Comparison of psychometric properties of GOHAI, OHIP-14, and OHIP-EDENT as measures of oral health in complete edentulous patients aged 60 years and more.

OBJECTIVES: To compare the psychometric properties of three OHRQoL indicators (GOHAI, OHIP-14, and OHIP-EDENT) in a group of complete edentulous subjects and to explore the ability of these instruments to distinguish between individuals with different prosthetic and oral health status. METHODS: This was a cross-sectional study. Edentulous individuals aged 60 years and more were recruited between January 2019 and February 2020 in a medical and dental care centers. The Lebanese versions of GOHAI, OHIP-14, and OHIP-EDENT were used. External and internal consistencies were assessed using intraclass correlation coefficient (ICC) and Cronbach alpha, respectively. The concurrent validity was evaluated by testing the indicators against a proxy measure of a similar concept. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile, respectively, and multivariate analyses were performed using sociodemographic, clinical, and subjective health parameters as explanatory variables. RESULTS: Two hundred and two edentulous subjects (age: 72.94 ± 7.378 years) were included. The proportion of subjects with no impact was lower for OHIP-EDENT (7.9%) compared to GOHAI (28.2%) and OHIP-14 (38.6%). Reproducibility was satisfactory for all OHRQoL tools since they were able to reproduce the results consistently in time (ICC > 0.80). The Cronbach alpha values were greater than 0.8 indicating acceptable internal consistency. The concurrent validity of the three tools was acceptable since subjects with lower OHRQoL score were less satisfied with their dentures and reported a higher need for self-rated therapy. Concerning the discriminant validity, OHIP-EDENT was more discriminant than OHIP-14 and GOHAI, since it was more able to identify patients with poor prosthetic issues or using instable denture. CONCLUSION: The OHIP-EDENT was more effective in identifying edentulous individuals with oral and prosthetic problems. Our results can help decide which dental instrument to use to assess the perception of oral health in edentulous individuals. More prospective studies are required to compare their evaluative properties.

Validation of the Arabic version of the SF-36, generic questionnaire of quality of life related to health among the elderly in Lebanon.

BACKGROUND: Measuring health status of elderly is essential for the prediction of their health care needs. Health research usually considers objective outcome measure; however there is a need to increase self-reported measures of health. AIMS: The aim of this study was to assess the psychometric properties of the SF36 among a group of Lebanese elderly. METHODS: It was a cross-sectional observational study. A systematic sample of elderly people aged 60 years and more was selected from dispensary, private and governmental hospitals in Lebanon. Data were collected using face-to-face interview. The first part of the questionnaire consisted of sociodemographic characteristics. The second part consisted of the Arabic version of the SF-36. The third part consisted of Activity of Daily Living (ADL) scale, presence of health problems and number of medication consumed per day. RESULTS: A total of 250 elderly people were included. The mean age was 70.69±7.70 years. Cronbach alphas for all SF-36 scales exceeded 0.798. The intra-Class correlation coefficient varied between 0.675 (item 2) and 0.980 (items 14, 16 and 18) indicating good reliability. The quality of life (QoL) of women was poorer than men (p<0.001). It was significantly lesser when the number of health problems (p<0.001) and medications (p<0.001) increased, and the ADL score (p<0.05) decreased. CONCLUSION: SF-36 is a valid and reliable instrument for measuring QoL among Lebanese elderly and could be used for monitoring the QoL of this population.

Prevalence of Hypodontia and Supernumerary Teeth in Patients Attending Private Pediatric Dental Clinic in Lebanon.

