Child dental neglect: is it a neglected area in the UK?

This commentary focuses on the condition of dental neglect (DN) in children in the UK. It is divided into three sections: the first section defines DN in children and its consequences, the second section discusses who may be responsible for dental diseases in children as a result of neglect and the third section proposes a holistic approach to address DN in children in the UK.

Religiosity, spirituality, social support, health behaviour and dental caries among 35- to 44-year-old Jerusalem adults: a proposed conceptual model.

The aim of this study was to assess the relationship between religiosity and dental caries, and whether oral health-related behaviours, spirituality and social support are included in the potential pathways which explain the association between religiosity and dental caries. The present cross-sectional study employed a stratified sample, according to religiosity level (33.1% secular, 33.1% religious and 33.9% orthodox), of 254 Jewish adults in Jerusalem. The objective was to examine the pathway between religiosity, spirituality and social support and its effect on oral health outcomes by DMFT, controlling for socio-economic position and health behaviour determinants. Religiosity was determined and validated by self-definition. Social support was assessed by the Multidimensional Scale of Perceived Social Support. Spirituality was estimated by the Hebrew version of the SpREUK Questionnaire for Religiosity, Spirituality and Health. The mean caries experience (DMFT) was 10.75. Secular people revealed significantly higher DMFT than their religious and orthodox counterparts (78.0 vs. 43.9 and 39.3%, respectively, p < 0.01). A conceptual logistic regression model revealed a possible pathway, wherein a higher level of religiosity was distally associated with superior dental health outcomes, mediated by high spirituality, strong social support and positive oral health behaviours. The present study identified a strong statistical association between caries experience and religiosity. The direction of the association suggested that being religious had a protective effect on caries experience. Our conceptual hierarchical approach suggests a pathway to explain the association between the level of religiosity and dental caries experience. In this study this association was mediated by extrinsic (i.e. social support) and intrinsic (i.e. spirituality) pathways.

Is religiosity related to periodontal health among the adult Jewish population in Jerusalem?

BACKGROUND AND OBJECTIVE: Religiosity may be a relevant protective factor for periodontitis, as it is for other chronic systemic diseases. The objective of the present study was to assess the relationship between periodontitis and religiosity, and whether oral health-related behaviours, spirituality and social support are included in the potential pathways that explain the association between religiosity and periodontitis. MATERIAL AND METHODS: Cross-sectional data were part of a retrospective study. The stratified random-sampling technique was limited to the Jerusalem Jewish population. Conceptual hierarchical data analysis modelling was adopted, assuming that socio-economic position was the most distal determinant, age and gender were confounders, and social support, spirituality and oral health behaviours were mediators in the relationship between religiosity and periodontitis. RESULTS: Kappa intra-examiner values (0.89) were satisfactory. Response rate was 88.0%. The final sample included 123 men and 125 women. The mean age was 38.6 years (SD 3.25 years), with 33.9% declared to be 'orthodox', 33.1% 'religious' and 33.1% 'secular'. Higher levels of religiosity (p=0.01), support of internal life through spirituality (p=0.03), higher family social support (p=0.02) and low levels of plaque (p=0.05) were related to lower levels of periodontitis. Religiosity led to higher family social support and support of internal life through spirituality, which was related to plaque level and periodontitis. CONCLUSION: Religiosity had a protective effect against periodontitis through extrinsic and intrinsic pathways. This should be considered as part of aetiology and prognosis, in potential prevention and care of periodontitis.

The relationship between sweetness preference and dental caries in mother/child pairs from Maringá-Pr, Brazil.

AIM: Children's patterns of sugar consumption and dental health status have been associated to their mothers' patterns. As a liking for sweetness has been related to caries levels, this study was carried out to analyse the relationship between sweetness preference and caries experience in mother/child pairs. PARTICIPANTS AND METHODS: A cross-sectional survey was conducted on a sample of low socio-economic mothers and their 4-5-year-olds from Maringá-Pr, Brazil. Mothers' and children's preference for sugar was measured using the Sweet Preference Inventory. Their caries experience was assessed according to World Health Organization (WHO) guidelines. RESULTS: High levels of sweetness preference and caries experience were found in the sample studied. Although not strong, a significant correlation in patterns of sweetness preference (r=0.12, P<0.05) and caries experience (r=0.14, P<0.05) between mother/child pairs was identified. Among the social-demographic variables, only family income was statistically associated with the children's preference for sweetness (P<0.05). No significant association between sweetness preference and caries experience could be established. CONCLUSION: The findings of this study suggest that mothers may play an important role on the establishment of their children dietary preferences and patterns of dental health. Also, that the socio-economic status may influence children's preference for sugar.

