Access to dental services in an elder population of African descent in Brazil.

OBJECTIVES: We investigated access to dental services and associated factors in a community of Quilombola older people. BACKGROUND: Quilombola populations are groups of individuals descended from black Africans subjected to slavery during part of Brazilian history. As marginalised and neglected individuals, they have high rates of negative indicators and require further attention to the social determinants that affect their health reality. MATERIALS AND METHODS: A cross-sectional quantitative study was conducted in the Quilombola community of Castainho, in the Northeast region of Brazil. In this community, 34 older people aged between 65 and 74 resided. We collected self-report data on sociodemographic and economic characteristics, along with oral examinations by the researchers. The primary dependent variable was regular access to dental services. Statistical analysis used Fisher's exact test (P = .05). RESULTS: Among the 32 participants in the final sample, 18.8% (n = 6) reported accessing dental services in the previous 6 months. Self-declared individuals of mixed race, with positive self-assessment of oral health, and those who did not self-perceive the need for treatment had lower rates of regular access to dental services (P < .05). CONCLUSION: Use of dental services by older Quilombola people is low, and there are differences by ethnicity and individual perception of oral health.

Dominant Power and the Concept of Caste: Implications for Dentistry and Oral Health Inequality.

This paper explores the issues of caste and casteism in the U.S. as described by Pulitzer Prize winning journalist Isabel Wilkerson in her 2020 book "Caste: The Origin of Our Discontents". Wilkerson argues that a caste system not only exists in the U.S. but operates as a hidden force affecting social inequality. The paper draws on Wilkerson's work to explore caste as an analytical concept. It begins by defining caste and casteism in contrast with racism, the eight pillars of a caste system, the consequences of casteism, and the psychological drivers of casteism. The paper then applies to concept of caste to understanding power, dentistry, and oral health inequality. The paper concludes by emphasizing that the concept of caste and its relationship to oral health inequality must be understood it if we want to create real social change.

Oral impacts on daily performances and its socio-demographic and clinical distribution: a cross-sectional study of adolescents living in Maasai population areas, Tanzania.

BACKGROUND: In a global perspective, oral health among adolescents has improved during recent decades. However, oral problems still persist especially in many underprivileged societies. This study aimed to estimate the prevalence of oral impacts in adolescents and to identify important clinical- and socio-demographic covariates. In addition, this study compares Maasai and non-Maasai adolescents regarding any association of socio-demographic and clinical covariates with oral impacts on daily performances. METHODS: A total of 989 adolescents were invited from 23 randomly selected public primary schools in Monduli and Longido districts, Tanzania. All adolescents attending 6th grade classes were invited to participate. A total of 930 accepted and of those 24 were excluded, leaving 906 (91.6%) participants for the study. RESULTS: A total of 143/906 (15.8%) had at-least one oral impact on daily performances (OIDP > 0), 14.6% among the Maasai and 20.5% among the non-Maasai ethnic group. Cluster adjusted logistic regression revealed that: adolescents from Longido district (OR = 0.4) and adolescents with good oral hygiene (OR = 0.7) were less likely to report OIDP> 0 and; non Maasai (OR = 1.6), those with least poor parents (OR = 2.0), DMFT> 0 (OR = 3.1) and those with positive answers to questions regarding TMD pain, 2Q/TMD > 0 (OR = 3.9) were more likely to report OIDP> 0. Stratified logistic regression by ethnicity revealed that, among the non-Maasais, older adolescents (OR = 3.7, 95% CI 1.1-12.8), those with DMFT> 0 (OR = 3.3 (1.2-9.0) and 2Q/TMD > 0 (OR = 9.0, 95% CI 3.3-25.0) were more likely to report at least one OIDP. The corresponding figures among the Maasais were (OR = 0.9, 95% CI 0.5-1.7), (OR = 2.8, 95% CI 1.4-5.5) and (OR = 3.0, 95% CI 1.7-5.2), respectively. CONCLUSIONS: The prevalence of oral impacts was moderate but higher among the non-Maasai- than Maasai-adolescents attending rural primary schools in the Maasai population areas of Tanzania. This study also confirmed socioeconomic and oral clinical disparities in OIDP, some of which differed according to ethnicity. Caries experience and self-reported TMD pain associated more strongly with OIDP among the non-Maasais than among the Maasais. These results are important for public oral health decision makers who plan strategies for optimal primary oral health care and quality of life among adolescents belonging to minority groups in Tanzania.

