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Assess the association between oral and general health related quality of life using oral impacts on daily performances (OIDP) and the quality of life tool EQ-5D-5L from EuroQoL among patients with substance use disorder (SUD) who receive opioid agonist therapy. 609 patients with SUD completed the EQ-5D-5L. A dental sub-study of 167 patients completed OIDP and an oral examination when attending outpatient clinics in Western Norway for their opioid agonist therapy. The merged analytical sample consisted of 165 patients. The association between OIDP and EQ-5D-5L was assessed by Spearman's rho and a linear multiple variable regression analysis. A line graph and a Pen's parade displayed the distributions of OIDP sum scores and EQ-5D-5L index values. Overall mean summary- and index EQ-5D-5L scores were 9.97 (sd 3.25) and 0.69 (sd 0.22). Mean score for OIDP was 9.75 (sd 9.59). Spearman's rho was 0.34 (p <.01) between OIDP and EQ-5D-5L summary scores. Linear regression revealed an association adjusted for sex and age of 0.12 (95% CI 0.07–0.17) and a coefficient of determination of 0.1460. This study reveals a strong association between OIDP and EQ-5D-5L reflecting the importance of oral health to general health for patients with SUD. Health care professionals should pay attention to oral health. Effective interventions might improve patients' oral and health related quality of life. [ABSTRACT FROM AUTHOR]

To explore whether plaque and gingival bleeding are more frequently experienced by adolescents with juvenile idiopathic arthritis (JIA) compared to matched controls without JIA; explore whether surface- and site-specific periodontal outcomes vary between the two groups; and for participants with JIA, investigate associations between disease-specific features and periodontal outcomes. In this comparative cross-sectional study, selected surfaces, and sites of index teeth in 10–16-year-olds with JIA and matched controls were examined by modified versions of Simplified Oral Hygiene Index (OHI-S) and Gingival Bleeding Index (GBI). Mixed-effects logistic regressions, reporting odds ratios (OR) with 95% confidence interval (CI), were applied. Intra-class correlation coefficients (ICCs) were calculated to quantify the degree of dependency of measures within the same individual. 144 and 159 adolescents with JIA were evaluated according to OHI-S and GBI; corresponding numbers of controls were 154 and 161. Plaque and gingival bleeding were more frequent in individuals with JIA than controls. Adjusted analyses showed association between JIA status and OHI-S > 0 (OR = 2.33, 95% CI: 1.47 − 3.67, ICC = 0.45) and GBI > 0 (OR = 1.54, 95% CI: 1.10 − 2.16, ICC = 0.41 and 0.30). Surface-specific distribution of plaque varied among the two groups. Our results highlight the importance of increased awareness of oral health care in patients with JIA and that surface- and site-specific differences in periodontal outcomes exist between individuals with JIA and controls. Few JIA disease-specific variables associated with plaque or gingival bleeding. [ABSTRACT FROM AUTHOR]

Opioid maintenance treatment (OMT) patients in Norway are eligible for free oral healthcare services; however, oral health morbidity remains high and the uptake of services among this patient group is low. As knowledge of the reasons for the low uptake of services among OMT patients is insufficient, this study adopted a qualitative approach to explore this from the perspectives of patients and dental healthcare workers (DHWs). Through focus group and individual interviews, data were collected from 63 participants: 30 patients receiving OMT and 33 DHWs. Key themes were identified through a thematic analysis. Teeth were a significant factor in OMT patients' quality of life and recovery. Accompaniment to scheduled dentist appointments was identified as a facilitator by both the patients and the DHWs. The dentist-patient relationship was also seen as an important facilitator of dental treatment; DHWs with previous experience of treating OMT patients were valued by patients because of their high verbal and non-verbal communication. Helping OMT patients attend dental appointments, improving the dentist-patient relationship, and expanding stakeholders' knowledge of OMT patients' right to oral healthcare services may increase the uptake and benefits of dental healthcare services among OMT patients. The current support framework within the OMT system has the potential to increase the communication and efficiency of dental healthcare services available to patients undergoing OMT. [ABSTRACT FROM AUTHOR]

