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Stigma towards men who have sex with men (MSM) is prevalent, and many MSM are married to women. This study aims to provide acomprehensive understanding of coping strategies and the need for support among women in serodiscordant relationships with MSM living with HIV. We conducted 19 qualitative in-depth interviews with these women living in Sichuan, China. Semi-structured interviews were recorded and transcribed. Qualitative data were transcribed verbatim and analyzed using content analysis. We found that these women utilized multiple coping strategies both within the family and externally. Coping strategies within the family included keeping husbands' HIV diagnosis confidential, integrating husband's HIV treatment management into family routines, restoring spousal relationship, protecting themselves from HIV infection, denying, self-blaming, and persuading the husbands to see the psychiatrist due to homosexual behaviors. Coping strategies outside the family included seeking information from multiple sources, peer support, and online support. Participants expressed needs for more information, psychological support, stigma reduction, and special counseling on how to handle their husband's homosexual identity and/or behavior. Women married to MSM living with HIV develop both adaptive and maladaptive coping strategies, and the majority of these women's needs are unmet under the current service system in China. [ABSTRACT FROM AUTHOR]

Background: To investigate changes in facial morphology during the first six months of orthodontic treatment among adult females receiving orthodontic treatment. Methods: 43 adult females receiving orthodontic treatment were randomly recruited. 3D facial images were taken at baseline (T0), three months (T1), and six months (T2) after treatment initiation. Spatially dense facial landmarks were digitized to allow for sufficient details in characterization of facial features. 3D geometric morphometrics and multivariate statistics were used to investigate changes in mean and variance of facial shape and facial form associated with treatment. Results: We observed statistically significant changes in facial shape across the three treatment stages (p = 0.0022). Pairwise comparisons suggested significant changes from T0 to T1 (p = 0.0045) and from T0 to T2 (p = 0.0072). Heatmap visualization indicated that the buccal and temporal region were invaginated while the labial region became protruded with treatment. The magnitude of shape change was 0.009, 0.004, and 0.010 from T0 to T1, T1 to T2, and T0 to T2, respectively, in unit of Procrustes distance. The average magnitude of change per-landmark was 1.32 mm, 0.21 mm, and 1.34 mm, respectively. Changes in mean facial form were not statistically significant (p = 0.1143). No changes in variance of facial shape were observed across treatment stages (p > 0.05). Conclusion: Rate of facial changes was twice as fast during the first three months as that during fourth to sixth month. Buccal and temporal region became invaginated while labial region became protruded with treatment. [ABSTRACT FROM AUTHOR]

This study explored the impact of serostatus disclosure on the spousal relationship between wives and their HIV-positive husbands who have had sex with men. A qualitative study using semi-structured interviews was conducted in Sichuan, China in 2017 with wives (n = 31) who had known their husbands' HIV-positive status. Participants were identified by local governmental and non-governmental organizations that provide routine services for people living with HIV and their family members. Qualitative data underwent a detailed content analysis. Both positive and negative impacts on the spousal relationship were expressed by wives. Six themes were identified: (1) reduced sexual activities; (2) changes in intimacy; (3) limited communication on HIV-related issues but improved communication on other topics; (4) increased instrumental support but decreased emotional support; (5) improved resilience in the spousal relationship; and (6) shared privacy management rules regarding HIV-positive status. Moreover, the acknowledgment of the husband's homosexual behavior hurt the spousal relationship more seriously than the disclosure of the husband's HIV-positive status, and irremediable marriages were observed among wives who knew both. Disclosure of HIV-positive status had a great impact on the spousal relationship, though such impact varied across individuals. [ABSTRACT FROM AUTHOR]

