ABSTRACT
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.
Subject(s)
Adolescent , Female , Humans , Male , Mouth Diseases/epidemiology , Oral Health , Quality of Life , Tooth Diseases/epidemiology , Dental Health Surveys , Prevalence , Sickness Impact Profile , Socioeconomic Factors , Thailand/epidemiologyABSTRACT
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.