To identify regional differences in, and determinants of dental caries among children in western Norway We studied dental caries in 705 children aged 12 years and 18 years living in the southern region (n = 403) and other parts of Hordaland County (n = 302) in Norway. Information on oral hygiene, fluoride intake, and sugar consumption was collected using questionnaires. We also collected information from the Public Dental Service (PDS) on the history of decayed, missing, or filled teeth; professional fluoride application; recall and regular check-up intervals and treatment visits. Residence (southern region versus the rest of Hordaland, the reference) was the independent variable. We analysed regional differences in (i) caries prevalence and severity, (ii) potential contributors to caries, and (iii) procedures and routines in PDS. Caries prevalence and severity were higher in the southern region (67% and 24%, respectively). Self-reported brushing habits, fluoride use, and sugar consumption patterns were similar between regions. We observed more frequent application of professional fluoride (incidence rate ratio [IRR] = 3.05, 95% CI: 1.99–4.66], fewer check-ups [IRR = 0.88, 95% CI: 0.81–0.95], and fewer treatment visits [IRR = 0.77, 95% CI: 0.60–0.98] among participants in the southern region, compared to the rest of Hordaland. The recall intervals in the southern region were 10% longer among 12-year-olds and 10% shorter among 18-year-olds, compared to their respective counterparts in Hordaland. The observed regional gradients in caries experience mirrored regional differences in dental routines and procedures. Caries-related risk behaviours did not explain the observed differences in caries experience. [ABSTRACT FROM AUTHOR]

To assess if and to what extent public dental health personnel (PDHP) receive inquiries from child welfare services (CWS), and to assess whether PDHP's experience of receiving inquiries is associated with PDHP's characteristics and whether the associations are influenced by PDHP's experience of reporting to CWS. Questionnaires were distributed to 1542 PDHP in Norway. Descriptive statistics were used for analysis. Negative-binominal-regression analyses with incidence rate ratios (IRRs) and confidence intervals (CIs) were used to estimate the association between received inquiries from CWS and PDHP characteristics. From a total of 1074 respondents, 52.4% had received inquiries from CWS (2012–2014) with a mean number of 3.9 (SD = 4.5). PDHP's likelihood of receiving inquiries was significantly associated with having many patients, working in small municipalities, working in eastern Norway, having good knowledge of the Health Personnel Act, and having experience reporting to CWS. Regional differences were the only association that varied according to PDHP reporting activity. PDHP receive inquiries from the CWS. The likelihood of receiving inquiries is associated with several characteristics of PDHP. To increase PDHP's likelihood of receiving inquiries, it is important to establish contact between the CWS and PDHS and ensure that the PDHP has good knowledge of the Health Personnel Act. [ABSTRACT FROM AUTHOR]

This study examined stability and change of Norwegian dental health care workers' mandated reporting of suspected child maltreatment from 2014 to 2019 as well as the influence on reporting practices from regional, sociodemographic- and attitudinal factors. It was hypothesised that those factors associate independently with reporting practices across the survey period. In 2014 a census of 1542 dental health care workers employed in the public dental health care service (PDHS) were invited to participate in an electronic survey and 1200 (response 77.8%) consented to participation. Corresponding figures in 2019 were 1791 and 1270 (response 70.9%). Of the 1200 participants in 2014, 591 participated in 2019 (follow up 49.3%). A total of 58% and 25.7% of the dental health care workers confirmed ever reporting and avoidance of reporting in both survey years whereas 24.6% and 17.2% changed the status of ever- and avoiding reporting across time. The likelihood of being a stable reporter was greatest in experienced participants, those living in eastern parts of Norway and confirming professional obligations to report. At the population level, 59.6% and 79.5% confirmed ever reporting of suspected maltreatment in 2014 and 2019. Corresponding figures for confirmed avoidance of reporting were 33.9% and 37.9%. Reporting of suspected child maltreatment is maintained at a relatively high level and varies by socio-demographic and attitudinal concerns. [ABSTRACT FROM AUTHOR]

Objectives: To assess caries experience in Ugandan mothers according to HIV status, socio-behavioural-characteristics, gingival bleeding status and to examine whether HIV status impacts the association of socio-behavioural characteristics with caries experience. Third, using multilevel analysis, this study assessed to what extent surface-specific caries experience varied between and within individuals. Materials and methods: Caries experience was recorded using the World Health Organization’s Decayed, Missed and Filled Teeth/Surfaces indices from a cohort of 164 HIV-1-infected Ugandan mothers and a cross sectional comparison group of 181 negative controls. Mixed-effects logistic regression was conducted with surface-specific caries experience as the outcome variable. Results: The prevalence of caries in HIV-1-infected and uninfected mothers was 81% and 71%, respectively. Significant associations occurred between caries experience at surface level and women’s increasing age (odds ratio [OR]= 1.8, 95% confidence interval [CI]: 1.1–2.8) and presence of gingival bleeding (OR= 2.0, 95% CI: 1.2–3.2). Intra-class correlation (ICC) coefficient amounted to 0.54 (95% CI 0.48–0.59). Conclusions: Caries prevalence was higher in HIV-1 infected than in uninfected mothers and increased with age and gingival bleeding. ICC indicated that 54% of the variance was attributable to variation between individuals. Socio-demographic differences in dental caries did not vary by HIV-1 status. [ABSTRACT FROM AUTHOR]

