scholarly journals Evaluating Cognitive/Emotional and Behavioral Mediators of Oral Health Outcomes in Vulnerable Older Adults

2020 ◽  
pp. 073346482097492
Author(s):  
Jean J. Schensul ◽  
Apoorva Salvi ◽  
Toan Ha ◽  
James Grady ◽  
Jianghong Li ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Oral Health ◽  
Locus Of Control ◽  
Low Income ◽  
Oral Hygiene ◽  
Behavioral Approach ◽  
Integrative Model ◽  
Plaque Score ◽  
Behavioral Domains

Inconsistent outcomes of oral hygiene interventions require testable theories combining cognitive and behavioral domains to guide intervention and improve results. This article evaluates the integrated model as a cognitive-behavioral approach to improve oral health clinical outcomes in ethnically diverse low-income older adults. Baseline data from a clinical trial utilizing the integrative model (IM) model evaluated predictors of gingival index (GI) and plaque score (PS). Individual logistic regression was performed for all predictors in relation to GI and PS. Multiple logistic regression was performed with significant predictors of GI and PS only. Greater locus of control and more brushing predicted lower GI; greater locus of control predicted lower PS. Both cognitive and behavioral domains impact GI, requiring more prolonged effort for improvement while locus of control, a cognitive variable, predicts PS, immediately improved by daily brushing/flossing. A streamlined IM including locus of control and tooth brushing should improve oral hygiene of low-income older adults.

scholarly journals Evaluating Mechanisms of Change in an Oral Hygiene Improvement Trial With Older Adults

2021 ◽  
Author(s):  
Jean Schensul ◽  
Susan Reisine ◽  
Apoorva Salvi ◽  
Toan Ha ◽  
James Grady ◽  
...  
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Locus Of Control ◽  
Low Income ◽  
Oral Hygiene ◽  
Perceived Risk ◽  
Mechanisms Of Change ◽  
Oral Diseases ◽  
Counseling Intervention ◽  
Group Randomized Trial

Abstract Objectives. This paper examines the relationship between theoretically-driven mediators and clinical outcomes of a group randomized trial to improve oral health and hygiene of older adults in subsidized housing were compared. Methods. Six low-income senior residences were paired and randomized into two groups. The first received a face to face counseling intervention (AMI) and the second, a peer-facilitated health campaign (three oral health fairs) both based on Fishbein’s Integrated Model. 331 participants were recruited at baseline and 306 completed the post-assessment one month after intervention. Clinical outcome s were Gingival Index (GI) and Plaque score (PS), collected by calibrated dental hygienists. Surveys obtained data on patient background characteristics, and ten oral health beliefs, attitudes, norms and behaviors. GLMM assessed the effects of time, intervention arm, moderators and mediators and intervention by time interactions. Results. Baseline moderators were similar. Both outcomes improved significantly. GI scores changed from baseline mean of 0.38 (sd=.032) to .26 (sd=.025) and PS scores changed from baseline mean of 71.4 (sd=18%) to 59.1% (sd=21%). Fears, intentionality, norms, worries, flossing and sugar consumption improved significantly in both interventions from baseline to post intervention. Self-efficacy, perceived risk of oral health problems, locus of control and brushing improved significantly only in the counseling intervention. Mechanisms predicting GI improvement were intentionality, locus of control, brushing and flossing in association with the counseling intervention. Mechanisms predicting PS improvement were worries about oral hygiene self-management and fear of oral diseases in association with the AMI intervention. In the trimmed final models, only locus of control (predicting GI) and fears of oral diseases (predicting PS) were significant. Conclusions. GI and PS improved more in response to the counseling intervention than the campaign. The counseling intervention had a greater impact on mechanisms of change than the campaign. Locus of control, a key concept in oral hygiene interventions including the IM was the main contributing mechanism for GI. Fear, an emotional response drove improvement in PS reinforcing the importance of cognitive/emotional mechanisms in oral hygiene interventions. Improvements in mediators across both interventions suggest a closer examination of the campaign intervention impact on outcomes over time. Trial Registration: Clinicaltrials.gov NCT02419144, first posted April 17, 2015

scholarly journals Evaluating mechanisms of change in an oral hygiene improvement trial with older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jean Schensul ◽  
Susan Reisine ◽  
Apoorva Salvi ◽  
Toan Ha ◽  
James Grady ◽  
...  
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Locus Of Control ◽  
Oral Hygiene ◽  
Self Management ◽  
Mechanisms Of Change ◽  
Oral Diseases ◽  
Background Characteristics ◽  
Counseling Intervention ◽  
Over Time