The association between oral health literacy and oral health behaviors in North Korean defectors: a cross-sectional study.

BACKGROUND: The present study aimed to investigate the association between oral health literacy and oral health behaviors among North Korean defectors. METHODS: This study involved the collection of self-reported questionnaires from 123 North Korean defectors visited a dental clinic that offered complimentary services, to receive dental treatment in a metropolitan area of South Korea from December 2017 to April 2018. Oral health literacy was measured with the Test of Korean Functional Health Literacy in Dentistry (TOKFHLiD), which consists of 30 items concerning verbal oral health literacy and 42 items concerning functional oral health literacy (28 items for reading comprehension and 14 items for numeracy). In addition, the questionnaire contains 15 and 14 items related to demographic characteristics and oral health behaviors (interest, lifestyle, diet, prevention), respectively, for a total of 101 items. RESULTS: The mean oral health literacy score was 44 (out of a maximum possible score of 72). Oral health literacy and oral health behaviors were positively correlated (r = 0.526, P < 0.001), and oral health literacy also had a significant effect on oral health behaviors (Beta = 0.26, 95% CI: 0.04-0.33). However, although functional oral health literacy had a significant effect on oral health behaviors (Beta = 0.20, 95% CI: 0.01-0.43), verbal oral health literacy did not (Beta = 0.13, 95% CI: - 0.06-037). CONCLUSIONS: Educational interventions are needed to improve oral health literacy, and thus oral health behaviors, as a part of the health promotion measures undertaken to facilitate the stable adjustment of North Korean defectors in South Korean society.

Acculturation and the oral health of a nationally representative sample of Hispanic children in the United States: an analysis of 2011-2012 National Survey of Children's Health data.

BACKGROUND: Oral disease is a serious public health issue, and Hispanic children in the United States (US) are more likely than children of other racial/ethnic groups to experience dental caries. Although Hispanic children are a growing segment of the US population there is limited research on the association between acculturation and oral health outcomes in this population. This study examined the associations between household acculturation and pediatric oral health in the Hispanic population using a nationally representative sample of children. METHODS: Data from the 2011-2012 National Survey of Children's Health were analyzed; analyses included Hispanic children ages 1 to 17. Household acculturation was assessed with a combination of language and parental nativity, while oral health was assessed via parents'/guardians' reports of children's dental caries. Logistic regression was used to examine the association between acculturation and oral health, adjusting for other demographic and social determinants of pediatric oral health. We assessed significance at the p < 0.05 level, and all analyses accounted for the survey's complex sample design. RESULTS: Analyses included 9143 Hispanic children. In total, 24.9% (95% CI: 22.9-27.0%) experienced dental caries, and there were significant associations between household acculturation and oral health. In unadjusted analyses, 32.0% (95% CI: 28.9-35.4%) of children in low acculturation households, 20.3% (95% CI: 16.0-25.4%) of children in moderate acculturation households, and 16.9% (95% CI: 14.2-20.0%) of children in high acculturation households experienced dental caries (p < 0.001). In adjusted analyses, children in high acculturation households were significantly less likely than those in low acculturation households to experience dental caries (p < 0.001; OR = 0.50; 95% CI: 0.35-0.70). The difference between children in moderate and low acculturation households approached but did not reach statistical significance (p = 0.057; OR = 0.69; 95% CI: 0.48-1.01). CONCLUSIONS: A dose-response relationship was observed between household acculturation and the oral health of Hispanic children in the US. As acculturation increases, the likelihood of a child experiencing dental caries decreases. These findings suggest that public health and community-based interventions intended to reduce oral health disparities in Hispanic children would likely be most impactful if the acculturation levels of the children's households are considered during program development.

Community based programs to improve the oral health of Australian Indigenous adolescents: a systematic review and recommendations to guide future strategies.