Following community dwelling cohorts in Norway and Sweden from 65 to 70 years, this study aimed to answer the following questions; Is there cross country variation in educational inequality in tooth loss between the Norwegian and Swedish cohorts? Does oral health behaviours and attitudinal beliefs play a role in explaining educational inequality in tooth loss across time and cohorts? In 2007 and 2012 Statistics Norway administered mailed questionnaires to all individuals born in 1942 in three counties. The response rate was 58% (n = 4211) in 2007 and 54.5% (n = 3733) in 2012. In Sweden the same questionnaires were sent to the 1942 cohort in two counties. The final response rate in 2007 and 2012 were respectively, 73.1% (n = 6078) and 72.2% (n = 5697). In Norway, tooth loss prevalence was 21.8% in 2007 and 23.2% in 2012. Corresponding figures in Sweden were 25.9% and 27.3%. The prevalence of tooth loss was higher among lower than higher educated participants and the gradient was significantly weaker in Sweden than in Norway. Multiple variable analyses adjusting for oral behavioural and attitudinal variables attenuated education related gradients in both cohorts. Education related inequality in tooth loss was stronger in the Norwegian than in the Swedish cohort across the survey years. Oral behaviours and attitudinal beliefs played a role in explaining the gradients across time. This illustrates a necessity to promote oral health enhancing behaviours and attitudinal beliefs, particularly so in lower educational groups. [ABSTRACT FROM AUTHOR]

To assess knowledge, beliefs and attitudes related to treatment of MAR patients among dentists and dental hygienists. Secondly, to investigate to what extent dental health care professionals' attitudes associate with their treatment experience and beliefs regarding MAR patients. We conducted a cross-sectional study, involving a census of dental hygienists and dentists in the public dental health care services in Hordaland and Rogaland counties in Norway. Data were collected by electronically administered questionnaires. The response rate was 187/344, 54% (26% dental hygienists and 74% dentists). A majority of both professional groups did not find it difficult to understand information on oral health and drug use. Although they confirmed familiarity with guidelines on good dental practice, they had received little information about oral health aspects of substance use. Both groups had slightly negative attitudes towards treatment of MAR patients. Beliefs that completion of treatment is often unsuccessful and that information on drug use and oral health is difficult to interpret associated with negative attitudes towards treatment. The findings suggest that promotion of information to dental care personnel to extend their knowledge and improve their skills regarding oral health aspects of substance use might contribute to positive attitudes and improved utilisation of the free dental care offered to MAR patients. [ABSTRACT FROM AUTHOR]

Objective: Focusing dentists and dental hygienists employed in the Public Dental Health Services (PDHSs) in Norway, this study set out to assess whether socio-demographic factors, familiarity with nanotechnology and social trust are associated with dental health care workers' perceived risks and benefits of use of nanomaterials in dentistry and whether those associations varied according to professional status. It was hypothesized that increased knowledge, trust in stakeholders and familiarity with nanomaterials would decrease the risk and increase benefit perceptions among dental health care workers.Methods: Electronic questionnaires were administered to a census of 1792 dentists and dental hygienists.Results: About 64% and 69% of respondents perceived respectively, risk and benefits associated with use of nanomaterials. Multiple variable logistic regression revealed that dentists were more likely than hygienists to perceive risks (OR = 1.9, 95% CI 1.1-3.3) and benefits (OR = 3.6, 95% CI 2.1-6.2). Having experience with dental nanomaterials (OR = 2.2, 95% CI 1.3-3.7) and feeling safe (OR = 6.6, 95% CI 3.1-14.2) increased perceived benefits. Having moderate or much correct knowledge about nanotechnology (OR = 2.3, 95% CI 1.5-3.5) increased the likelihood of perceived risk.Conclusions: Policy makers should consider the factors that influence dental health care workers' risk and benefit perceptions associated with the use of nanomaterials in dentistry. [ABSTRACT FROM AUTHOR]

