ABSTRACT
UNLABELLED: Low health literacy and alexithymia have separately been emphasized as barriers to patient-practitioner communication, but the association between the two concepts has not been explored. OBJECTIVE: To test the hypothesis that low oral health literacy and alexithymia are associated. METHOD: Adults (n=127) aged 21-80 years (56% women) participated in this cross-sectional study. Oral health literacy was assessed using the interview-based Adult Health Literacy Instrument for Dentistry (AHLID) with scores from 1-5. The self-administered Toronto Alexithymia Scale (TAS-20) was used to assess three distinct TAS-20 factors and TAS-20 total score. RESULTS: Significant negative correlations between AHLID scores and TAS-20 factors 2, 3 and TAS-20 total score were found. Regression analyses showed that TAS-20 factor 3, externally-oriented thinking (ß=-0.21, SE=0.02, p=0.017), and TAS-20 total score (ß=-0.18, SE=0.01, p=0.036) were significant predictors of AHLID level. CONCLUSION: The hypothesis that low oral health literacy is associated with alexithymia was supported. This finding proposes that alexithymia may be considered as a possible factor for low oral health literacy. However, the correlations are not strong, and the results should be regarded as a first step to provide evidence with additional research on this topic being needed.
Subject(s)
Affective Symptoms/complications , Health Literacy , Oral Health , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , NorwayABSTRACT
Dental health care is largely based on primary care. It is therefore logical to train students in external dental clinics in addition to university facilities. Consequently, the new dental curriculum at The University of Tromsø in Northern Norway has implemented outreach teaching and training as an extensive part of their curriculum. The overall opinion is that the external training has been very valuable both regarding volume and diversity of treatment experiences and has contributed substantially to the clinical maturity of the students. Educating the tutors is considered to be an essential part of the programme.
Subject(s)
Community Dentistry/education , Education, Dental/organization & administration , General Practice, Dental/education , Curriculum , Educational Measurement , Humans , Norway , Program EvaluationABSTRACT
Medication and psychological processes may affect salivary flow and cause subjective oral dryness. The importance of these factors is unclear. The aim of this study was to evaluate the association of medication, anxiety, depression, and stress with unstimulated salivary flow and subjective oral dryness. We studied 1,202 individuals divided into three groups, and controls. Intake of medication was evaluated. Anxiety, depression, and stress were assessed. Unstimulated salivary flow < 0.1 mL/min and subjective oral dryness were significantly associated with age, female gender, intake of psychotropics, anti-asthmatics, and diuretics. Unstimulated salivary flow < 0.1 mL/min and no subjective oral dryness were significantly associated with age, intake of antihypertensives, and analgesics. Subjective oral dryness and unstimulated salivary flow > 0.1 mL/min were significantly associated with depression, trait anxiety, perceived stress, state anxiety, female gender, and intake of antihypertensives. Age and medication seemed to play a more important role in individuals with hyposalivation, and female gender and psychological factors in individuals with subjective oral dryness.
Subject(s)
Anxiety/physiopathology , Depression/physiopathology , Drug-Related Side Effects and Adverse Reactions , Saliva/metabolism , Stress, Psychological/physiopathology , Xerostomia/physiopathology , Adult , Age Factors , Aged , Anxiety/complications , Anxiety/psychology , Depression/complications , Depression/psychology , Female , Humans , Male , Middle Aged , Psychophysiology , Secretory Rate , Sex Characteristics , Stress, Psychological/complications , Stress, Psychological/psychology , Xerostomia/etiology , Xerostomia/psychologyABSTRACT
Saliva plays an important role in maintaining oral health and functions. In the present study, unstimulated and stimulated whole salivary flow and various oral complaints were surveyed in 1427 individuals, 669 men (47%) and 758 women (53%). These individuals, aged 20 to 69 years and from different socioeconomic backgrounds, were recruited from 2000 randomly selected men and women in the register of the public dental health service in northern Sweden. The unstimulated salivary flow rate ranged from 0 to 2.07 mL/min (mean 0.33+/-SD 0.26) for men, and from 0 to 1.35 mL/min (mean 0.26+/-SD 0.21) for women. The stimulated salivary flow rate ranged from 0.17 to 7.3 mL/min (mean 2.50+/-SD 1.06) for men, and from 0 to 6.40 mL/min (mean 2.02+/-SD 0.93) for women. Women over 55 years of age had a reduced unstimulated salivary flow (P<0.05). Individuals with many teeth had a higher stimulated salivary flow than those with fewer teeth (P<0.001). Male smokers had a lower unstimulated salivary flow than male non-smokers (P<0.05). Women with oral lesion complaints had a lower unstimulated salivary flow (P<0.05), and women with burning mouth had a lower stimulated salivary flow (P<0.01). Individuals with subjective oral dryness had reduced salivary flow, both unstimulated (men P<0.01, women P<0.001) and stimulated (P<0.001). Subjective oral dryness was associated with complaints of burning mouth (P<0.001), muscle pain (P<0.01), taste disturbances (P<0.01), and dry eyes (P<0.05). Individuals with subjective oral dryness had fewer teeth than individuals with no such complaints (P<0.001). Information regarding salivary flow rate in adults is important in understanding and evaluating the relationship between salivary flow and various types of oral complaints in patients.
