. It has become part of an anti-caries prevention program, especially in patients suffering from xerostomia. Chewing gum not only acts as a salivary stimulant but may also be a useful vehicle for some agents such as fluoride, chlorhexidine and calcium phosphate. Moreover, in some countries gum containing nicotine has been used to substitute the nicotine from cigarettes to reduce the effects of nicotine withdrawal reaction from people attempting to stop smoking.     

Multidimensionality of perceived locus of control: Two replications.

Administered Rotter's Internal-External Locus of Control Scale to 2 Australian samples, one of 159 14-19 yr old male adolescents and one of 134 18-20 yr old female adolescents. Both samples indicated the multidimensional structure of the scale in another culture, and pointed to the basic lack of relationship among its items. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological health and problem-solving self-appraisal in older adults.

This study investigated relations between psychological health and problem-solving self-appraisal in 97 adults aged 65–96 years. Participants completed the Problem-Solving Inventory (P. P. Heppner, 1988) and two measures of psychological health encompassing both well-being and distress dimensions. Results of a canonical correlation analysis indicated that relations between problem-solving self-appraisal and psychological health were complex and sometimes contradictory. On the one hand, as problem-solving self-appraisal became more favorable (more confidence, more control, and increased approaching of problems), well-being increased and distress decreased. Conversely, perceptions of avoidant problem solving and decreased control were also associated with some increases in psychological health. Research and counseling implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Subjectively reported oral health status in an adult population

This study describes the subjectively reported oral health status of an adult population aged 18 yr and over. The study used measures of the functional, social and psychological impact of oral disorders, originally developed for surveys of older adults, and aimed to determine whether or not they were sensitive to the oral health concerns of younger adults. It compared four age groups (18-29 yr; 30-49 yr; 50-64 yr; 65 yr and over) in terms of the following subjective oral health indicators: ability to chew, problems speaking, oral and facial pain; other oral symptoms; problems eating; problems with communication-social relations; limitations in activities of daily living and worry and concern. The initial hypothesis that few younger subjects would report the kinds of problems documented by these indicators was not supported. On all measures except ability to chew, younger subjects were as likely to be compromised by oral conditions as older subjects.     

Culture, dental professionals and oral health values in multicultural societies: measuring cultural factors in geriatric oral health research and education

Culture has significant impacts upon professional practice and patient health behaviours, especially in multicultural societies. This paper introduces the concept of culture and examines how it may be of importance to dental health professionals. Using the Dental Impact Profile and other dental social science measures, dental researchers and students can be engaged in studying cultural values and characteristics as a way of dealing with cultural differences.