Objective: To examine whether long-term utilization of dental care, treatment with fillings and crowns and persistent tooth loss between age 50 and 65 years associate with subsequent changes in OHRQoL from age 65 to 70 years.Method: In 1992, a census of 50-year-olds received invitation to participate in a questionnaire survey. Of 6346 respondents, 3585 completed follow-ups in 1997, 2002, 2007 and 2012. OHRQoL was measured using the Oral Impacts on Daily Performances (OIDP) inventory.Results: Around 70.4%, 11.2% and 18.4% confirmed respectively, no change, worsening, and improvement in OIDP scores between age 65 and 70 years. Compared to those being permanent non-routine dental attenders, ORs of improving and worsening of OIDP were respectively, 0.4 and 0.6 if being a permanent routine dental attender. ORs for improving OIDP was 1.6 if reporting persistent specialist attendance and 2.5 if having received crowns and fillings. Participants with permanent tooth loss were most likely to both worsen and improve OIDP.Conclusion: Long-term routine dental attendance and permanent tooth loss occurred as predictors simultaneously for improvement and worsening of OIDP. Accumulation of advantages and disadvantages throughout the life-course increases and decreases the probability of improvement and worsening in OIDP among older people in Sweden. [ABSTRACT FROM AUTHOR]

Objectives: To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen's model.Methods: Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data.Results: Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only.Conclusions: In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people. [ABSTRACT FROM AUTHOR]

Objective: Detecting and responding to child-maltreatment is a serious challenge and public health concern. In Norway, public dental health personnel (PDHP) have a mandatory obligation to report to child welfare services (CWS) if they suspect child-maltreatment. This study aimed to assess PDHP's frequency of reporting and failing to report to CWS and whether the frequencies varied according to personal, organizational and external characteristics.Material and Methods: An electronic questionnaire was sent to 1542 public dental hygienists and dentists in Norway, 1200 of who responded (77.8%).Results: The majority 60.0%, reported having sent reports of concern to CWS throughout their career, 32.6% had suspected child-maltreatment but failed to report it in their career and 42.5% had sent reports during the three-year period from 2012 to 2014. The reporting frequency to CWS was influenced by PDHP's personal, organizational and external characteristics, while failure to report was influenced by personal characteristics.Conclusions: Compared to international studies, PDHP in Norway sends reports of concern and fails to report to CWS at relatively high rates. PDHP's likelihood of reporting was influenced by age, working experience, number of patients treated, size of the municipality and geographical region, while failure to report to CWS was influenced by working experience. [ABSTRACT FROM AUTHOR]

Objectives: The first objective of this study is to examine the association between caretakers’ caries experience and caries experience of their children. Second, to investigate whether children’s and caretaker’s caries experience is associated with oral health-related quality of life (OHRQoL) of children and their families. Methods:This study is based on the prenatal recruitment interviews and the 5-year follow-up of 417 caretaker–children pairs from the Ugandan site of the PROMISE-EBF trial conducted in Mbale, Eastern Uganda. Face-to-face interviews were conducted with caretakers at the household level. Caries experience of caretakers (DMFT >0) and children (dmft >0) were assessed in accordance with the criteria of the World Health Organization. OHRQoL was assessed using an abbreviated version of the Early Childhood Oral Health Impact Scale (ECOHIS). Results:Adjusted negative binomial regression analysis revealed that caretaker’s caries experience was positively associated with early childhood caries of their offspring (IRR 2.0, 95% confidence interval (CI) 1.3–3.0). Children’s caries experience (IRR 1.8, 95% CI 1.2–3.0), but not caries experience of caretakers, was associated with worse OHRQoL of children and their families. Caretakers who perceived good child oral health were less likely to report OHRQoL impacts (IRR 0.20, 95% CI 0.12–0.35). Conclusion:Improving caretaker’s caries experience and her perception of child’s oral health status could improve children’s caries experience and the OHRQoL of children and family. Such knowledge is important and should inform public oral health programs for young children. [ABSTRACT FROM PUBLISHER]