BACKGROUND: To review the international literature on community-based interventions aiming to improve the oral health of Indigenous adolescents and identify which demonstrate a positive impact. METHODS: Data sources were MEDLINE, EMBASE, CINAHL, SCOPUS, the COCHRANE library and the Australian Indigenous HealthInfoNet. Articles were included where they: were published in English from 1990 onwards; described oral health outcomes for Indigenous adolescents aged 10 to 19 years; implemented a community based oral health intervention. The Quality Assessment Tool for Quantitative Studies from the Effective Public Health Practice Project was applied. RESULTS: Nine studies met inclusion criteria; two rated strong in quality; only one study was conducted with an urban community; five reported moderate community engagement. Five intervention strategies were identified, and schools were the most common setting reported. Statistically significant improvements were described in eight studies with the most frequently reported outcome being change in decayed missing or filled teeth. CONCLUSIONS: Few good quality peer reviewed international studies of community-based oral health interventions which address the needs of Indigenous adolescents exist. Studies must include strong Indigenous community leadership and governance at all stages of the research, adopt participatory action-based research approaches, and are required in urban communities.

Cultural factors and oral health-related quality of life among dentate adults: Hispanic community health study/study of Latinos.

Objective: Research on the relationships between acculturation, ethnic identity, and oral health-related quality of life (OHRQOL) among the U.S. Hispanic/Latino population is sparse. The aim of this study is to examine the association between acculturation, ethnic identity, and OHRQOL among 13,172 adults in the 2008-2011 Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Design: Participants self-reported their acculturation (immigrant generation, birthplace, residence in the U.S., language, and social acculturation), ethnic identity (sense of belonging and pride), and four OHRQOL measures. Key socio-demographic, behavioral, and oral health outcomes were tested as potential confounders.Results: Overall, 57% of individuals experienced poor OHRQOL in at least one of the domains examined. In multivariable analyses, some elements of higher acculturation were associated with greater food restriction and difficulty doing usual jobs/attending school, but not associated with pain or difficulty chewing, tasting, or swallowing. While sense of belonging to one's ethnic group was not associated with poor OHRQOL, low sense of pride was associated with food restriction. Socio-behavioral characteristics were significant effect modifiers.Conclusion: This study contributes to the understanding of the role of Hispanic/Latino's cultural factors in OHRQOL perception and can inform targeted strategies to improve OHRQOL in this diverse population.

Yarning about oral health: perceptions of urban Australian Aboriginal and Torres Strait Islander women.

BACKGROUND: Many factors influence how a person experiences oral health and how such experiences may facilitate supportive oral health behaviours. Women in particular face different challenges due to their environment, responsibilities and physiological differences to men. Within Australia, Aboriginal and Torres Strait Islander women are reported to have poorer oral health and are faced with additional barriers to supporting their oral health compared with non-Indigenous women. The objective of this paper is to report the experiences and perceptions of oral health from the perspective of urban, Aboriginal and Torres Strait Islander women. METHODS: The present data derive from a descriptive study that used yarning circles and face-to-face interviews with women who were mothers/carers of urban, Aboriginal and/or Torres Strait Islander children. This was a qualitative study to investigate the impact of child oral health on families. Participants used the opportunity to share their own personal experiences of oral health as women, thus providing data for the present analyses. Information collected was transcribed and analysed thematically. RESULTS: Twenty women shared their personal narratives on the topic of oral health which were reflective of different time points in their life: growing up, as an adult and as a mother/carer. Although women are trying to support their oral health across their life-course, they face a number of barriers, including a lack of information and the costs of accessing dental care. The teenage years and pregnancy were reported as important time periods for oral health support. CONCLUSIONS: To improve the oral health of Indigenous Australian women, policymakers must consider the barriers reported by women and critically review current oral health information and services. Current oral health services are financially out of reach for Indigenous Australian women and there is not sufficient or appropriate, oral information across the life-course.

Socioeconomic inequalities in adult oral health across different ethnic groups in England.

BACKGROUND: Ethnic inequalities in oral health among British adults remain largely unexplored. This study explored the role of socioeconomic position (SEP) in explaining ethnic inequalities in oral health; and the consistency of socioeconomic inequalities in oral health across ethnic groups. METHODS: Data from 45,599 adults, aged 16 years and over, who participated in the Health Survey for England were pooled across 5 years. The seven ethnic groups included were White British, Irish, Black Caribbean, Indian, Pakistani, Bangladeshi and Chinese. Edentulousness and toothache were the outcome measures. A composite measure of SEP was developed based on education, social class, income and economic activity using confirmatory factor analysis. Ethnic inequalities in oral health were assessed in logistic regression adjusting for sex, age, survey year and SEP. RESULTS: Indian (OR: 0.55, 95%CI: 0.40-0.76), Pakistani (0.56, 0.38-0.83), Bangladeshi (0.35, 0.23-0.52) and Chinese (0.41, 0.25-0.66) were less likely to be edentulous than White British after controlling for SEP. Irish (1.22, 1.06-1.39) and Caribbean (1.37, 1.19-1.58) were more likely and Bangladeshi (0.83, 0.69-0.99) were less likely to have toothache than White British after controlling for SEP. Socioeconomic inequalities in edentulousness were consistently found across almost all ethnic groups while socioeconomic inequalities in toothache were found among White British and Irish only. CONCLUSION: This study shows that the role of SEP in explaining ethnic inequalities in oral health depended on the outcome being investigated. Socioeconomic inequalities in oral health among minority ethnic groups did not consistently reflect the patterns found in White British.