Background/purpose There is a need to comprehensively investigate the relationship between tooth eruption and obesity. The study aimed to investigate the relationship between erupted permanent tooth number and obesity among 12-year-old children in a population-based study. Materials and methods A random sample of 806 12-year-old schoolchildren in Hong Kong was recruited. Oral examinations were conducted and the eruption status of the permanent teeth was assessed. Body height, body weight, waist circumference (WC), hip circumference, and triceps skinfold thickness (TRSKF) were measured to assess the adiposity statuses [weight-height ratio (W/H) and body mass index (BMI) for general obesity; WC and waist-hip ratio (WHR) for central obesity; and TRSKF for peripheral obesity]. The relationships between erupted permanent tooth number and adiposity statuses were examined in bivariate analysis and analysis of covariance. Results The response rate was 82.9% ( n = 668/806). Three hundred and forty-six (50.9%) children had 28 teeth erupted. Second molars had the highest rate of noneruption (17.5–35.8%). The mean number and standard deviation (SD) of erupted permanent tooth were 26.4 (2.4). The mean value and SD were 31.1 (6.3) for W/H, 19.8 (3.7) for BMI, 70.4 (9.4) for WC, 0.82 (0.06) for WHR, and 11.8 (4.5) for TRSKF, respectively. After accounting for sociodemographic factors, analysis of covariance identified that W/H, BMI, WC, and WHR were positively associated with the number of erupted permanent teeth (P < 0.01). Conclusion Erupted permanent tooth number was positively associated with obesity (general and central) among a population-based sample of 12-year-old children in Hong Kong. [ABSTRACT FROM AUTHOR]

Background To date, research on the relationship between dental caries experience and adiposity status is debated. Aim To determine associations between dental caries experience and adiposity status among a community sample of preschool children in Hong Kong. Design Among a random sample of 5-year-old children, clinical assessment for dental caries was conducted using WHO criteria. Anthropometric measurements for body weight, body height, waist circumference ( WC), hip circumference, and triceps skinfold thickness ( TRSKF) were performed to assess general adiposity, central adiposity, and peripheral adiposity. Associations between adiposity status and caries were examined in regression analyses. Results The response rate was 83.1% (324/390). Regression analyses (adjusted for tooth brushing habits, snacking habits, and socio-demographic factors) identified that weight/height ratio z-score was associated with caries experience: prevalence of dental caries experience (dmft > 0), OR 1.41 (95% CI 1.04, 1.91), and 'very high' caries experience (dmft ≥ Si C10 Index value), OR 1.62, (95% CI 1.05, 2.50). In addition, WC z-score was associated with 'very high' caries experience (dmft ≥ Si C10 Index value), OR 1.72, 95% CI 1.06, 2.81. Conclusion In a Hong Kong community sample of preschool children, dental caries experience was associated with general adiposity (as assessed by weight/height ratio) and central adiposity (as assessed by WC). [ABSTRACT FROM AUTHOR]

Objectives To compare the prevalence and severity of diffuse opacities among subjects whose maxillary incisors developed during periods with different concentrations of fluoride in the Hong Kong public water supply. Methods Standardized intra-oral photographs of random samples of 12-year-old children were collected in 1983, 1991, 2001 and 2010 ( n = 2658) in Hong Kong and were assessed for diffuse opacities by a calibrated and blinded examiner. The fluoride concentrations in the public water supply at the times when the enamel on their maxillary incisors developed were 1.0, 0.7, 0.5 and 0.5 ppm, respectively. Results The mouth prevalence figures for diffuse opacities of these children (based on the maxillary incisors) were 89.3%, 48.5%, 32.4% and 42.1 in the years 1983, 1991, 2001 and 2010, respectively. Variation in the mouth and tooth prevalences of diffuse opacities was apparent among the four different year groups ( P < 0.0001). Marked differences in severity of diffuse opacities, in terms of different subtypes and maximum extent of tooth affected, were also observed in association with the year of study ( P < 0.001). Conclusions The prevalence and severity of diffuse opacities among maxillary incisor teeth of Hong Kong children decreased from 1983 and then increased in 2010; however, this change did not fully correspond to the concentration of fluoride in the drinking water during the time of enamel development. [ABSTRACT FROM AUTHOR]

Background Oral health literacy is a newly emerging field with considerable research potential. Aim To validate an original instrument, the Hong Kong Oral Health Literacy Assessment Task ( HKOHLAT-P) for paediatric dentistry. Design A convenient sample of 200 child/parent dyads attending a dental hospital in Hong Kong was selected. Convergent validity was tested by examining the association of HKOHLAT-P scores with those derived from the Test of Functional Health Literacy in Dentistry ( TOFHLi D) and Hong Kong Rapid Estimate of Adult Literacy in Dentistry ( HKREALD-30). The predictive validity of HKOHLAT-P was determined by testing the association between HKOHLAT-P and children's caries experience (dmft) and the Chinese Early Childhood Oral Health Impact Scale ( ECOHIS). The test-retest reliability and internal consistency of HKOHLAT-P were also evaluated. Results HKOHLAT-P was positively correlated with TOFHLi D and HKREALD-30 ( P < 0.01), and was negatively correlated with children's dmft and ECOHIS. In the regression model, HKOHLAT-P was associated with TOFHLi D, HKEALD-30, children's dmft, and ECOHIS ( P < 0.05) after controlling for participants' demographic characteristics. The intra-class correlation coefficient of HKOHLAT-P was 0.63 and the Cronbach's α was 0.71. Conclusion Initial testing of HKOHLAT-P suggested that it is a valid and reliable instrument. [ABSTRACT FROM AUTHOR]