Subject(s)
Mouth Diseases/epidemiology , Saliva/metabolism , Adult , Aged , Cross-Sectional Studies , Female , Humans , Interviews as Topic/methods , Male , Middle Aged , Mouth Diseases/diagnosis , Mouth Diseases/physiopathology , Random Allocation , Secretory Rate , Sex Characteristics , Surveys and Questionnaires , Sweden/epidemiologyABSTRACT
To compare new flat-sheet and hollow-fiber membrane oxygenators for use in cardiopulmonary bypass, we randomly divided 40 coronary artery surgery patients into 2 groups of 20 patients each. The Shiley M-2000 flat-sheet membrane oxygenator was used in 1 group, and the Bentley BOS-CM40 hollow-fiber membrane oxygenator was used in the other group. Both oxygenators allowed for adequate transfer of oxygen and carbon dioxide. At the end of perfusion, the platelet counts were significantly lower and the arterial pH significantly higher in the Shiley group than in the Bentley group. The other hematologic parameters, as well as postoperative blood losses, were similar in the 2 groups, but were also similar to those reported earlier with respect to bubble oxygenators. On the basis of these results, we conclude that, for routine short-term perfusion, these new membrane oxygenator models, while marginally different from one another, offer no real advantage over bubble models.
ABSTRACT
We randomised 119 patients who had been referred for removal of partially impacted mandibular third molars to be given either metronidazole 1600 mg or placebo as a single dose 45 min before operation. Ten of the fifty-nine patients who were given metronidazole and 13 of the 60 given placebo developed dry sockets. Two variables were significantly associated with the development of a dry socket: pericoronitis and oral contraceptives.
Subject(s)
Anti-Infective Agents/administration & dosage , Dry Socket/prevention & control , Metronidazole/administration & dosage , Molar, Third/surgery , Tooth Extraction/adverse effects , Tooth, Impacted/surgery , Administration, Oral , Adolescent , Adult , Chi-Square Distribution , Contraceptives, Oral/adverse effects , Double-Blind Method , Dry Socket/etiology , Female , Humans , Logistic Models , Male , Mandible , Pericoronitis/complications , Preoperative Care , Statistics, Nonparametric , Tooth, Impacted/complicationsABSTRACT
Self-reported cognitive symptoms are frequent in persons with amalgam-related complaints, but few studies have focused on their cognitive function. The aim was to examine a symptom profile and whether participants with amalgam-related complaints have cognitive deficits in comparison with control individuals. We drew 342 participants with amalgam-related complaints and 342 one-to-one matched control individuals from a longitudinal population-based study. For 81 of the participants with amalgam-related complaints and controls, data were available approximately five years before the onset of complaints, making a longitudinal analysis possible. All participants were assessed by a self-reported health questionnaire and a comprehensive cognitive test battery. The participants with amalgam-related complaints reported more symptoms, mainly musculoskeletal and neuropsychological, compared with control individuals (p < 0.001). The results revealed no significant difference between the amalgam and control group, either cross-sectionally or longitudinally, for any of the cognitive tests. These results suggest that cognitive decline is not associated with amalgam-related complaints.
Subject(s)
Cognition/physiology , Dental Amalgam/adverse effects , Dental Restoration, Permanent/adverse effects , Case-Control Studies , Cognition Disorders/etiology , Cross-Sectional Studies , Female , Humans , Longitudinal Studies , Male , Memory/physiology , Mercury/adverse effects , Middle Aged , Musculoskeletal Diseases/etiology , Nervous System Diseases/etiology , Population Surveillance , Self-Assessment , Space Perception/physiology , Visual Perception/physiologyABSTRACT
BACKGROUND: Erosive lichen planus is a severe, recurrent and recalcitrant disease that affects several mucosal areas, mostly the genital area and the mouth, but also, for example, the oesophagus and perianal area. The disease causes serious symptoms, because of the raw, de-epithelialized mucosa and healing with scars/adhesions, which affect the patient's life in many ways. It causes, for example, difficulties in eating, drinking and going to the bathroom. Treatment is complicated and, so far, few therapeutic drugs other than steroids have been reported. OBJECTIVES: As the disease has severe implications on the patient's life it is important to investigate the psychological health of the patients, as well as the influence of stress on their health and wellbeing, in order to improve treatment. STUDY DESIGN, SUBJECTS AND METHODS: Forty-nine consecutive patients with erosive lichen planus were included during a 1-year period. The study was carried out as 'state-of-the-last-month', and stress, state anxiety, depression and 'erosive lichen planus factors', i.e. symptoms affecting daily life, were assessed. RESULTS: Eighty-seven per cent of the patients had symptoms, severely affecting daily life. Unexpectedly, oral symptoms seemed to be the most prominent. Our results showed that depression, anxiety and stress were more common in patients with erosive lichen planus than in a control group. DISCUSSION AND CONCLUSIONS: Erosive lichen planus is a severe disease with symptoms and complications affecting the patient's life. Our results indicate that their psychological health is also affected and emphasize the need for close collaboration between physicians, dentists with special knowledge in oral medicine and counsellors/psychologists to optimize handling of these patients.