Dental health and treatment needs among a sample of Bangladeshi medical users aged 40 years and over living in Tower Hamlets, UK.

AIM: To assess the dental health status and treatment needs of Bangladeshi medical care users aged 40 years and over and to explore the relationship of oral disease status, tobacco usage and paan (betel quid) chewing. DESIGN: Multi-centre cross-sectional study. SETTING: General medical practitioners' waiting areas in Tower Hamlets, UK. SUBJECTS: 185 Bangladeshi adults aged 40 years and over. INTERVENTION: A clinical examination and an interview schedule. MEASURES: Dental status, periodontal status, dental plaque, calculus and denture status. Tobacco smoking and paan chewing behaviour. RESULTS: The response rate was 74%. 85% of participants were dentate with an average number of 24 (SD +/- 5.4) standing teeth. The mean DMFT score was 5.38, with missing teeth (3.81) being the major component. The decayed component was 0.43 and the filled was 1.14. 46% of participants were assessed as being free from gingivitis. Significant relationships between chewing paan and aspects of dental and periodontal status were found. Impacts of oral health were reported by 45% of the respondents. The normative need for dental treatment was 96% with a perceived need of 48%. CONCLUSION: There was considerable normative dental need. Whilst caries experience was low, there were high levels of periodontal treatment needs. Paan chewing was related to aspects of dental and periodontal status.

Prevalence of oral lesions among a sample of Bangladeshi medical users aged 40 years and over living in Tower Hamlets, UK.

AIM: To collect data on the prevalence of oral mucosal lesions among Bangladeshi medical care users aged 40 years and over and to explore the relationship of oral disease status and tobacco smoking and paan (betel quid) chewing. DESIGN: Multi-centre cross-sectional study. SETTING: General medical practitioners' waiting areas in Tower Hamlets, UK. SUBJECTS: 185 Bangladeshi adults aged 40 years old and over. METHOD: An oral mucosal examination, based on WHO criteria and an interview. Information on tobacco smoking and paan chewing behaviour was collected during the interview. RESULTS: Out of 185 adults there was a response rate of 74%. Oral mucosal lesions were observed in 40% of participants. The most common lesion was found to be leukoplakia with a prevalence of 25%. Significant relationships were found between smoking and the presence of oral pathology and between paan chewing with tobacco and the presence of leukoplakia. CONCLUSION: In this study of older Bangladeshi medical care users there was a high prevalence of oral mucosal lesions. Sensitively tailored health promotion interventions, which aim to reduce tobacco use, should be developed for this population.

Dental service use and the implications for oral cancer screening in a sample of Bangladeshi adult medical care users living in Tower Hamlets, UK.

AIM: To assess the use of dental services, barriers to uptake of dental care and attitudes to regular dental examinations and the prevalence of tobacco and paan chewing habits in a group of Bangladeshi medical care users. DESIGN: Multi-centre cross-sectional study. SETTING: Four general medical practices' waiting areas in Tower Hamlets. SUBJECTS: Bangladeshi adults aged 40 years and over. INTERVENTION: An interview schedule. MAIN OUTCOME MEASURES: The prevalence of tobacco smoking and paan chewing with or without the addition of tobacco. The use of dental services, barriers to the use of dental services and attitudes to regular dental examinations. RESULTS: Results were obtained from 158 subjects (response rate 85%). 25% of the whole sample had never visited a dentist. These were significantly (P < 0.05) more likely to be women, who also thought regular check-ups were of little value. In their use of health services 73% experienced language difficulties. 33% of the sample were tobacco smokers. Paan was chewed by 78% of the sample with significantly (P < 0.05) more females than males adding tobacco to their quid and chewing more frequently than males. CONCLUSION: There are considerable barriers to be overcome if dental practices are to be the site for oral cancer screening and oral health promotion in this population. There are sex differences in reported behaviour and attitudes about use of dental services and in tobacco and paan use in this Bangladeshi sample. Further research is needed to establish why this ethnic minority attend general medical practices but not general dental practices.