Developmental regulation of lifelong dental experiences and beliefs in Guangzhou and Hong Kong.

AIMS: The aim of this study was to explain through the life-course and life-span perspectives of developmental regulation theory the controls on dental experiences and beliefs throughout the lives of older people in Guangzhou and Hong Kong. BACKGROUND: Dental diseases and disabilities among older people are serious public health concerns in China. METHODS: A facilitator conducted eight focus groups, three in Hong Kong and five in Guangzhou, involving a total of 51 participants. She encouraged discussions about lifetime events to explain dental experiences and beliefs. Transcripts were coded and analysed using a constant comparative approach to identify themes that explained the regulators of dental experiences throughout the participants' lives. RESULTS: Participants explained the influence of culture and history through critical events, and how external and internal factors regulated their current oral health status and beliefs. They emphasised the role of Traditional Chinese Medicine and family, and the stress of social upheaval compounded by a scarcity of dental services. They revealed also how current choice of dental services and health promotional programs, helped by personal food choice, self-reliance, and scepticism, helped them to adjust and cope with dental diseases and disabilities and the commercialisation of dental services. CONCLUSIONS: Dental experiences and beliefs of older people living in Guangzhou and Hong Kong were regulated strongly during personal development by culture and history during critical events, and by various controlling factors, such as health promotion and choice of services supplemented by food choice, nutritional balance, self-reliance, scepticism and social adjustments.

Cultural challenges to oral healthcare implementation in elders.

For successful implementation of oral healthcare services for elders, there is a need to understand and respond to their oral health beliefs, perceived needs and preferred type of care services, all of which are shaped by their cultural beliefs and values. This poses challenges to oral healthcare providers, especially when serving a diverse elderly population with people coming from different cultural backgrounds. The general principles of oral healthcare provision and their adaptation to serve culturally diverse elderly populations are discussed. The oral health beliefs and behaviours of Chinese, an ethnic group that can be found in many countries across the world, are highlighted and used as examples. Chinese elders generally attach a higher value to the physical functions than to the appearance of their dentition and prefer to use traditional self-care methods to deal with their oral health problems rather than to seek professional services. There is need to incorporate into the training of oral healthcare providers the competence to adapt their services to the beliefs and practices of culturally diverse elderly population groups in different settings.

An ex vivo study of arrested primary teeth caries with silver diamine fluoride therapy.

OBJECTIVES: This ex vivo study compared the physico-chemical structural differences between primary carious teeth biannually treated with silver diamine fluoride (SDF) and carious teeth without such treatment. METHOD: Twelve carious primary upper-central incisors were collected from 6-year-old children. Six teeth had arrested caries after 24-month biannual SDF applications and 6 had active caries when there was no topical fluoride treatment. The mineral density, elemental contents, surface morphology, and crystal characteristics were assessed by micro-computed tomography (micro-CT), energy-dispersive X-ray spectrometry (EDX), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). RESULTS: Micro-CT examination revealed a superficial opaque band approximately 150µm on the arrested cavitated dentinal lesion. This band was limited in the active carious lesion. EDX examination detected a higher intensity of calcium and phosphate of 150µm in the surface zone than in the inner zone, but this zone was restricted in the active cavitated dentinal lesion. SEM examination indicated that the collagens were protected from being exposed in the arrested cavitated dentinal lesion, but were exposed in the active cavitated dentinal lesion. TEM examination suggested that remineralised hydroxyapatites were well aligned in the arrested cavitated dentinal lesion, while those in the active cavitated dentinal lesion indicated a random apatite arrangement. CONCLUSIONS: A highly remineralised zone rich in calcium and phosphate was found on the arrested cavitated dentinal lesion of primary teeth with an SDF application. The collagens were protected from being exposed in the arrested cavitated dentinal lesion. CLINICAL SIGNIFICANCE: Clinical SDF application positively influences dentine remineralisation.

Discussions on oral health care among elderly Chinese immigrants in Melbourne and Vancouver.

BACKGROUND: This study explored how elderly Chinese immigrants value and relate to how acculturation influences oral health and subsequent service use. METHODS: Elders who had immigrated to Melbourne and Vancouver within the previous 15 years were recruited from local community centres and assigned to focus groups of 5-7 participants in Vancouver (4 groups) or Melbourne (5 groups). RESULTS: Following an iterative process of thematic analysis, the discussions revealed that immigrants care about the comfort and appearance of their teeth, and they value Western dentistry as a supplement to traditional remedies, but they have difficulty getting culturally sensitive information about oral health care. Accessing dentistry, they explained, is distressing because of language problems and financial costs that impose on their children. Consequently, many immigrants obtain dental treatment in China when they return for occasional visits. They felt that separation of dentistry from national health care programmes in Canada and Australia disregards natural links between oral health and general health. CONCLUSIONS: The similarity of concerns in both cities suggests that dissemination of information and availability of services are the important themes influencing oral health, and that, beliefs developed over a lifetime play an important role in interpreting oral health in the host country.