Objective. Focusing on 6-36 months old infants, this study assessed (1) whether socio-economic status, current anthropometric status, presence of enamel hypoplasia, number of erupted teeth, oral hygiene and consumption of sugared snacks varied between children with normal birthweight (NBW) and low birthweight (LBW) and (2) the association between ECC and birthweight whilst adjusting for covariates of ECC, such as current anthropometric status. Method: A cross-sectional study was conducted in Kampala in 2007, involving 816 child/caretaker pairs. All caretakers completed face-to-face interviews. Children were examined for ECC and enamel defects using WHO (1997) criteria and the developmental defects of enamel (DDE) index. Weight at birth was obtained from hospital records and current anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ). Results. Prevalence of LBW (< 2500 g) and ECC were estimated to 11.5% and 18.1%, respectively. Children with LBW and those with ECC presented with more visible plaque, higher sugar consumption and more current underweight (WAZ < −2) than children with normal birth weight (NBW) and no caries; 26.7% of LBW vs 17.3% ( p < 0.001) of NBW children presented with ECC. Enamel defects (OR = 2.8, 95% CI = 1.6-4.8) and presence of visible plaque (OR = 2.4, 95% CI = 1.3-4.1), but not LBW, were associated with ECC in multiple variable logistic regression analyses. Conclusion. Both LBW and ECC were associated with poor oral hygiene, high intake of sugars and current underweight. Enamel defects were associated with ECC. Adjusting for covariates there were no clear association between LBW and ECC. Studies using a prospective study design are needed for further investigation. [ABSTRACT FROM AUTHOR]

Objective. To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC. Method. Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child-caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding. Results. Cohen's kappa for intake of sugar items ranged from 0.40-1.0, with no differences observed between average intakes at test-re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC. Conclusion. Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers. [ABSTRACT FROM AUTHOR]

Objective. To assess the impact of oral health promotion integrated with a health promoting school (HPS) initiative on the oral health outcomes of secondary school students. Materials and method. Using an urban-rural stratified cluster randomized approach, the intervention was applied to secondary school students in Arusha, Tanzania. In the urban, three control ( n = 315) and two intervention ( n = 214) schools performed oral clinical examination and questionnaires at baseline. In rural the corresponding figures at baseline were two ( n = 188) and three ( n = 360) schools. After 2 years, 374 and 358 students remained in the intervention and control arms. Results. Mean number of decayed teeth (DT) increased in the intervention (mean score 1.0 vs 1.7, p < 0.001) and control schools (mean score 1.2 vs 1.7, p < 0.001). Mean number of teeth with plaque decreased significantly in intervention and control schools. No significant difference in caries increment and plaque decline scores was observed between groups. Mean number of teeth with bleeding decreased (0.5 vs 0.3, p < 0.05) in intervention schools, whereas no change was observed in the control schools (0.4 vs 0.5, p = 0.051). Increment in mean number of DT between baseline and follow-up was largest and smallest in students who, respectively, deteriorated and improved their plaque and bleeding scores. Conclusion. The intervention activities did not show any effect with respect to dental caries, calculus and plaque status among the students investigated. Compared with the control group, more favorable changes in the intervention group occurred with respect to bleeding on probing, suggesting a weak but positive effect on students' oral hygiene status. [ABSTRACT FROM AUTHOR]

Objective. The aims of this study were to identify explanatory factors of satisfaction with oral health among Norwegian and Swedish 65 year olds in terms of items from four different domains of ICF and to compare the strengths of the various ICF domains in explaining satisfaction with oral health. Further it was to assess whether the explanatory factors of ICF domains vary between Norway and Sweden. Materials and methods. In 2007, standardized questionnaires were mailed to all the residents in certain counties of Sweden and Norway who were born in 1942. Response rates were 73.1% ( n = 6078) in Sweden and 56.0% ( n = 4062) in Norway. Results. In total, 33 questions based on four different ICF domains were chosen to explain satisfaction with oral health. Logistic regression showed that four different ICF domains in terms of body function, body structure, activity/participation and environmental factors explained, respectively, 53%, 31%, 12% and 34% of the explanatory variance in the satisfaction with oral health. In the final analysis, only nine items were statistically significant ( p < 0.05). Conclusion. This study indicates that ICF as a conceptual model could cover a broad spectrum of factors embedded in OHRQoL measured by a global question in Sweden and Norway. Nine items, representing four ICF domains, were important in the final model for explaining satisfaction with oral health. [ABSTRACT FROM AUTHOR]