Abstract Background This paper compares the relationship between theoretically-driven mechanisms of change and clinical outcomes across two different interventions to improve oral hygiene of older adults participating in a group randomized trial. Methods Six low-income senior residences were paired and randomized into two groups. The first received a face to face counseling intervention (AMI) and the second, a peer-facilitated health campaign (three oral health fairs). Both were based on Fishbein’s Integrated Model. 331 participants were recruited at baseline and 306 completed the post-assessment one month after intervention. Clinical outcomes were Gingival Index (GI) and Plaque score (PS), collected by calibrated dental hygienists. Surveys obtained data on patient background characteristics and ten mechanisms of change including oral health beliefs, attitudes, norms and behaviors. GLMM was used to assess the effects of time, intervention arm, participant characteristics, intervention mechanisms and differences between the two interventions over time in relation to outcomes. Results At baseline, both groups had similar background characteristics. Both groups improved significantly in outcomes. Overall GI scores changed from baseline mean of 0.38 (SD = .032) to .26 (SD = .025) and PS scores changed from baseline mean of 71.4 (SD = 18%) to 59.1% (SD = 21%). T-tests showed that fears of oral disease, oral health intentionality, oral health norms, worries about self-management of oral health, flossing frequency and sugar control improved significantly in both interventions from baseline to post intervention. Oral health self-efficacy, perceived risk of oral health problems, oral health locus of control and brushing frequency improved significantly only in the counseling intervention. GLMM models showed that the significant predictors of GI improvement were intentionality to perform oral hygiene, locus of control, and improvement in frequency of brushing and flossing in association with the counseling intervention. Predictors of PS improvement were worries about oral hygiene self-management and fear of oral diseases, in association with the counseling intervention. In the reduced final models, only oral health locus of control (predicting GI) and fears of oral diseases (predicting PS) were significant in association with the counseling intervention. Locus of control, a key concept in oral hygiene interventions including the IM was the main contributing mechanism for GI improvement. Fear, an emotional response, drove improvement in PS, reinforcing the importance of cognitive/emotional mechanisms in oral hygiene interventions. Conclusions Though both groups improved in outcomes, GI and PS outcomes improved more in response to the counseling intervention than the campaign. The counseling intervention had an impact on more mechanisms of change than the campaign. Improvements in intervention mechanisms across both interventions however, suggest a closer examination of the campaign intervention impact on outcomes over time. Trial Registration: Clinicaltrials.gov NCT02419144, first posted April 17, 2015.

scholarly journals Association of Oral Health with Multimorbidity among Older Adults: Findings from the Longitudinal Ageing Study in India, Wave-1, 2017–2019

2021 ◽  
Vol 18 (23) ◽  
pp. 12853
Author(s):  
Srikanta Kanungo ◽  
Shishirendu Ghosal ◽  
Sushmita Kerketta ◽  
Abhinav Sinha ◽  
Stewart W Mercer ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Logistic Regression ◽  
Oral Health ◽  
Descriptive Analysis ◽  
Nationwide Survey ◽  
Self Rated Health ◽  
Multivariable Logistic Regression ◽  
Ageing Study ◽  
Using Data