Purpose: Because of the high rate of agenesis and supernumerary teeth in orthodontic patients and the lack of studies in Lebanon that document the prevalence of those anomalies, the aim of this study was to determine the prevalence of hypodontia and supernumerary teeth in patients attending a pediatric dental office and examine the associated factors. Study design: This was a cross-sectional design study. The patients were clinically examined followed by panoramic radiograph. Two calibrated investigators have examined the radiographic films and diagnosed the dental anomalies. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Tooth agenesis was diagnosed when there were no sign of crown calcification and no evidence or history of loss attributable to orthodontic treatment, caries, periodontal problems and dental trauma. Tooth agenesis and supernumerary teeth were the outcome variables of the study. Chi-Square tests and Fisher Exact tests were performed to assess the association between outcome variables, gender and presence of medical problem. Results: 334 participants (mean age 7.31±2.17 years) were included in the study. The presence of dental anomalies was not reported as a reason for dental visits. The rate of tooth agenesis was 8.7% in the whole sample, 9.9% among boys and 7.6% among girls with no difference (p=0.442). The rate of tooth agenesis was elevated in participant with medical problems (14.5%) compared to those with no medical problem (7.0%) (p=0.041). The rate of supernumerary teeth was 0.6% among boys and 0% among girls (p=0.485). Conclusion: Oral anomalies could be detected relatively at early age. It can help in a long-term and effective treatment planning. Early diagnosis and appropriate follow-up with panoramic radiograph is extremely important to avoid maxillofacial deformity and other complications.

Assessment of nutritional status of older patients attending a tertiary hospital in Middle Eastern country.

BACKGROUND AND PURPOSE: In hospitals, poor nutritional status could be associated with a higher incidence of nosocomial infections, postoperative complications and mortality. Subsequently the costs of providing health care and social services will increase. Malnutrition has often been described as the skeleton in the hospital closet, as it is often ignored, undiagnosed and untreated. Our study aimed to describe the nutritional status of hospitalized patients aged 60 years or more and to evaluate the associated risk factors. MATERIALS AND METHODS: This was an observational cross-sectional study conducted at a major tertiary teaching hospital in Beirut city. During a 7 months period, patients aged 60 and over and admitted in the medical and surgical units of the hospital were invited to participate in the study. Data were collected by means of a questionnaire including sociodemographic and medical characteristics, the Arabic version of the Mini Nutritional Assessment (MNA), the Activity of Daily Living (ADL) scale, and the American Society of Anesthesiologists (ASA) score. RESULTS: 171 participants aged 73.15 ± 8.06 years were included in the study. 52% of them were at risk of malnutrition and 13.5% were malnourished. Prevalence of malnutrition was higher in medical compared to surgical departments (16.2% vs. 10.5%, p = 0.003). Moreover, malnutrition was significantly associated with low level of education, high age, prolonged hospital stay, high number of medical comorbidities, polymedication, high ASA score and low ADL score (p < 0.05). CONCLUSIONS: Malnutrition or risk of malnutrition are found in 2 out of 3 hospitalized patients aged 60 years or more, and is associated with several specific risk factors. Screening and management of malnutrition should be considered a priority in order to improve the overall medical status of older people, reduce hospital stay and improve outcome and quality of life.

Social inequalities in oral health in a group of older people in a Middle Eastern country: a cross-sectional survey.

BACKGROUND AND OBJECTIVE: The percentage of Lebanese older people has increased considerably. Given that Lebanese seniors are marginalized in the health policy-making process, we suggest a high social inequality in oral health that has not been studied so far. The purpose of our study was to describe and compare oral health status in a group of Lebanese older people according to their socioeconomic status (SES) MATERIALS AND METHODS: Participants were recruited from three different primary health care clinics in Beirut, Lebanon. Data were collected from an administered questionnaire that included sociodemographic variables, perception of oral health, and regular dental visits. Oral examination included the number of missing and decayed teeth, the prosthetic status, and the number of functional dental units (FUs). The SES of the participants was determined by educational level, previous or actual work, and neighborhood level. RESULTS: 264 participants aged 71.4 ± 6.27 years (64.7% female) were included in the study. Regular dental visit, dental status, FU, and oral health perception were significantly related to the participants' place of residence, educational level, and work. Moreover, the mean number of missing teeth (p = 0.048) and decayed teeth (p = 0.018) was significantly elevated in the low SES. CONCLUSION: There is a clear socioeconomic inequality in oral health among the Lebanese older people. Further researches should explore the potential contribution of psychosocial and behavioral factors in explaining these disparities.