Reliability, validity and responsiveness of the Mandarin (Simplified) Chinese version of the EORTC QLQ-OH45 among cancer patients.

PURPOSE: The goal of our study was to evaluate the reliability, validity, responsiveness and acceptability of the Mandarin (simplified) Chinese version of the EORTC QLQ-OH45. METHODS: From October 2017 to February 2018, 393 cancer patients were enrolled from three different hospitals in China. A forward and backward translation was made to develop the Mandarin (simplified) Chinese version of EORTC QLQ-OH15. The QLQ-C30 and QLQ-OH15 questionnaires (which we have assembled and named QLQ-OH45 in this paper) were self-administered. Results were statistically analysed using SPSS 21.0. The reliability and validity tests of the questionnaires were assessed by Cronbach's α coefficient, Pearson correlation test and Mann-Whitney U tests. Responsiveness to change was measured in an independent sample of patients with head and neck cancer undergoing surgery or radiotherapy or chemotherapy. RESULTS: An acceptable internal consistency reliability for most multiple-item scales was demonstrated, as Cronbach's α coefficients were greater than 0.7 for most multiple-item scales, excepting for cognitive functioning (0.36) and oral health-related QoL functioning (0.55). All domain's test-retest reliability coefficients (r) was higher than 0.8. Multi-trait scaling analysis showed good convergent and discriminant validity. A difference in the quality of life (QoL) between older (≥65 years) and younger (<65 years) groups of patients was showed by the known-group comparisons. Low correlations were found between the scales of the QLQ-OH15 and QLQ-C30 in all areas. CONCLUSION: The Mandarin (simplified) Chinese version of QLQ-OH45 demonstrates satisfactory psychometric properties and can be used to measure the oral health-related QoL (OHRQoL) for Chinese cancer patients.

Dental care utilization: examining the associations between health services deficits and not having a dental visit in past 12 months.

BACKGROUND: A growing literature supports the contention that closing the divide between dental and medical care can improve access to and coordination of patient care. Health service deficits (HSDs) entail: no routine medical exam, no personal healthcare provider (HCP), no health insurance, and/or delaying medical care because of cost all within the last 12 months. Examining the associations between HSDs and dental care utilization could inform strategies and interventions aimed at narrowing the gap between the medical and dental professions. This study explored whether HSDs are associated with not having a dental care visit within the last 12 months. In addition, the study sought to provide an updated analysis of the characteristics and factors associated with dental care utilization. METHODS: Two thousand sixteen Behavioral Risk Factor Surveillance System survey data were analyzed using bivariate and multivariable techniques. The outcome variable for this study was: last dental visit was longer than 12 months ago. RESULTS: US adults without healthcare insurance, without a personal HCP, who had delayed medical care because of cost, and who had their last routine medical visit longer than 12 months ago had greater odds of not having a dental visit within the last 12 months. Further, this study identified disparities in dental care utilization among males, rural residents, those earning less than $50,000 per year, Non-Hispanic Blacks and Non-Hispanic other races. Individuals with six or more and/or all of their permanent teeth removed and current smokers also had greater odds of not having had a dental care visit in the past 12 months. CONCLUSIONS: Findings suggest that a stronger integration of medical and dental care might increase dental care utilization. In addition, persistent disparities in dental care utilization remain for several demographic groups. Targeted interventions offer the promise of helping achieve HP 2020 goals for improved oral health.

Psychosocial factors and oral health practices of preschool-aged children: a qualitative study with Hispanic mothers.