India is witnessing an increase in the prevalence of multimorbidity. Oral health is related to overall health but is seldom included in the assessment of multimorbidity. Hence, this study aimed to estimate the prevalence of oral morbidity and explore its association with physical multimorbidity using data from Longitudinal Ageing Study in India (LASI). LASI is a nationwide survey amongst adults aged ≥ 45 years conducted in 2018. Descriptive analysis was performed on included participants (n = 59,764) to determine the prevalence of oral morbidity. Multivariable logistic regression assessed the association between oral morbidity and physical multimorbidity. Self-rated health was compared between multimorbid participants with and without oral morbidity. Oral morbidity was prevalent in 48.56% of participants and physical multimorbidity in 50.36%. Those with multimorbidity were at a higher risk of having any oral morbidity (AOR: 1.60 (1.48–1.73)) than those without multimorbidity. Participants who had only oral morbidity rated their health to be good more often than those who had physical multimorbidity and oral morbidity (40.84% vs. 32.98%). Oral morbidity is significantly associated with physical multimorbidity. Multimorbid participants perceived their health to be inferior to those with only oral morbidity. The findings suggest multidisciplinary health teams in primary care should include the management of oral morbidity and physical multimorbidity.

scholarly journals Health Behaviors and Tooth Retention among Older Adults in China: Findings from the 4th Chinese National Oral Health Survey

2021 ◽  
Author(s):  
Xiaoyan Ou ◽  
Liwei Zeng ◽  
Yixuan Zeng ◽  
Yaolin Pei ◽  
Xiujuan Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Oral Health ◽  
Health Behaviors ◽  
Health Survey ◽  
Urban Areas ◽  
Univariate Analysis ◽  
Education Levels ◽  
Natural Teeth ◽  
Tooth Retention

Abstract Background This study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults. Methods Data were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth. Results The average number of remaining teeth in the sample was 24.4 ± 7.8. There was a higher proportion of residents living in urban areas with ≥ 20 teeth than rural residents (83.2% vs 79.4%, χ2 = 20.862, p = 0.000); and a higher proportion of individuals with high education levels with ≥ 20 teeth compared to those with low education levels (χ2 = 148.168, P = 0.000). Logistic regression models showed that older adults who used toothpicks (OR = 3.37, 95% CI: 2.94–3.85), dental floss (OR = 1.93, 95%CI: 1.05–3.53), toothpaste (OR = 3.89, 95%CI: 3.14–4.83); and never smoked (OR = 1.43 95%CI: 1.20–1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI: 0.39-052). Conclusion This study did not find the association between frequency of tooth brushing and tooth retention. This study demonstrates that improvement of oral hygiene and preventive dental care are key for good oral health.

scholarly journals Life-conditions and anthropometric variables as risk factors for oral health in children in Ladakh, a cross-sectional survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maria Grazia Cagetti ◽  
Fabio Cocco ◽  
Ezio Calzavara ◽  
Davide Augello ◽  
Phunchok Zangpoo ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Relative Risk ◽  
Oral Health ◽  
Waist Circumference ◽  
Oral Hygiene ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Gingival Bleeding ◽  
Low Bmi ◽  
Caries Lesions

Abstract Background The aim of this survey was to evaluate the severity of dental caries among children living in Zanskar Valley (Ladakh, India) and its association with anthropometric and background variables. Methods This cross‐sectional survey was conducted on schoolchildren divided into four age groups (< 6, ≥ 6 < 11, ≥ 11 < 14 and > 14 years of age). A total of 1474 schoolchildren (607 males, 41.2%) were examined. Actual caries prevalence (dt/DT) and gingival bleeding were recorded by four calibrated dentists. An ad hoc questionnaire evaluated general health, eating habits, oral hygiene and the self-perception of oral conditions. Height, weight, waist circumference, heart-rate and oxygen-saturation were also collected directly by examiners. Responses to questionnaire items were treated as categorical or ordinal variables. The relationship between children’s caries data, gingival bleeding, gender, Body Mass Index (BMI) following the International Obesity Task Force, waist circumference and questionnaire items was assessed using the Kruskal–Wallis test and Pearson correlation. Conditional ordinal logistic regression was used to analyse associations among caries severity, gender, BMI, waist circumference, oxygen saturation and questionnaire items. A forward stepwise logistic regression procedure was also carried-out to estimate the ORs of gingival bleeding prevalence and the covariates derived from examination or questionnaire. Results Caries was almost ubiquitarian with only 10.0% of caries-free children (dt/DT = 0). Caries severity, in both primary and permanent dentitions, was statistically significantly related to gender, waist circumference, BMI, oral hygiene frequency and self-reported chewing problems (p < 0.01 in both dentitions). An increasing relative risk for caries in permanent dentition compared to caries-free subjects was observed in children with a low BMI (RRR = 1.67, 95%CI = 1.54/2.83 for subjects with 1–3 caries lesions and RRR = 1.52, 95%CI = 1.36/1.74 for subjects with > 3 caries lesions); also, children with reduced waist circumference had a higher relative risk to have 1–3 caries lesions (RRR = 2.16, 95%CI = 1.84/2.53) and an even higher risk to have more than 3 caries lesions (RRR = 4.22, 95%CI = 3.33/5.34). Conclusions A significant impact of untreated caries lesions was observed in Ladakh schoolchildren; low BMI values and reduced waist circumference showed to be the main caries risk predictors. Preventive and intervention programmes should be implemented to improve children's oral health.

