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.

Factors associated with chewing problems and oral dryness among older Chinese people in Hong Kong.

OBJECTIVES: This study aims to describe the prevalence of chewing problems and oral dryness when eating and examine their risk factors among Chinese community-dwelling older adults. BACKGROUND: Chewing problems and oral dryness are two common oral health complaints in older people. A number of factors associated with these two oral health problems in older people have been reported, but information regarding Chinese older adults is scarce. MATERIALS AND METHODS: Secondary analysis was conducted on the data collected from 3422 Hong Kong adults aged ≥60 who had completed a screening instrument for long-term care services for the first time. RESULTS: Among the respondents, 15.3% reported having chewing problems and 3.5% reported having oral dryness when eating. More dependence on instrumental activities of daily living (IADL, OR = 1.06, p < 0.001) was associated with a greater likelihood of chewing problems, while more negative mood (OR = 1.19, p < 0.001) was associated with a greater likelihood of oral dryness when eating, after adjusting for the effects of socio-demographic characteristics and medical conditions. Informal care support, poor nutrition status and difficulty in brushing teeth/dentures were positively and significantly associated with these two perceived oral health problems. CONCLUSIONS: The prevalence of both chewing problems and oral dryness was low in Hong Kong older Chinese adults. IADL was related to chewing problems, while negative mood was related to oral dryness independently and significantly, which provide a knowledge base upon which to develop strategic programs of oral health promotion among older Chinese adults.

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.

Perceived Stress, Social Support, and Dry Mouth Among US Older Chinese Adults.

OBJECTIVES: Dry mouth is a common condition among older adults that negatively influences oral health, general health, and quality of life. The role of psychosocial factors in oral health conditions and diseases remains largely unknown. We conducted a study to examine the relationship between perceived stress and dry mouth among US older Chinese adults and further investigated the potential moderating role of social support and social strain from different sources in the relationship. DESIGN: Cross-sectional analysis. SETTING: Baseline of the Population Study of Chinese Elderly in Chicago, a community-engaged, population-based longitudinal study of health and well-being among community-dwelling US older Chinese adults. PARTICIPANTS: Individuals 60 years or older (N = 3157). MEASUREMENTS: Perceived stress was measured by the 10-item Chinese Perceived Stress Scale to evaluate the degree to which life situations were perceived as stressful during the preceding month on a 5-point scale, ranging from 0 ("never") to 4 ("very often"). Dry mouth was a binary self-reported outcome variable (1 = "dry mouth"). Social support was measured by the Health and Retirement Study's social support and strain scale from sources including spouse, other family members, and friends with a 3-point response set, ranging from 0 ("hardly ever") to 2 ("often"). Sociodemographics and disease processes were assessed as covariates. We conducted stepwise logistic regressions with interaction terms. RESULTS: Having higher levels of perceived stress was significantly associated with a higher likelihood of reporting dry mouth (odds ratio = 1.03; 95% confidence interval = 1.02-1.04). The effect of perceived stress on dry mouth may vary by levels of family and friend support. CONCLUSION: Perceived stress may influence dry mouth either directly or indirectly. To prevent or reduce dry mouth, in addition to disease processes, interventions need to consider psychosocial factors in dry mouth, especially perceived stress and social support, in this growing population. J Am Geriatr Soc 67:S551-S556, 2019.