Objectives . This study aimed to assess the long-term effect of socio-behavioral characteristics on oral impacts on daily performances (OIDP) at age 65 and the influence on OIDP at age 65 of changes in socio-behavioral characteristics between age 50 and 65. Methods . In 1992, all 50-year-olds in two counties of Sweden were invited to participate in a longitudinal survey. A total of 6346 responded and, of those, 4143 completed follow-ups at ages 55, 60 and 65 years. Results . At age 65, 26.9% had oral impacts. Subjects being immigrants, being unmarried, reporting economic barriers, bad general health, bad quality dental care, less than annual dental attendance, limited social network and smoking at age 50 experienced oral impacts at age 65 more frequently than their counterparts in the opposite groups. Compared to the stable advantaged groups, stable disadvantaged groups regarding marital status, health status, smoking and reported quality of care had increased ORs for oral impacts. Compared to the stable advantaged groups, those who experienced deterioration with respect to health status, dental attendance and quality of oral health care and those who quitted smoking had increased ORs for oral impacts. Conclusions . Disadvantaged socio-behavioral condition at age 50 had a long lasting detrimental effect on OHRQoL at age 65. Deterioration in socio-behavioral circumstances was associated with increased oral impacts. Early protection against the effect of socio-behavioral adversity by imposing economic barriers, ensure provision of high quality care and by promotion of healthy lifestyles seems to have the potential to reduce oral impacts at older ages. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to evaluate the factor structure of health and oral health-related behaviors and it's invariance across gender and to identify factors associated with behavioral patterns. Materials and methods . A cross-sectional study included 2412 students attending 20 secondary schools in Arusha. Self-administered questionnaires were completed at school. Results . Principal component analysis of seven single health and oral health-related behaviors (tooth brushing, hand wash after latrine, hand wash before eating, using soap, intake of sugared mineral water, intake of fast foods and intake of sweets) suggested two factors labeled hygiene behavior and snacking. Confirmatory factor analyses, CFA, provided acceptable fit for the hypothesized two-factor model; CFI == 0.97. Multiple group CFA across gender showed no statistically significant difference in fit between unconstrained and constrained models ( p == 0.203). Logistic regression revealed ORs for hygiene behaviors of 1.5, 0.5, 1.5, 1.5 and 0.6 if being a girl, current smoker, reporting good relationship with school, access to hygiene facilities and bad life satisfaction, respectively. ORs for snacking were 1.3, 1.4, 0.4 and 0.5 if female, in the least poor household quartile, low family socio-economic status and high perceived control, respectively. Conclusion . The two factors suggest that behaviors within each might be approached jointly in health promoting programs. A positive relationship with school and access to hygiene facilities might play a role in health promotion. Provision of healthy snacks and improved perceived behavioral control regarding sugar avoidance might restrict snacking during school hours. [ABSTRACT FROM AUTHOR]

Objective. Guided by the conceptual framework of Gilbert and co-workers, this study assesses satisfaction with oral health as reported by 65-year-olds in Sweden and Norway, the relationship of socio-demographic factors, clinical and subjective oral health indicators with satisfaction of oral health, and the consistency of those relationships across countries. Material and methods. In 2007, standardized questionnaires were mailed to all the residents in two counties in Sweden and three in Norway who were born in 1942. Response rates were 73.1% (n=6078) in Sweden and 56.0% (n=4062) in Norway. Results. Totals of 76.8% of the Swedish and 76.5% of the Norwegian participants reported satisfaction with oral health. Corresponding figures for toothache were 48.1% (Sweden) versus 51.5% (Norway), and for temporomandibular joint symptoms, 10.9% (Sweden) versus 15.1% (Norway). Multiple logistic regression analysis revealed that subjects who perceived they had bad health, smoked daily, had missing teeth, experienced toothache, had problems with chewing, bad breath, and oral impacts were less likely than their counterparts in the opposite groups to be satisfied with their oral health status. The corresponding odds ratios (ORs) ranged from 0.08 (problems chewing) to 0.2 (oral impact). No statistically significant two-way interactions occurred and the model explained 46% of the variance in satisfaction with oral health across the two countries (45% in Sweden and 47% in Norway). Conclusions. The oral condition of 65-year-olds in Norway and Sweden produced impacts in oral symptoms, functional limitations, and problems with daily activities that varied to some extent. Satisfaction with oral health varied by socio-demographic factors and subjective oral health indicators. A full understanding of the oral health and treatment needs of 65-year-olds cannot be captured by clinical measures alone. [ABSTRACT FROM AUTHOR]