Wong HM, McGrath CPJ, King NM. Rasch validation of the early childhood oral health impact scale. Community Dent Oral Epidemiol 2011; 39: 449-457. © 2011 John Wiley & Sons A/S Abstract - Objectives: The early childhood oral health impact scale (ECOHIS), a proxy measure to assess the impact of oral health problems and on the quality of life of preschool children and their families, has been translated into Chinese and validated employing the classical test theory. However, some invariable problems are related to this theory. The objective of this study was to assess the metric properties of the ECOHIS by applying the item response theory. Methods: A random sample of 1296 Chinese preschool children in Hong Kong participated in the study and were subjected to an oral examination for their caries status. Their parents were asked to respond to the ECOHIS and an extra set of questions concerning their socio-demographic backgrounds. The collected data were analysed using Rasch model. Results: The obtained results support the interpretation of adequate total fit of persons and items, because the mean infit MNSQ (1.08) and outfit MNSQ (0.94) for persons, and the mean infit MNSQ (0.99) and outfit MNSQ (0.94) for items, are within the acceptable ranges (0.6-1.4). The difficulty spread of the items was between −0.81 and 1.96 logits, and the levels of respondents spanned from −5.56 to 6.72 logits on the person-item map. The spread of respondents was skewed and mistargeting, between the items and respondents, was confirmed. Combination of responses of 'often' and 'very often' was suggested because of their flat probability showing on the characteristic curves. Conclusions: Rasch model has been shown to be a feasible and practicable way of assessing the metric properties of the ECOHIS. The results allow the use of ECOHIS to be recommended for clinical research in oral health-related quality of life in young children with minor modifications. [ABSTRACT FROM AUTHOR]

Background: There is a need to comprehensively investigate the relationship between tooth eruption and infant growth to explain the theory of tooth emergence. This study aimed to investigate the association between infant growth during the first year of life and the emergence of the permanent teeth. Methods: A random sample of 668, 12-year-old students was recruited from a birth cohort. Erupted permanent tooth number was recorded. The association of infant growth (growth trajectories and growth rates) and permanent tooth emergence was examined through logistic regression analyses. The regression model was adjusted by potential confounders including gender, gestational age, mode of delivery, type of feeding, parental education, and health status. Results: The response rate was 76.9% (n = 514). Two hundred and forty-five (47.7%) children had all 28 permanent teeth erupted. Infants who had higher birth weight z-scores and those who had grown slowly during the first three months of life were more likely to have complete permanent teeth emergence at their 12-year-old in both unadjusted (p < 0.01) and adjusted model (adjusted for gender, gestational age, mode of delivery, type of feeding, parental education, and health status, p < 0.01). However, no significant association was found between the growth trajectories and permanent tooth emergence in either unadjusted or adjusted models (p > 0.05). Conclusion: Birth weight and infant growth during the first three months of life might be associated with permanent tooth emergence at their 12 years of age. This association may be applied in the assessment of risk for dental caries or malocclusion. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to identify the trends in incidence and prevalence of untreated caries in permanent teeth in China during 1993-2017.Methods: Data representing >31 billion person-years of observation from the Global Burden of Disease study 2017 were analyzed. Age-period-cohort modeling was performed to investigate the trends in untreated caries that may be of value to policymakers. Analyses were conducted in 2019-2020.Results: Prevalence of untreated caries in permanent teeth decreased steadily before 2010; after which, an increasing trend was noted without the signs of plateauing (age-adjusted annual percentage change, 1993-2017: -0.54%, 95% CI= -0.75%, -0.33%; declining period RR, 1993-2017: p=6.33 × 10-9; declining cohort RR, 1993-2017: p=3.46 × 10-6). Although untreated caries prevalence declined overall among multiple age groups (p<0.05), an increase in prevalence after 2010 was noted. This was driven by the deteriorating oral health condition in recent birth cohorts aged <25 years. Estimates of the longitudinal age trend (incidence: -0.013, 95% CI= -0.015, -0.011; prevalence: -0.0038, 95% CI= -0.0060, -0.0015) suggested that the highest untreated caries incidence and prevalence rate were both observed among young adults aged 20-24 years. No differences between incidence and prevalence of untreated caries were observed among adults aged >55 years (p>0.05).Conclusions: The increased burden of untreated caries in China after 2010 is driven by those aged <25 years. Untreated caries data from the Global Burden of Disease study are a valid complement to the data from the Chinese National Oral Health Epidemiology Surveys. [ABSTRACT FROM AUTHOR]