The effects of methyl methacrylate monomer on testosterone level in male rats. An experimental study.

INTRODUCTION: Methyl methacrylate (MMA) is commonly used in medicine and dentistry. The adverse effects of MMA are well described in the literature. Animal studies have largely confirmed the risks reported in clinical observations. There is no study indicating direct implication of MMA on male fertility mechanism. OBJECTIVES: The purpose of this study was to determine whether MMA is able to modify the testosterone level. METHODS: The target population consisted of 60 male Sprague-Dawley rats. They were closed in colony cages and divided into five groups: The first group (n=15) designated as the control group and four experimental groups (n=45). Experiments were conducted by exposing the four experimental groups to MMA with water at different concentrations (4% per hundred, 8% per hundred, 16% per hundred and 32% per hundred) administered per os. The exposure duration was eight months. Blood was obtained before and at the end of the exposure and the measurement of the testosterone level was made by EIA test. RESULTS: The exposure of rats at a moderate concentration of MMA (16% per hundred) showed an increase in testosterone level of 60% (p = 0.003) while the other groups showed a decrease of testosterone level. The control group showed a decrease of 44.8% (p = 0.001), the rats exposed at 4% per hundred showed a decrease of 67.7% (p = 0.000), those exposed at 8% per hundred showed a decrease of 432% (p = 0.35), the rats exposed at 32% per hundred showed a decrease of 71.7% (p = 0.002). CONCLUSION: Despite the fact that MMA at low concentration was rapidly hydrolyzed in blood due to the nonspecific carboxylesterase and metabolized at high concentration by the liver, its effects on testosterone level were significant. These preliminary results showed an interference of the MMA with the testosterone hormonal equilibrium that could be an interesting target for further investigations.

Toxic effects of methyl methacrylate monomer on male genital tissues. In vitro study in rats.

INTRODUCTION: Methyl methacrylate (MMA), a widely used monomer in dentistry and medicine has been reported to cause abnormalities or lesions in several organs. Experimental and clinical studies have documented that monomers may cause a wide range of adverse health effects such as irritation to skin, eyes, and mucous membranes, allergic dermatitis, stomatitis, asthma, neuropathy, disturbances of the central nervous system, liver toxicity, and fertility disturbances. OBJECTIVES: The purpose of this study was to determine whether MMA mixed with water at four different concentrations is able to affect the histological structure of testicular tissues and seminal vesicle on male rats. METHODS: The target population consisted of 60 male Sprague-Dawley rats. They were housed in colony cages and divided into five groups: The first group (n=15) designated as the control group and four experimental groups (n=45). Experiments were conducted by exposing the four experimental groups to MMA administered per os mixed with water at different concentrations (4% per hundred, 8% per hundred, 16% per hundred, 32% per hundred). The exposure duration was eight months. The testicles and the seminal vesicles were then extracted, dissected, fixed in Bouin liquid fixative and were submitted to the pathology laboratory (National Institute of Pathology) for histopathological examination. RESULTS: Seven out of 10 rats to which the MMA was administrated at a concentration of 32% per hundred showed partial seminal vesicle atrophy. The seminal vesicles in the remaining rats showed normal histology in all specimens. Testis, epididymis and vas deferens showed normal histology in all rats. CONCLUSION: The data in this study showed that MMA administered at high concentration is associated to seminal vesicle atrophy. These findings let us suggest that this effect could be the result of either a direct effect of MMA on testosterone levels (as shown in our first study), or through its possible action on other organs involved in testosterone metabolism and seminal vesicle trophicity such as the hypophysis.