scholarly journals Self-reported Oral and Dental Health Status among the Pregnant Women of a Selected Hospital in Dhaka City

2014 ◽  
Vol 4 (2) ◽  
pp. 61-64 ◽  
Author(s):  
MR Hassan ◽  
AB Dithi ◽  
NA Nomann ◽  
J Nessa ◽  
T Saito
Keyword(s):  
Health Status ◽  
Oral Health ◽  
Pregnant Women ◽  
Low Income ◽  
Oral Hygiene ◽  
Dental Health ◽  
School Level ◽  
Mouth Rinse ◽  
Hygiene Practices ◽  
Dental Health Status

Aims: The aims of this study were to gain an understanding of pregnant women s oral hygiene practices and to assess the oral and dental health status. Materials and Methods: A semi - structured questionnaire was completed by 100 pregnant women of the gynecology department of Dr. Akhter Jahan Mirza Hospital, Dhaka. Results: The women in this study 40% were in 19-22 years age group. Forty eight percent (48%) women of the subjects were having up to high school level education & 28% had low income of Sixty Thousand to One Lac taka yearly. In relation to oral hygiene habit before pregnancy majority of the women (56%) stated that they brush their teeth once a day, 19% use dental floss and 14% use mouth rinse once a day. During pregnancy women seemed to be slightly more concerned about oral hygiene but not significantly. Only 66% brush their teeth and 17% floss their teeth and 18% use mouth rinse once a day during pregnancy. The major problem in their mouth noticed by the women during pregnancy was bleeding gums (58%). Conclusion: This study feels the necessity of giving special attention to pregnant women s oral health in Bangladesh. Women should be educated on good oral hygiene practices so as to minimize prevalence of poor maternal oral health during pregnancy. DOI: http://dx.doi.org/10.3329/bjdre.v4i2.20251 Bangladesh Journal of Dental Research and Education Vol.4(2) 2014: 61-64

scholarly journals The effect of the SIMS Programme versus existing preschool oral healthcare programme on oral hygiene level of preschool children: study protocol for a cluster randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zamros Yuzadi Mohd Yusof ◽  
Nurul Hayati Anwar ◽  
Nor Azlida Mohd Nor ◽  
Mariani Md Nor ◽  
Siti Ezaleila Mustafa
Keyword(s):  
Oral Health ◽  
Oral Hygiene ◽  
Controlled Trial ◽  
Random Effect ◽  
Cluster Randomised Controlled Trial ◽  
Matched Pair ◽  
Outcome Variable ◽  
Plaque Score ◽  
Healthcare Programme ◽  
Cluster Randomised

