Cultural factors and oral health-related quality of life among dentate adults: Hispanic community health study/study of Latinos.

Objective: Research on the relationships between acculturation, ethnic identity, and oral health-related quality of life (OHRQOL) among the U.S. Hispanic/Latino population is sparse. The aim of this study is to examine the association between acculturation, ethnic identity, and OHRQOL among 13,172 adults in the 2008-2011 Hispanic Community Health Study/Study of Latinos (HCHS/SOL).Design: Participants self-reported their acculturation (immigrant generation, birthplace, residence in the U.S., language, and social acculturation), ethnic identity (sense of belonging and pride), and four OHRQOL measures. Key socio-demographic, behavioral, and oral health outcomes were tested as potential confounders.Results: Overall, 57% of individuals experienced poor OHRQOL in at least one of the domains examined. In multivariable analyses, some elements of higher acculturation were associated with greater food restriction and difficulty doing usual jobs/attending school, but not associated with pain or difficulty chewing, tasting, or swallowing. While sense of belonging to one's ethnic group was not associated with poor OHRQOL, low sense of pride was associated with food restriction. Socio-behavioral characteristics were significant effect modifiers.Conclusion: This study contributes to the understanding of the role of Hispanic/Latino's cultural factors in OHRQOL perception and can inform targeted strategies to improve OHRQOL in this diverse population.

Informed consent in dental care and research for the older adult population: A systematic review.

BACKGROUND: Ethics in health care and research is based on the fundamental principle of informed consent. However, informed consent in geriatric dentistry is not well documented. Poor health, cognitive decline, and the passive nature of many geriatric patients complicate this issue. METHODS: The authors completed this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The authors searched the PubMed (MEDLINE), Web of Science, PsycINFO, and Cochrane Library databases. The authors included studies if they involved participants 65 years or older and discussed topics related to informed consent beyond obtaining consent for health care. The authors explored informed consent issues in dentistry and other biomedical care and research. RESULTS: The authors included 80 full-text articles on the basis of the inclusion criteria. Of these studies, 33 were conducted in the United States, 29 addressed consent issues in patients with cognitive impairment, 29 were conducted in patients with medical conditions, and only 3 involved consent related to dental care or research. CONCLUSIONS: Informed consent is a neglected topic in geriatric dental care and research. Substantial knowledge gaps exist between the understanding and implementation of consent procedures. Additional research in this area could help address contemporary consent issues typically encountered by dental practitioners and to increase active participation from the geriatric population in dental care and research. PRACTICAL IMPLICATIONS: This review is the first attempt, to the authors' knowledge, to identify informed consent issues comprehensively in geriatric dentistry. There is limited information in the informed consent literature covering key concepts applicable to geriatric dentistry. Addressing these gaps could assist dental health care professionals in managing complex ethical issues associated with geriatric dental patients.

Associations of serum concentrations of IgG, IgA, IgM and interleukin-1beta with early-onset periodontitis classification and race.

BACKGROUND: The significance of serum concentrations of various antibodies and cytokines in the pathogenesis of early-onset periodontitis (EOP) is not well understood. Recent reports suggest differences between young blacks and whites in certain humoral responses, regardless of periodontal status. This study was undertaken to compare the serum concentrations of IgG, IgA, IgM, and IL-1beta in EOP subjects with that of healthy controls, and to study the effect of race on these levels. MATERIAL AND METHODS: This case-control study included 228 individuals, 19-25 years old who were selected from a larger population examined in the National Survey of Oral Health of United States Children in 1986/1987. The subjects were classified by their EOP status and they included 166 subjects with EOP and 62 healthy controls. Blood samples were used to assess the serum concentrations of IgG, IgM, IgA, IgG subclass, and IL-1beta. RESULTS: The serum concentrations of IgG, IgG subclasses, IgA, and IgM in blacks were not significantly different in the generalized, localized and incidental EOP groups as compared to the healthy controls. The serum IL-1beta concentration was slightly and uniformly lower in the EOP groups than in the control group, although not statistically significant. Blacks had significantly higher serum concentrations of total IgG, and of IgG1, IgG2 and IgG3 than whites and Hispanics. Hispanics had significantly higher serum concentrations of IgM and IgG4 than whites and blacks. Hispanics also had a significantly higher serum concentration of IL-1beta than blacks. CONCLUSIONS: Total antibody response in blacks is not associated with EOP classification. Race has a significant effect on serum antibody concentrations irrespective of disease classification, with blacks having significantly higher serum concentrations of IgG1, IgG2 and IgG3 than whites and Hispanics.