Using associations between oral diseases and oral health-related quality of life in a nationally representative sample to propose oral health goals for 12-year-old children in Thailand.

OBJECTIVES: This study was carried out to assess the associations between oral diseases and specifically oral health-related quality of life (OHRQoL) in a nationally representative sample of 12-year-old children in Thailand in order to classify children according to their levels of risk for adverse OHRQoL and to apply findings to formulate proposals for oral health goals. METHODS: Oral examinations and OHRQoL interviews using the Child-Oral Impacts on Daily Performances (Child-OIDP) schedule were conducted in 1,100 children as part of the Thailand National Oral Health Survey. The severity of oral impacts was categorised according to their 'intensity'. Associations of oral diseases and condition-specific (CS) OHRQoL impacts were investigated. RESULTS: Oral impacts were prevalent. Most were of low intensity; these were excluded from the analysis used to develop goals. At the threshold of moderate/high intensity, CS impacts attributable to dental caries, edentulous areas, periodontal disease and discolouration were reported by 18.5%, 0.2%, 8.7% and 2.6% of participants, respectively. Missing teeth was significantly related to CS impacts. Condition-specific impacts were 1.6 times and three to four times more likely to affect children with one decayed tooth and two or more decayed teeth, respectively. Children with gingivitis or calculus in three or more sextants were twice as likely and children with calculus and gingivitis in three or more sextants were 3.5 times more likely to report CS impacts. Based on these findings, these recommendations are proposed: all 12-year-old children should have fewer than two untreated decayed teeth; 60% of 12-year-old children should not have periodontal disease in any form in more than two sextants, and the proportion of 12-year-old children with calculus with gingivitis in three or more sextants should not exceed 5%. CONCLUSIONS: Measures of oral health and goals for oral health in children should include measures of OHRQoL.

Setting oral health goals that include oral health-related quality of life measures: a study carried out among adolescents in Thailand.

The aim of this study was to assess the association between oral diseases and condition-specific oral health-related quality of life (CS-OHRQoL) as a basis for proposing OHRQoL-based goals for the population of 15-year-olds in Thailand. Oral examinations and OHRQoL interviews were conducted with 871 15-year-olds as part of the Sixth Thailand National Oral Health Survey. The severity of oral impacts was categorized using "intensity". Associations between oral diseases and CS-OHRQoL were analyzed using chi-square and logistic regression. Thirty-nine percent of 15-year-olds experienced moderate/higher levels oral impacts on quality of life. Compared to those individuals with no tooth decay, adolescents with one or four or more decaying teeth were three and seven times more likely to experience moderate/higher impacts, respectively. Adolescents with extensive gingivitis in 3 or more mouth sextants were twice as likely to experience moderate/higher CS-impacts. Based on these findings, it is proposed that goals should focus on untreated decaying teeth and extensive gingivitis. Oral health goals for 15-year-olds should include specific OHRQoL measures.

Setting oral health goals that include oral health-related quality of life measures: a study carried out among adolescents in Thailand / Incorporação da qualidade de vida relacionada à saúde bucal em metas de saúde bucal: estudo conduzido em adolescentes tailandeses

The aim of this study was to assess the association between oral diseases and condition-specific oral health-related quality of life (CS-OHRQoL) as a basis for proposing OHRQoL-based goals for the population of 15-year-olds in Thailand. Oral examinations and OHRQoL interviews were conducted with 871 15-year-olds as part of the Sixth Thailand National Oral Health Survey. The severity of oral impacts was categorized using "intensity". Associations between oral diseases and CS-OHRQoL were analyzed using chi-square and logistic regression. Thirty-nine percent of 15-year-olds experienced moderate/higher levels oral impacts on quality of life. Compared to those individuals with no tooth decay, adolescents with one or four or more decaying teeth were three and seven times more likely to experience moderate/higher impacts, respectively. Adolescents with extensive gingivitis in 3 or more mouth sextants were twice as likely to experience moderate/higher CS-impacts. Based on these findings, it is proposed that goals should focus on untreated decaying teeth and extensive gingivitis. Oral health goals for 15-year-olds should include specific OHRQoL measures.