OBJECTIVE: This qualitative study sought to gain an in-depth understanding of Hispanic mother's parenting experiences and perceptions about select psychosocial factors. How psychosocial factors influence mothers' engagement in recommended oral health-related behaviors for their preschool-aged children (3-5 years) was explored. Psychosocial resources and barriers explored included maternal knowledge about children's oral health, beliefs such as perceived self-efficacy and health locus of control, and parenting experience and stress. DESIGN: Six focus groups and one individual interview with lower-income, Hispanic mothers of preschoolers (n = 36 total participants) were conducted in Spanish at a community health clinic on the California-Mexico border during summer 2010. A bilingual dentist led all sessions using a set of open-ended guiding questions. All sessions were audio-taped, translated and transcribed in English. Transcripts were coded and analyzed for common themes. RESULT(S): Six themes were identified around dental knowledge, the mothers' primary role in performing the child's oral hygiene among multiple caregiving priorities, parenting challenges, perceived self-efficacy, perceived future outlook for their child's oral health, and family influences. Mothers recognized the importance of caring for primary teeth. However, few were knowledgeable about preventive practices to promote young children's oral health, such as the recommended ages for brushing or first dental visit. Mothers that were more knowledgeable expressed feeling more efficacious about maintaining their child's oral hygiene. All mothers believed they were primarily responsible for their child's oral health, and most held positive future expectations for their child's oral health. CONCLUSION: These findings provide insight into how Hispanic mothers of young children perceive their role as caregiver. Maternal knowledge and perceptions affect their ability to care for their child's oral health and should be accounted for in future interventions.

Oral problems and associated risk indicators in adults in the Russian Federation, India, and China.

BACKGROUND: Oral problems, known as a neglected epidemic, have become prevalent in Brazil, the Russian Federation, India, China, and South Africa (BRICS) countries in last decade. The objective of the study is to examine the prevalence and associated risk indicators of oral problems in adults in the Russian Federation, India, and China in BRICS countries. METHODS: We used data from the first round of the Study of Global AGEing and Adult Health (SAGE), conducted by WHO in 2007-10 in selected BRICS countries. Oral problems are defined as if an adult had any mouth and/or teeth related problems including swallowing problems in last 1 year of the survey. We estimated the mean age of adults who had oral problems and used a t-test for comparing it by sex of adults. We determined the prevalence of oral problems in adults. We designed a hierarchical conceptual model to identify associated risk indicators with oral problems. Finally, we applied a multivariable binary logistic regression model based on a conceptual model to examine associated socioeconomic and demographic, behavioral and nutritional risk indicators and systemic diseases - diabetes, hypertension, and angina pectoris/angina with oral problems in adults. RESULTS: The mean age of adults who had oral problems is lowest in India (57 years; SD: 15) and highest in China (65 years; SD: 11). However, it does not vary by sex of adults except India. The prevalence of oral problems is highest in the Russian Federation (35%) and lowest in China (9%). Adults with body mass index (BMI) less than 25 kg/m2, age 45 years or more, diabetes, hypertension, and angina pectoris/angina have a higher risk of oral problems. Females and adults using alcohol are also more likely to have oral problems in selected countries. CONCLUSIONS: The study concludes that females, adults using alcohol and those having any systemic disease are at higher risk of oral problems in the Russian Federation, India, and China. A one-third of adults had oral problems in particularly, in the Russian Federation; thus there is an urgent need to formulate oral policy and program, which the country currently lacks in.

Dental markers of poverty: Biocultural deliberations on oral health of the poor in mid-nineteenth-century Ireland.

OBJECTIVES: Despite subsisting on a low-cariogenic diet comprising virtually nothing more than potatoes and dairy products, poor oral health affected the quality of life for the poor of nineteenth-century Ireland. This study investigates potential biocultural reasons that may explain why this was the case. MATERIAL AND METHODS: A total of 6,860 teeth and 9,889 alveoli from 363 permanent dentitions from the skeletal remains of impoverished adult Irish males and females who died between 1847 and 1851 in the Kilkenny Union Workhouse were examined for evidence of dental caries, periodontal disease and ante-mortem tooth loss. Caries rates were quantified and assessed by crude prevalence, frequencies, corrected caries rates and a t-health index, and evaluated by sex and age groups. RESULTS: A higher rate of caries was present among 18-25-year-old males than females, while the opposite relationship was evident for older age groups. The prevalence rates of periodontal disease and ante-mortem tooth loss increased with age. When assessed by corrected caries rates, tooth decay is observed at a lower rate compared to contemporaneous lower to upper-class population samples from London. DISCUSSION: Despite being low cariogenic foods, the potato starch and milk lactose of a nineteenth-century Irish laborer's diet would have lowered oral pH-values thereby increasing the risk of bacterial fermentation in dental plaque resulting in caries. Nutritional features alone cannot explain the high rates of dental caries observed in the Kilkenny workhouse population sample, however, and lifestyle factors, particularly habitual clay-pipe smoking, is considered a significant cause of poor oral health.