Abstract: Dental age assessment is one the most accurate methods for estimating the age of an unknown person. Demirjian''s dataset on a French-Canadian population has been widely tested for its applicability on various ethnic groups including southern Chinese. Following inaccurate results from these studies, investigators are now confronted with using alternate datasets for comparison. Testing the applicability of other reliable datasets which result in accurate findings might limit the need to develop population specific standards. Recently, a Reference Data Set (RDS) similar to the Demirjian was prepared in the United Kingdom (UK) and has been subsequently validated. The advantages of the UK Caucasian RDS includes versatility from including both the maxillary and mandibular dentitions, involvement of a wide age group of subjects for evaluation and the possibility of precise age estimation with the mathematical technique of meta-analysis. The aim of this study was to evaluate the applicability of the United Kingdom Caucasian RDS on southern Chinese subjects. Dental panoramic tomographs (DPT) of 266 subjects (133 males and 133 females) aged 2–21 years that were previously taken for clinical diagnostic purposes were selected and scored by a single calibrated examiner based on Demirjian''s classification of tooth developmental stages (A–H). The ages corresponding to each stage of tooth developmental stage were obtained from the UK dataset. Intra-examiner reproducibility was tested and the Cohen kappa (0.88) showed that the level of agreement was ‘almost perfect’. The estimated dental age was then compared with the chronological age using a paired t-test, with statistical significance set at p <0.01. The results showed that the UK dataset, underestimated the age of southern Chinese subjects by 0.24 years but the results were not statistically significant. In conclusion, the UK Caucasian RDS may not be suitable for estimating the age of southern Chinese subjects and there is a need for an ethnic specific reference dataset for southern Chinese. [Copyright &y& Elsevier]

HIV disclosure to spouses can promote HIV prevention and facilitate support from those spouses; it can also cause mental health challenges for the spouses. We conducted a qualitative study of the mental health status and potential contributing factors of mental health challenges of spouses of men living with HIV in Sichuan, China. We interviewed 31 spouses whose husbands were living with HIV. Qualitative data were analyzed using content and thematic analyses. We found that mental health challenges were common among the spouses; leading challenges were themed as hopelessness, depression, and anxiety. Greater HIV knowledge, close relationship with husband, and psychological support may protect spouses from mental health challenges, whereas HIV-related stigma, heavy caregiving burden, and an unsupportive environment might be detrimental to mental health. Spouses of men living with HIV need mental health services, which should take into account a wide spectrum of contributors at individual, couple, and social levels.

Objectives: To investigate the impact of adaptive functioning and oral hygiene practices on tooth-brushing performance among preschool children with special health care needs (SHCN)., Methods: A cross-sectional study was conducted in Special Child Care Centers. Children's tooth-brushing performance was assessed by a standardized 13-step pro forma. Information regarding children's socio-economic status, adaptive skills, and oral hygiene practices were collected. Bivariate analysis and ANCOVA were used to explore the potential factors which might be associated with children's tooth-brushing performance., Results: The tooth-brushing assessment was provided to 379 children with SHCN. Approximately 3% of the recruited children performed the whole tooth-brushing procedure independently. The number of tooth-brushing steps practiced by those children was 4.47 ± 3.56. Children who had established tooth-brushing habit before age one practiced more tooth-brushing steps than children who brushed their teeth after age one (p = 0.029). When children's age, gender, and socio-economic status were adjusted, children who had established regular tooth-brushing habit or children who had high levels of adaptive skills showed better tooth-brushing performance than their peers. Children who used gauze, cotton swab, or dental floss to clean their teeth practiced fewer key tooth-brushing steps than their peers who had never used additional cleaning approaches (p = 0.038)., Conclusions for Practice: Children's tooth-brushing performance was associated with adaptive skills and oral hygiene practices. Tooth-brushing training should be provided to children with SHCN in early childhood. For children who had limitations in adaptive functioning, parental assistance or supervision is recommended to guarantee the efficacy and safety of daily tooth brushing.