O objetivo deste estudo foi avaliar a associação entre doença bucal e a condição específica de qualidade de vida associada à saúde bucal (CS-OHRQoL), como base para propor OHRQoL metas para adolescentes tailandeses. Exame clínico bucal e entrevista foram realizados em 871 adolescentes na faixa etária de 15 anos, como parte da 6ª Pesquisa Nacional Tailandesa de Saúde Bucal. A severidade do impacto bucal foi categorizada usando-se a "intensidade". A associação entre doença bucal e CS-OHRQoL foi investigada usando-se o teste qui-quadrado e regressão lógica. Trinta e nove por cento da amostra reportaram impactos bucais de grau moderado/elevado. A probabilidade de reportar um impacto bucal de grau moderado/elevado dos adolescentes com um dente cariado e aqueles com 4 ou mais foi 3 e 7 vezes maior, respectivamente, quando comparada à dos adolescentes sem dentes cariados. A presença de gengivite severa em 3 ou mais sextantes dobrou a probabilidade de ocorrência do CS-impacto de grau moderado/elevado. Metas de saúde bucal para adolescentes devem incluir instrumentos específicos de OHRQoL.

Funding health promotion and disease prevention programmes: an innovative financing experience from Thailand.

Sustainable sources of funding for health programmes have been explored by many countries. In Thailand, the Health Promotion Foundation (ThaiHealth) was established in 2001 as an innovative state agency for funding health promotion from the 2% surcharge on alcohol and tobacco excise tax. ThaiHealth is governed by a Board chaired by the Prime Minister. It is not part of the conventional health services. ThaiHealth explicitly pursues a "socio-cultural" rather than a "biomedical model" of health. It has fostered strategic partnerships with government, private sector, nongovernmental organizations, and communities to implement health promotion plans. In 2010, its budget was 3700 million bahts (119 million US dollars). Since ThaiHealth plays a catalytic, coordinating, empowering and enabling role, its impact can only be assessed "collectively" with all partner organizations. ThaiHealth contributed to development of several policies that led to enactment of laws and building the capacity of organizations, communities and individuals in planning and carrying out health promotion activities. The "Collective impact" includes decline in smoking among the more-than-15-year-olds from 25.47% in 2001 to 20.7% in 2009; harmful alcohol drinkers from 9.1% in 2004 to 7.3% in 2009; death rate from vehicle accidents from 22.9 per 100 000 in 2003 to 16.82 per 100 000 in 2010. The main factors leading to achievements of ThaiHealth are: flexibility, financial security and effective strategy. However, inadequate understanding among public and stakeholders about the philosophy, governance and operation of ThaiHealth is reckoned as a huge challenge.

The effect of a new toothpaste containing potassium nitrate and triclosan on gingival health, plaque formation and dentine hypersensitivity.

OBJECTIVES: The purpose of this study was to investigate the effect of a new toothpaste containing an antiplaque and antiinflammatory agent (0.3% triclosan), a desensitizing agent (5% potassium nitrate) and an anticaries agent (0.76% sodium monofluorophosphate (SMFP)) on gingival health, plaque formation and dentine hypersensitivity in a 12-week home study. The efficacy of the test toothpaste was compared with that of a control toothpaste containing 5% potassium nitrate and 0.76% SMFP and a benchmark product containing only 0.76% SMFP. MATERIAL AND METHODS: One hundred and two healthy volunteers, who had a minimum of 20 natural permanent teeth with no probing depth >4 mm and at least one sensitive tooth, participated in this study. Following enrollment, the subjects received a dental prophylaxis and instruction in brushing technique. After a 4-week pre-experimental phase, baseline gingival bleeding index (GBI), plaque index (PI) and visual analogue scales (VASs) indicating dentine hypersensitivity levels responding to tactile and air stimuli were assessed. The subjects were then randomly given one of the three toothpastes; test, control, or benchmark toothpaste, and a soft-filamented toothbrush for home use. The GBI, PI and VASs were re-examined at weeks 4 and 12. RESULTS: Overall, the GBI scores were significantly reduced compared with baseline in all groups (p<0.01). However, there was no significant difference in GBI score among the three comparison groups. The PI score decreased in the test group and benchmark group from baseline to the end of study, whereas there was no significant change in the control group. Post hoc comparison indicated that the PI score was not statistically different between the three groups. There was a significant difference between the three treatment groups for sensitivity. For both the tactile and air stimuli, the reductions in VAS sensitivity scores for the test group and the control group were significantly greater compared with the benchmark group. Although the sensitivity score for air stimulus decreased more rapidly from baseline to week 4 in the test group, there was no overall difference between the test group and the control group. CONCLUSIONS: This study demonstrated that the new toothpaste was effective in reducing dentine hypersensitivity. More studies are needed to further determine the potential interaction between triclosan and potassium nitrate in dentifrices.