The role of indigenous health workers in promoting oral health during pregnancy: a scoping review.

BACKGROUND: Early childhood caries is the most common chronic childhood disease worldwide. Australian Aboriginal and Torres Strait Islander children are twice more likely to develop dental decay, and contributing factors include poor maternal oral health and underutilisation of dental services. Globally, Indigenous health workers are in a unique position to deliver culturally competent oral healthcare because they have a contextual understanding of the needs of the community. METHODS: This scoping review aimed to identify the role of Indigenous health workers in promoting maternal oral health globally. A systematic search was undertaken of six electronic databases for relevant published literature and grey literature, and expanded to include non-dental health professionals and other Indigenous populations across the lifespan when limited studies were identified. RESULTS: Twenty-two papers met the inclusion criteria, focussing on the role of Indigenous health workers in maternal oral healthcare, types of oral health training programs and screening tools to evaluate program effectiveness. There was a paucity of peer-reviewed evidence on the role of Indigenous health workers in promoting maternal oral health, with most studies focusing on other non-dental health professionals. Nevertheless, there were reports of Indigenous health workers supporting oral health in early childhood. Although some oral health screening tools and training programs were identified for non-dental health professionals during the antenatal period, no specific screening tool has been developed for use by Indigenous health workers. CONCLUSIONS: While the role of health workers from Indigenous communities in promoting maternal oral health is yet to be clearly defined, they have the potential to play a crucial role in 'driving' screening and education of maternal oral health especially when there is adequate organisational support, warranting further research.

An Experimental Test of the Two-Dimensional Theory of Cultural Sensitivity in Health Communication.

Based on a theoretical framework describing culturally sensitive (CS) health communication, this experiment tested the relative contributions of surface structure and deep structure in the recall of oral health information from pamphlets varied in written message and images. Using a 2 × 2 factorial design, Spanish-speaking Mexican heritage mothers of children under six (n = 160) were randomly assigned to read one of four 12-page pamphlets containing the same oral health information in Spanish: (1) standard written message/standard images; (2) standard written message/CS images; (3) CS written message/standard images; and (4) CS written message/CS images. Participants completed a 22-item oral health knowledge questionnaire before and after reading the pamphlet. Controlling for the effects of pretest scores, acculturation, and educational level on information recall, findings showed significant positive main effects for CS images (F(1, 152) = 5.03, p = .026, partial ŋ2 = .032) and CS written message (F(1, 152) = 5.21, p = .024, partial ŋ2 = .033). There was no interaction. These results support the two dimensions of CS and their independent effects. They should be applicable to a variety of health communication channels. Further research is needed to investigate the causal mechanism behind the observed effects.

Knowledge and behaviours related to oral health among underserved older adults.

OBJECTIVE: To examine the mouth and body knowledge, beliefs and behaviours of Dominican, Puerto Rican and African American older adults, and their relationships to oral and general health and health care. BACKGROUND: In his seminal framework, Handwerker posited that the norms, attitudes and behaviours related to the experience of disease and treatment reflect where patients live and have lived and are seeking and have sought care, along with their webs of social and health relations. This framework guides the analysis for the present study, wherein qualitative data are used to understand mouth and body knowledge, beliefs and behaviours among racial/ethnic minority older adults, ie, why individuals do what they do and what it means to them. MATERIALS AND METHODS: Focus groups were conducted in Spanish or English with 194 racial/ethnic minority older adults living in northern Manhattan who participated in one of 24 focus group sessions about improving oral health. All groups were digitally audio-recorded, transcribed and translated into English from Spanish, where apt. Analysis involved the classification of evidence from all datasets, organised to identify patterns and relationships. RESULTS: Four themes were manifest in the data regarding cultural understandings of the mouth, the body and health: (a) the ageing mouth and its components; (b) the mouth in relation to the body, health and disease; (c) social meanings of the mouth; and (d) care of the ageing mouth. CONCLUSION: Underserved older adults from diverse cultural backgrounds understand the importance of their mouths to both their overall health and social lives.