Abstract Background Despite the implementation of the preschool oral healthcare programme (POHP) for 5–6-year-old children over the past 3 decades in Malaysia, dental plaque and caries levels in this age group remain high. Among the child-level attributable factors are unhealthy self-care behaviours (poor oral hygiene and high sugary diet). In order to improve the children’s oral health, an improved programme called the ‘Senyuman Indah Milik Semua’ Programme (SIMSP) or ‘Beautiful Smile for All’ programme is introduced. In this programme, a triad of dental hygienist-teacher-parent works together to improve children’s oral hygiene levels compared with the existing POHP that involves dental hygienists only. The aim of this study is to compare the effect of the SIMSP versus the existing POHP on oral hygiene levels of 5–6-year-old children in the Kampar district, Perak state, Malaysia. Methods This study is a pragmatic, cluster-randomised, parallel-group, matched pair, controlled trial with blinded outcome assessment. Randomisation is performed using a computer-generated table with a 1:1 allocation comparing the SIMSP and the POHP involving 28 preschools in the Kampar district, Perak, Malaysia. The intervention consists of preschool visits by a group of dental therapists, in-class oral health lessons and daily toothbrushing conducted by class teacher, child home toothbrushing supervised by parents, and infographic oral health messages to parents. The control consists of the existing POHP that involves preschool visits by a group of dental therapists only. The trial lasts for 6 months. Primary outcome variable is the mean plaque score change after 6 months. To determine the feasibility of the SIMSP, a process evaluation will be conducted using the perspectives of dental therapists, teachers, and parents on the appropriateness, effectiveness, facilitators, and barriers to the SIMSP implementation as well as an audit trail to assess the trial intervention. Discussion Cluster randomisation may lead to a random effect and cluster selection bias. These factors will be accounted for when analysing the data and interpreting the outcomes. The effectiveness of the SIMSP will be evaluated by comparing the results with those of the POHP. Trial registration ClinicalTrials.gov NCT04339647. Registered on 5 April 2020 – Retrospectively registered.

Oral Health in Low-Income Older Adults in Korea

2016 ◽  
Vol 33 (2) ◽  
pp. 98-106
Author(s):  
Young-Shin Lee ◽  
Hee-Gerl Kim ◽  
Jung-Yi Hur ◽  
Kyeongra Yang
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Low Income

scholarly journals 540. The Impact of Diet and Oral Hygiene on the Risk of Multidrug-Resistant Organism Carriage in the Mouth and Gut

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S258-S258
Author(s):  
Ashley Kates ◽  
Lauren Watson ◽  
Julie Mares ◽  
Krista Christensen ◽  
Lindsay Kalan ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Oral Health ◽  
Oral Cavity ◽  
Oral Hygiene ◽  
Multidrug Resistant ◽  
Whole Grains ◽  
Resistant Organism ◽  
Oral Swab ◽  
Stool Samples ◽  
The Relationship

Abstract Background Little is known about the relationship between oral hygiene and multidrug-resistant organism in the mouth and gut. We aimed to assess the relationship of oral hygiene and diet with multidrug-resistant organism (MDRO) carriage in the oral cavity and gut. Methods Participants were adults over age 18 from the 2016–2017 Survey of the Health of Wisconsin (SHOW) and its ancillary Wisconsin Microbiome Study. SHOW surveys residents of Wisconsin, collecting health determinants including a food frequency questionnaire, oral health, as well as biologic specimens. MDROs were defined as the presence of methicillin-resistant Staphylococcus aureus, Vancomycin-resistant Enterococcus, and Fluoroquinolone-resistant Gram-negative bacteria identified via culture from saliva, oral swabs, and stool samples. Statistical analysis was performed in R v3.5.1. Univariate analyses were conducted for all variables in the data set. Any variable with a P-value < 0.2 in the univariate analysis was considered for the logistic regression. Logistic regression using the glm function was done modeling MDRO carriage in either the saliva, oral swab, saliva and oral samples combined, and stool against diet, oral health, and known confounders. Results 876 participants were included in the dataset with all 876 providing oral and stool samples and 784 providing saliva samples. Thirty-three patients were MDRO positive in the saliva (4.2%), 36 were positive in the oral swabs (4.1%), 55 were positive in either the saliva or oral swabs (6.3%), and 103 were positive in the stool (11.8%). In the logistic regression, consumption of whole grains was significantly associated with reduced MDRO carriage in the saliva (P = 0.046) and saliva and oral swab combined (P = 0.036) data sets (Table 1). Conclusion Consuming more whole grains was associated with a lower prevalence of MDRO carriage in the oral cavity. Higher levels of sugar consumption were associated with a higher prevalence of MDRO in the gut. Oral hygiene was not found to be associated with MDRO colonization in the mouth and a higher prevalence in the gut in this cross-sectional study. This may be due to over-reporting of hygiene practices by participants. Being positive for an MDRO in the oral cavity significantly increased the risk of MDRO carriage in the gut. Disclosures All authors: No reported disclosures.

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