Objective. The aim of the study was to assess dental fluorosis (DF) in the deciduous and permanent teeth of children in areas with high-F coal (area A) and high-F water (area C) compared to children from area B, with low-F water and coal. Material and Methods. 596 children were examined. DF was assessed by TF-score. F-content of indoor air, drinking water, coal, tea, rice, and maize was analyzed. Results. F-content of air and coal ranged from 3.2 µg/m3 and 25.8 mg/kg (area B), 3.8 µg/m3 and 36.3 mg/kg (area C) to 56.8 µg/m3 and 713.1 mg/kg (area A). Likewise, mean F-content of water ranged from ∼0.50 mg/l (areas A and B) to 3.64 mg/l (area C). F-content of tea leaves was similar in all three areas. Maize and rice contained <5 mg F/kg. Prevalence of primary teeth with DF was 49.1%, 2.0%, and 66.8% in areas A, B, and C, respectively. Similarly, DF was found in 96.7% (area A), 19.6% (area B), and 94.4% (area C) of the permanent teeth. Severe fluorosis (TF ≥ 5) was found in area A (47.0%) and area C (36.1%) (p<0.01). Early erupting teeth had slightly higher mean TF-scores in area A than in area C. Conclusions. DF was prevalent in both dentitions in areas A and C. Similarity in percentages of DF may indicate that indoor air with ∼60 µg F/m3 and drinking water with 3.6 mg F/L are similarly toxic to developing permanent teeth. The percentage of deciduous teeth with DF was significantly lower in area A compared to area C. Where low-F coal and low-F water were used (area B), ∼20% of permanent teeth had DF, indicating a relatively low tolerance to fluoride in Chinese children brought up under the present living conditions. [ABSTRACT FROM AUTHOR]

Objectives: To study the dental fluorosis and caries in the permanent teeth of 12 to 13-year-old children in fluorosis-endemic areas; to assess the relationship between fluorosis and the fluoride content of the drinking water and the relationship between caries and the fluoride content of the water; finally, to analyze the effect of fluoride intake and water stored in clay pots on dental fluorosis.Material and Methods: 477 children were divided into 5 groups (A to E) according to the fluoride concentration of the waters, i.e. by 0.4, 1.0, 1.8, 3.5, and 5.6 mg F/l, respectively. Dental fluorosis was assessed by TF score and caries by the DMF-T index. A questionnaire was used to obtain information about water storage and other information relevant to children's fluoride intake.Results: A positive relationship was found between the mean TF scores and the water fluoride concentration. In groups B and D, the TF score was higher in 13-year-olds than in 12-year-olds. Caries prevalence and mean DMF-T ranged from 2.6% and 0.03 (group E) to 22.1% and 0.38 (group A). Storage of water in clay pots seemed to increase the severity of fluorosis slightly, and to decrease the caries prevalence.Conclusions: Defluoridation of drinking water, or--alternatively--the provision of low-fluoride water sources, should be given high priority in the examined Shaanxi rural areas. Fluoride concentration of drinking water should be maximum 0.6 mg/l. Storage of water in the local clay pots may increase the severity of dental fluorosis. [ABSTRACT FROM AUTHOR]

The objective was to assess the socio-demographic variation in caries experience and sugar intake among urban (Kampala) and rural (Lira) students in Uganda. In a cross-sectional survey, a total of 1146 adolescents aged between 13 and 19 years (response rate 87%) attending 10 secondary schools, 5 rural and 5 urban, completed questionnaires in respective schools. Clinical examination was conducted among 372 respondents (response rate 90%) from the main survey and dental caries was assessed. The results showed that a total of 80% of the students had DMFT >0. The corresponding rates in Kampala and Lira were 85% and 76% (P < 0.05), respectively. The mean DMFT, DT, and MT for the sample were 2.9, 2.5, and 0.5. Adjusted mean DMFT scores were 2.4 in Kampala and 3.3 in Lira (P < 0.05). The mean frequency sugar score was 2.6 and sugar consumption was higher in females and in students of highly educated parents compared to their counterparts in the opposite groups. In conclusion, higher mean DMFT scores in urban than in rural areas are often reported from developing countries but this does not seem to apply to the Ugandan areas investigated. Kampala and Lira students were equally exposed to sweets and soft drinks but the differences in sugar consumption between students of higher and lower educated parents were most marked in Lira. [ABSTRACT FROM AUTHOR]

This study was conducted in three Ethiopian Rift Valley villages known for endemic fluorosis. Three-hundred-and-six adolescents (12-15 years) and 233 mothers participated. The aim was to study dental fluorosis in the youngsters and to assess the extent of agreement between clinical and self-rated discoloration and pitting of teeth, and also the level at which dental fluorosis is perceived as a problem both by children and their mothers. The children (154 M and 152 F) gave a simple self-assessment of tooth-color and quality of their teeth, and were subsequently examined for dental fluorosis. Finally, four color photographs of teeth with dental fluorosis (TF-scores 2, 3, 5, and 7) were used as references during a structured oral interview of the children, as well as their mothers. At TF score > or = 2, the prevalence of dental fluorosis on maxillary central incisors was 72% and 37% at TF score > or = 4. The mean TF score was significantly higher among boys than among girls of unemployed fathers compared to children of employed fathers. The likelihood of reporting problems with dental appearance increased with increasing individual TF scores. The child/mother pairs found teeth with TF scores 2 and 3 esthetically acceptable, while teeth with TF scores 5 and 7 were considered unacceptable. Mothers were more critical of severe fluorosis than were their children. [ABSTRACT FROM AUTHOR]

