Role of Dentistry in Global Health: Challenges and Research Priorities.

Despite some improvements in the oral health of populations globally, major problems remain all over the planet, most notably among underprivileged communities of low- and middle-income countries but also in high-income countries. Furthermore, essential oral health care has been a privilege, instead of a right, for most individuals. The release of the Lancet issue on oral health in July 2019 built up some momentum and put oral conditions and dental services in the limelight. Yet, much work is still needed to bridge the gap between dental research and global health and get oral health recognized as a population health priority worldwide. Using the framework proposed by Shiffman, we argue that a global health network for oral health must be harnessed to influence global health policy and drive health system reform. We have identified challenges around 4 key areas (problem definition, positioning, coalition building, and governance) from our experience working in the global health arena and with collaborators in multidisciplinary teams. These challenges are outlined here to validate them externally but also to call the attention of interested players inside and outside dentistry. How well our profession addresses these challenges will shape our performance during the Sustainable Development Goals era and beyond. This analysis is followed by a discussion of fundamental gaps in knowledge, particularly in 3 areas of oral health action: 1) epidemiology and health information systems; 2) collection, harmonization, and rigorous assessment of evidence for prevention, equity, and treatment; and 3) optimal strategies for delivering essential quality care to all who need it without financial hardship.

Maternal Oral Health and Early Childhood Caries amongst Low-Income Families.

OBJECTIVE: To determine the association between maternal oral health and Early Childhood Caries (ECC) and discover the role of maternal and child behaviours in explaining this association. BASIC RESEARCH DESIGN: A cross-sectional analytic study. CLINICAL SETTING: Public Healthcare Services in Pasto, Colombia. PARTICIPANTS: 384 mothers and their 2-5-year-old children. METHODS: Mothers completed a questionnaire to provide information on sociodemographic and behavioural factors and were examined for caries experience (DMFS index) and periodontal status (Community Periodontal Index, CPI). Children were examined for dental caries (dmfs index). The association between maternal dental indicators and child dmfs was assessed in negative binomial regression adjusting for confounders. RESULTS: About 96% and 33% of mothers had caries experience and periodontal disease, respectively. The mean dmfs was 7.4 (SD: 9.5, range: 0-71). Maternal DMFS, but not CPI, was positively associated with children's dmfs (Rate Ratio: 2.51, 95%CI: 1.59-3.97) after adjustments for sociodemographic and behavioural factors. CONCLUSIONS: Maternal caries experience, but not periodontal status, was positively associated with ECC in their children. Maternal and child behaviours explained little of this association.

Impacts on daily performances attributed to malocclusions by British adolescents.

The aim of this study was to assess the prevalence of condition-specific impacts on daily performances attributed to malocclusion in British adolescents. Two hundred 16- to 17-year-old adolescents were randomly selected from 957 children attending a public college in London, UK. During interviews, participants provided information about demographic variables and socio-dental impacts on quality of life attributed to malocclusions, using the Condition-Specific form of the Oral Impacts on Daily Performances (CS-OIDP) index. Adolescents were also clinically examined using the Index of Orthodontic Treatment Need. Statistical comparison by covariates was performed using chi-squared test and chi-squared test for trends. The prevalence of oral impacts on daily performances attributed to any oral condition was 26.5% whereas the prevalence of CS-OIDP attributed to malocclusion was 21.5%. There was no statistically significant difference by sex, age, ethnicity or orthodontic treatment status of schoolchildren in the prevalence of CS-OIDP attributed to malocclusion (P >/= 0.243 for all cases). However, there was a linear trend for the prevalence of CS-OIDP attributed to malocclusion, by level of normative orthodontic treatment need (P = 0.042). The prevalence of such impacts increased from 16.8% for adolescents with no/slight need for orthodontic treatment, to 31.7% for those with definite need for orthodontic treatment. Although findings support the idea that malocclusion has physical, psychological and social effects on quality of life of these adolescents, the inconsistencies in findings between the self-reports of impacts of malocclusion and the assessment of normative needs highlight the shortcomings of using only clinical indexes to estimate orthodontic treatment needs.

Reasons for choosing dentistry as a career: a study involving male and female first-year students in Peru.

The aim of this study was to compare the reported reasons to choose dentistry as a career between Peruvian male and female first-year students. A self-completion questionnaire was administered to 75 first-year students registered at the Faculty of Dentistry of the Universidad Peruana Cayetano Heredia, Lima, Peru. The questionnaire comprised 16 items grouped into four categories (economic, professional, vocational and personal background). Students rated the importance of each item for selecting dentistry as a career on a Likert-type scale of five points. The Mann-Whitney test was used to compare groups and item scores by gender. A male/female proportion of 1/2.1 was found in the pool of participating students. When group and item scores were compared between genders, statistically significant differences were only found for vocational and personal background reasons (P < 0.05); however, the three reasons that obtained higher scores for each gender were found to be different. It is recommended that further studies be conducted to increase the sample, by extending the study and evaluating not only reasons for choosing dentistry, but also other factors that may influence the decision.

Prediction of mesiodistal canine and premolar tooth width in a sample of Peruvian adolescents.

OBJECTIVES: To compare the predicted tooth width measurements of permanent canine and premolars from Tanaka-Johnston regression equations and Moyers probability tables with the in situ measurements in a sample of Peruvian adolescents. DESIGN: Cross-sectional. SETTING AND SAMPLE POPULATION: Trujillo, Peru; 248 dental casts were measured using a sliding caliper with a Vernier scale rounded to 0.1 mm. RESULTS: Tanaka-Johnston regression equations were not precise, except for the upper arch in the male sample. For females, the Moyers 95th percentile in the upper arch and the 65th percentile in the lower arch predicted the sum precisely. For males, the Moyers 65th percentile for the lower arch predicted the sum precisely, but none of the Moyers percentiles provided precise prediction in the upper arch. CONCLUSIONS: Using tooth width prediction methods from a different racial origin could create an under- or overestimation of the actual combined canine and premolar tooth width, although their clinical significance is disputable.