Association between maternal acculturation and health beliefs related to oral health of Latino children.

BACKGROUND: This report is presenting the association of maternal acculturation, measured by preferred language, and oral health-related psychosocial measures in an urban Latino population. METHODS: A cross-sectional survey was conducted with 100 mother-child dyads from the Dental Center at the Children's Hospital Colorado, the University of Colorado. A portion of Basic Research Factors Questionnaire capturing information about parental dental knowledge, attitudes, behavior and psychosocial measures was used to collect data from the participating mothers. Descriptive statistics were calculated for demographics and psychosocial measures by acculturation. A univariate linear regression model was performed for each measure by preferred language for primary analysis followed by adjusted model adjusting for parent's education. RESULTS: The mean age of the children was 3.99 years (SD = 1.11), and that of the mother was 29.54 years (SD = 9.62). Dental caries, measured as dmfs, was significantly higher in children of Spanish-speaking mothers compared to children of English-speaking mothers. English-speaking mothers had higher mean scores of oral health knowledge, oral health behaviors, knowledge on dental utilization, self-efficacy, and Oral Health Locus of Control as compared to Spanish-speaking mothers. Univariate analysis demonstrated significant association for preference for Spanish language with knowledge on dental utilization, maternal self-efficacy, perceived susceptibility and perceived barriers. The effect of language was attenuated, but significant, for each of these variables after adjusting for parent's education. CONCLUSION: This study reported that higher acculturation measured by a preference for the English language had a positive association with oral health outcomes in children. Spanish-speaking mothers perceived that their children were less susceptible to caries. Additionally, they perceived barriers in visiting the dentist for preventive visits.

Ethnic disparities in children's oral health: findings from a population-based survey of grade 1 and 2 schoolchildren in Alberta, Canada.

BACKGROUND: Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada. METHODS: A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables. RESULTS: We observed significant ethnic disparities in children's oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment. CONCLUSIONS: Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for demographic, socioeconomic and caries-related behavioral factors, with Filipino, Arab, and Indigenous children being the most affected.

A collaboration with local Aboriginal communities in rural New South Wales, Australia to determine the oral health needs of their children and develop a community-owned oral health promotion program.

INTRODUCTION: As part of an oral health service for Aboriginal people in central northern New South Wales (NSW), Australia, oral health promotion was identified as a priority by the local Aboriginal community. The objective of this study was to collaborate with local Aboriginal communities to determine (1) the oral health needs of Aboriginal children aged 5-12 years, (2) the oral health knowledge and attitudes towards oral health of parents/guardians and (3) the perceived barriers and enablers towards oral health promotion for school children by local school staff and community health workers. The results of this collaboration will inform a community-owned oral health promotion program. METHODS: Aboriginal children aged 5-12 years enrolled in local schools received a dental screening by a single examiner. The number of decayed, missing and filled teeth of primary and permanent dentition (dmft/DMFT), plaque and gingivitis were recorded. Children completed a questionnaire assessing current oral hygiene practices, dental history and information on their diet. Parents/guardians completed a questionnaire assessing oral health knowledge and attitudes towards oral health. School staff and community health workers completed a questionnaire assessing attitudes, barriers and enablers towards implementing an oral health promotion program in schools. RESULTS: Eighty-eight children, representing 94% of those eligible, were screened, and 78 (82%) completed a questionnaire. The mean dmft/DMFT score was 5.3. Risk factors for dental caries identified included lack of toothbrush ownership (35%), minimal fluoride toothpaste use (24%), limited daily tooth brushing (51%) and frequent consumption of sugary foods (72%) and soft drinks (64%). Questionnaires were completed by 32 parents/guardians and 39 school and community health workers. Parents/guardians had limited oral health knowledge. School and health staff were willing to support a health promotion program to improve dental health of children. CONCLUSION: Aboriginal children living in rural and remote communities in NSW experience high rates of dental caries. Oral health promotion is urgently required to reduce the burden of dental caries and should address oral hygiene behaviours, fluoride use and access to healthy foods and drinks. Note: This article uses the term 'Aboriginal people' when referring to the first peoples of Australia. This term is inclusive of Australian Aboriginal and Torres Strait Islander people.