This study applies an abbreviated version of the Oral Impacts on Daily Performances (OIDP) and the Life Satisfaction scale to oral-health-related quality of life (OHRQOL) and quality of life (QOL) among Tanzanian university students. The following questions were addressed: Are social and behavioral status associated with overall OIDP frequency scores? Do social and behavioral variables contribute to the explainable variance of the OIDP frequency scores beyond the effect of clinical indicators of oral disorders? Do OIDP frequency scores influence general QOL as measured by the Life Satisfaction scale? A two-wave cross-sectional study was conducted during the summer of 1999, involving 19-45-year-old students at the University of Dar es Salaam. One-thousand-one-hundred-and-twenty-three students completed self-administered questionnaires and 228 respondents were re-examined clinically after 4 weeks. The rates of tooth decay and tooth loss were 34% and 37%, respectively. Medical-non-medical status (OR = 2.7) self-perceived health status (OR = 2.7), and sugar avoidance (OR = 2.2) varied systematically with OIDP scores in multivariate analyses. Tooth decay and tooth loss alone contributed 10% to the explainable variance in the OIDP scores. Entering social and behavioral variables increased the explainable variance to 19%. Finally, life-satisfaction scores varied systematically and positively with the OIDP frequency scores in bi- and multivariate analyses. This study gives some indications that the social and behavioral contexts of Tanzanian university students are important in shaping their responses to oral disorders. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate 1) the temporal changes in oral health behaviors and 2) the development of the distribution of oral health behaviors on the basis of socioeconomic factors among Norwegian adolescents from 1985 to 1997. Large-scale national surveys to assess smoking, intake of sweets, soft drink consumption, and toothbrushing among Norwegian adolescents were conducted in November 1985, 1989, 1993, and 1997. The surveys were part of the World Health Organisation (WHO) international study, Health Behaviour in School-aged Children. A total of 3955 (1985), 5037 (1989), 4952 (1993), and 5026 (1997)11-, 13-, and 15-year-old students completed anonymous questionnaires at school. The response rates varied from 79% to 90%. The results showed a strong increase in the percentages reporting ever smoking and daily intake of soft drinks and sweets with age from 11 to 15 years in each survey year. In 1997, at the age of 15 years, most students reported toothbrushing more than once a day (94% boys, 97% girls) and ever smoking (39% boys, 36% girls), whereas moderate proportions confirmed daily intake of soft drinks (28% boys, 19% girls). Comparison of the results across the survey years, from 1985 to 1997, showed an overall decrease in ever smoking (boys, 59% versus 39%; girls, 52% versus 36%) and toothbrushing more than once a day (boys, 95% versus 94%; girls, 99% versus 97%). Contemporary increases occurred with regard to daily soft drink consumption. Inequalities in ever smoking and daily soft drink consumption between socioeconomic status groups decreased and increased, respectively, from 1985 to 1997. The sex disparities observed in 1985, with boys being more likely than girls to report ever smoking and daily soft drink consumption, leveled off in 1997. [ABSTRACT FROM AUTHOR]

This study was designed to assess levels of oral health knowledge, beliefs and self-reported behavior among teacher trainees in Uganda and Tanzania. Anonymous questionnaire data were collected from trainees attending the final year at teacher training colleges in Rungwe district, Tanzania, in 1997, and in Mbale and Kampala districts of Uganda, in 1998. A total of 195 trainees from Tanzania and 225 trainees from Uganda participated. Results from Pearson's χ[sup 2] test and independent sample t tests indicated that Tanzanian students had less experience with oral impairments, were more resolutely prepared to teach about the importance of personal habits for oral health maintenance, and had higher levels of oral health knowledge than Ugandan students. Ugandan students endorsed frequent consumption of sugar products more often than their Tanzanian counterparts, but they were more diligent in visiting dentists. Most of the Tanzanian (97.4%) and Ugandan (95.6%) students reported daily toothbrushing. In both countries, beliefs about the importance of preventive behaviors for oral health were closely related to the frequency with which such habits occurred. This cross-cultural consistency highlights the importance of cognitive factors. The implications for oral health educational programs among teacher trainees across East African countries are discussed. [ABSTRACT FROM AUTHOR]