Background: Dental age estimation can assist in the identification of victims following natural disasters and it can also help to solve birth date disputes in individuals involved in criminal activities. A reference dataset (RDS) has been developed from the dental development of 2306 subjects of southern Han Chinese origin and subsequently validated. This study aimed to test the applicability of the southern Han Chinese dental maturation RDS on three distinct East Asian population groups., Methods: A total of 953 dental panoramic radiographs of subjects aged 2 to 24 years were obtained from Philippines, Thailand and Japan. The staging of dental development was conducted according to Anglo-Canadian classification system. The dental age (DA) was calculated using six methods; one un-weighted average and five weighted average (n-tds, sd-tds, se-tds, 1/sd-tds, 1/se-tds) methods based on the scores of the southern Han Chinese RDS. Statistical significance was set at p < 0.05 and the variation between chronological age (CA) and DA was evaluated using paired t-test and Bland & Altman scatter plots., Results: From six dental age calculations, all methods of DA accurately estimated the age of Japanese and few methods in Filipino subjects (n-tds, 1/sd-tds, 1/se-tds). There was consistent overestimation of age for all the methods for Thai females (p < 0.05)., Conclusions: The southern Han Chinese dental reference dataset was shown to be most accurate for Japanese, followed by Thai males and it was particularly ineffective for Filipinos and Thai females.

Objective: To investigate the oral health status and associated factors among preschool children with special healthcare needs., Subjects and Methods: This was designed as a cross-sectional study. Dental examination was provided to 383 children at Special Child Care Centres. Covariates of interest included children's age, developmental profile, oral health-related behaviours and family social-economic status. The association between children's dental caries experiences, dental plaque deposition and gingival health status were analysed by negative binomial regression, multiple factor ANOVA and binary logistic regression when appropriate., Results: The proportion of children with caries, gingival inflammation and plaque were 30.3%, 89.6% and 95.0%, respectively. Final regression models indicated that (a) tooth decay was associated with dental visit experiences, night bottle-feeding habit, fluoridated toothpaste and monthly income; (b) plaque deposition was associated with intellectual functioning, practical skills, night bottle-feeding habit, use of toothpaste, initiation of toothbrushing habit, toothbrushing duration and additional cleaning habit; (c) gingival status was associated with children's intellectual functioning and toothbrushing frequency., Conclusions: Poor oral hygiene status existed among preschool children with special healthcare needs. Children's oral health status was associated with their developmental profile, oral health-related behaviours and social-economic status., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.)

Objective: To compare the dental development and rate of tooth development between children with and without cleft lip and palate., Patients: Age- and gender-matched pairs (231 in all) of southern Chinese children ages 3 to 12 years, with and without cleft lip and palate., Methods: Dental histories and radiographs were studied. From these, dental development was determined., Results: Of 2946 tooth pairs in the children with cleft lip and palate, 252 (8.6%) were found to be asymmetric, significantly (p < .001) more than the 63 of 3179 (2.0%) tooth pairs observed in the children without cleft lip and palate. The teeth with the highest frequency of asymmetry were the maxillary lateral incisors (38.1%). Differences in dental development on the cleft versus noncleft sides of children with unilateral cleft lip and palate were significant for both maxillary and mandibular teeth (p < .001 and p = .039, respectively). The mean delay in tooth formation of the children with cleft lip and palate was 4.4 months relative to the children without cleft lip and palate. The majority of the teeth in the cleft lip and palate group were delayed by one developmental stage. This happened in 40.0% of the maxillary teeth and 30.1% of the mandibular teeth. The delay in tooth formation increased as the number of missing teeth increased in the children with cleft lip and palate, although not significantly., Conclusions: This group of southern Chinese children with cleft lip and palate demonstrated a higher prevalence of asymmetric and delayed dental development than did their counterparts who did not have cleft lip and palate.