Subject(s)
Genital Diseases, Female/psychology , Genital Diseases, Male/psychology , Lichen Planus, Oral/psychology , Lichen Planus/psychology , Activities of Daily Living/psychology , Adult , Aged , Aged, 80 and over , Anxiety/etiology , Depression/etiology , Female , Genital Diseases, Female/complications , Genital Diseases, Male/complications , Humans , Lichen Planus/complications , Lichen Planus, Oral/complications , Male , Middle Aged , Stress, Psychological/etiology , Surveys and QuestionnairesABSTRACT
Patients with symptoms allegedly caused by abnormal sensitivity to dental fillings and/or to electromagnetic fields and other environmental factors frequently report oral complaints. Forty-four consecutive patients with these symptoms were studied. The aim was to investigate whether unstimulated salivary flow rate was associated with Candida, symptoms, disease, medication, age, sex, anxiety, depression, and stress. Furthermore, the aim was to compare the level of anxiety, depression, and stress in these patients with an age- and sex-matched control group. Fifty percent had no or low flow rate from the minor salivary glands. Candida pseudohyphae were found in 50% of the patients. Hypothyroidism and/or intake of thyroid hormones, headache, fatigue, and age were negatively associated with unstimulated salivary flow rate, and dizziness was positively associated. Unstimulated salivary flow rate was positively associated with stimulated salivary flow rate and flow rate from the minor salivary glands. Burning mouth and subjective oral dryness were reported by 48%, and 46%, respectively. The patients were more anxious, stressed, and especially more depressed than the control group. Unstimulated salivary flow rate was negatively associated with state anxiety. Measurement of salivary flow rate is important in patients with environmental illness and can be used in combination with other measurements as a diagnostic tool.
Subject(s)
Environmental Illness/physiopathology , Saliva/metabolism , Adult , Aged , Behavioral Symptoms , Candida/isolation & purification , Chronic Disease , Dental Restoration, Permanent/adverse effects , Drug-Related Side Effects and Adverse Reactions , Electromagnetic Fields/adverse effects , Environmental Illness/etiology , Female , Humans , Hypothyroidism/complications , Least-Squares Analysis , Linear Models , Male , Middle Aged , Mouth Mucosa/microbiology , Secretory Rate , Statistics, Nonparametric , Xerostomia/physiopathologyABSTRACT
Burning mouth syndrome (BMS) is characterized by a burning sensation in the oral cavity although the oral mucosa is clinically normal. The syndrome mostly affects middle-aged women. Various local, systemic and psychological factors have been found to be associated with BMS, but its etiology is not fully understood. Oral complaints and salivary flow were surveyed in 669 men and 758 women randomly selected from 48,500 individuals between the ages 20 and 69 years. Fifty-three individuals (3.7%), 11 men (1.6%) and 42 women (5.5%), were classified as having BMS. In men, no BMS was found before the age group 40 to 49 years where the prevalence was 0.7%, which increased to 3.6% in the oldest age group. In women, no BMS was found in the youngest age group, but in the age group 30 to 39 years the prevalence was 0.6% and increased to 12.2% in the oldest age group. Subjective oral dryness, age, medication, taste disturbances, intake of L-thyroxines, illness, stimulated salivary flow rate, depression and anxiety were factors associated with BMS. In individuals with BMS, the most prevalent site with burning sensations was the tongue (67.9%). The intensity of the burning sensation was estimated to be 4.6 on a visual analogue scale. There were no increased levels of depression, anxiety or stress among individuals with more pain compared to those with less pain. It was concluded that BMS should be seen as a marker of illness and/or distress, and the complex etiology of BMS demands specialist treatment.
Subject(s)
Burning Mouth Syndrome/diagnosis , Burning Mouth Syndrome/epidemiology , Adult , Age Factors , Aged , Cross-Sectional Studies , Female , Humans , Linear Models , Male , Middle Aged , Prevalence , Risk Factors , Taste Disorders/diagnosis , Xerostomia/diagnosisABSTRACT
It has been known for many centuries that there is a relationship between saliva flow rate and emotional status. The significance of psychological processes in the subjective sensation of a dry mouth has been discussed earlier, and this study deals with the presence of depressive symptoms in individuals with idiopathic subjective sensation of a dry mouth. Depressive symptoms in 94 healthy subjects with normal flow rates for unstimulated and stimulated whole saliva but with a subjective sensation of a dry mouth were assessed by the Beck Depression Inventory (BDI) and compared with healthy age- and gender-matched controls. The subjects with a subjective dry mouth condition were significantly more depressive and also had a significantly higher frequency of depressive symptoms. Depression was found in 21.3% of the individuals with a subjective dry mouth sensation and in 3.2% of the controls. The results of this study indicate that, in some cases, subjective dry mouth may be of psychological origin.