Effectiveness of an oral function intervention for older Taiwanese people.

OBJECTIVE: Oral function disorders occur often in older people with increasing age. Oral function disorders affect bodily function and self-esteem, which are related to quality of life (QOL). The aim of this study was to evaluate the effectiveness of an oral function intervention programme on the oral function of older Taiwanese people. MATERIALS AND METHODS: A one-group pretest-post-test study design was used. A total of 529 older Taiwanese people (women, 68.2%; men, 31.8%; average age, 75.07 ± 5.95 years) participated in this study. The oral function intervention programme consisted of a brief oral health education programme and oral function exercises. The total test period was 8 months. The oral condition and function examination comprised two questionnaires (self-reported symptoms of oral function disturbance and the Geriatric/General Oral Health Assessment Index [GOHAI]) and three oral function assessments (Repetitive Saliva Swallowing Test [RSST], Oral Diadochokinesia Test [ODT] and Cheek Expanding Test [CET]). RESULTS: After the oral function intervention, the self-reported symptoms on the oral function questionnaire and GOHAI showed significant improvement (P < 0.05). Additionally, RSST, ODT and CET showed differences between pretest and post-test measurements (P < 0.05). CONCLUSION: The oral function intervention programme was effective in maintaining their feeding, swallowing and articulatory functions of older Taiwanese people. Significant improvements in self-reported symptoms of oral function and GOHAI scores indicated that the oral function intervention programme might improve the QOL of older Taiwanese people.

Evaluating the effect of a community-based lay health advisor training curriculum to address immigrant children's caries disparities.

Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.

Immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors: a cross-sectional study in Taiwan.

BACKGROUND: With the growing number of transnational marriages in Taiwan, oral health disparities have become a public health issue. This study assessed immigrant-native differences in oral health behaviors of urban mothers and their children. METHODS: We used the baseline data of an oral health promotion program to examine the immigrant-native differences in caries-related knowledge, attitude, and oral health behaviors. A cross-sectional study was conducted to collect data from mothers in urban area, Taiwan. A total of 150 immigrant and 440 native mothers completed the self-report questionnaires. Logistic regression models analyzed the racial differences in oral health behaviors. RESULTS: Approximately 37% of immigrant mothers used dental floss, 25% used fluoride toothpaste, and only 13.5% of them regularly visited a dentist. Less that 40% of immigrant mothers brush their children's teeth before aged one year, 45% replaced child's toothbrush within 3 months, and only half of the mothers regularly took their child to the dentist. Immigrant mothers had lower level of caries-related knowledge and attitudes than native mothers (p < .001). Compared to native group, the immigrant mothers were less likely to use of dental floss ([Adjusted odds ratio (aOR) =0.35], fluoride toothpaste (aOR = 0.29), visit a dentist in the past 2 years (aOR = 0.26), and take their children to regular dental check-up (aOR = 0.38); whereas, they were more likely to not consume sweeten beverages (aOR = 3.13). CONCLUSIONS: The level of caries-related knowledge, attitudes and oral health behaviors were found lower in immigrant mothers than native ones. The findings suggested cross-cultural caries prevention programs aimed at reducing immigrant-native disparities in child oral health care must be developed for these immigrant minorities.

Immigrant⁻Native Differences in Sugar-Sweetened Beverage and Snack Consumption and Preventive Behaviors Associated with Severe Early Childhood Caries: A Large-Scale Survey in Taiwan.

This study assessed the differences between immigrants and natives in terms of combined effects of sugar-sweetened beverage (SSB) or snack consumption and preventive behaviors for severe early childhood caries (SECC) through a large-scale survey of 31,565 native and 1046 immigrant child⁻parent pairs in Taiwan. Children aged 3⁻5 years underwent dental examinations, and parents completed structured questionnaires. Immigrants had a significantly higher SECC prevalence than native children (32.3% vs. 19.4%). A combined effect of SECC was observed in native children who did not receive assistance when brushing teeth at night before sleep and those who consumed SSBs more than four times weekly (adjusted odds ratio (aOR) = 4.8). Moreover, native children who did not use dental floss and who consumed snacks more than four times weekly had an aOR of 4.1 for SECC. The combined effects of children with immigrant parents who did not receive assistance when brushing their teeth at night before sleep and those who consumed snacks more than four times weekly had an aOR of 8.2 for SECC. The results suggest the necessity of cross-cultural caries prevention programs for immigrants. Parents must limit children's SSB and snack intake, and implement preventive measures to reduce SECC development.

Reasons for permanent tooth extractions in Taiwan.

There has been no study in Taiwan on reasons for extraction of permanent teeth. This study aimed to determine the reasons for permanent teeth extraction in Taiwan. This study performed a secondary data analysis based on the National Health Insurance Research Database. The 2009 database was adopted and there are 131 104 records of dental visits in the database; among them, 4958 visits (from 4811 patients) have a coding of extraction. The results showed that dental caries (55.3%) was the main reason for tooth extraction, followed by periodontal disease (22.1%). Extraction because of dental caries was commonly observed in all age-groups, and extractions because of periodontal disease increased in those older than 35 years. Maxillary and mandibular third molar were the most frequently removed tooth types, and most were extracted because of dental caries and impaction respectively.

Association between periodontal disease and osteoporosis by gender: a nationwide population-based cohort study.

Periodontitis and osteoporosis are primary concerns in public health and clinical management. The aim of this study was to investigate the association between periodontitis and osteoporosis by gender.Data were retrieved from the National Health Insurance Research Database, Taiwan. A diagnosis of periodontitis was defined on the basis of subgingival curettage, periodontal flap operation, and gingivectomy (excluding those with restorative or aesthetic indications). Multiple logistic regression was used for analysis. After adjusting for age, sex, income, and geographical region, there was a significant association between periodontitis and osteoporosis among women (odds ratio: 1.96; 95% confidence interval 1.17-3.26). The association between periodontitis and osteoporosis was significant among women.

Development and validation of a self-rating scale for betel quid chewers based on a male-prisoner population in Taiwan: the Betel Quid Dependence Scale.

BACKGROUND: Betel quid is a substance that commonly used among male labor in Taiwan, and the dependence potential has been reported in some studies, but no instrument has been developed specifically to assess areca/betel quid dependence. OBJECTIVE: To develop a reliable and valid research instrument/screening tool for the measurement of betel quid dependence. METHODS: There were 223 male prisoners with a history of betel quid chewing behavior before they were incarcerated in Kaohsiung Prison enrolled in this study. The items of the Betel Quid Dependence Scale (BQDS) were developed by the authors and were designed referring to previous research findings and the diagnostic criteria of Substance Dependence in DSM-IV. RESULTS: The BQDS has high internal consistency (Cronbach's α=0.921), and a three-factor structure consisting of "physical and psychological urgent need," "increasing dose" and "maladaptive use," which accounted for 61.2% of the total variance. There were 94 (42.2%) male-prisoners who satisfied DSM-IV criteria for dependent use, and the receiver operating characteristic (ROC) curve showed that the BQDS had an optimal cut-off score of 4, the optimal sensitivity was 0.926 and the specificity was 0.977, with the predictive accuracy up to 99.3%. CONCLUSIONS: The BQDS has good internal consistency and construct validity, and was proved to have optimal reliability and criterion validity in this special sample. Further investigation is suggested in different samples such as the general population or oral submucous fibrosis (OSF) patients to test the generalization of this instrument.