The relationship between self-efficacy and oral health status of older adults.

OBJECTIVES: The objectives of this study were to determine the relationship between reported self-efficacy and dental status in older adults, identify factors which might influence self-efficacy and, their willingness to pay (WTP) for preventive care. METHODS: Participants aged 60-90 years of age living in Singapore were recruited. All participants completed an oral health questionnaire and a clinical examination. Details of participants' socio-economic status and educational attainment were collected, and participants also answered a range of questions related to self-efficacy, oral health attitudes, beliefs and dental attendance patterns. Participants were asked to indicate their willingness to pay for preventive care using contingent valuation. The clinical examination recorded decayed, missing and filled teeth [DMFT], root caries, periodontal attachment loss, bleeding on probing index, occlusal status and, denture wearing status. Associations between self-efficacy, self-report and clinical variables were assessed using Kendall's Tau B coefficient. RESULTS: 614 participants [mean age 68.07 (5.99) years] were recruited. There was a high level of dental awareness and nearly 70% of the participants reported visiting a dentist once or twice a year. Self-efficacy was associated with levels of bleeding on probing and self-reported satisfaction with oral health. Nearly 60% of participants were not willing to pay for preventive advice from an oral healthcare professional. CONCLUSION: Older adults with a high level of self-efficacy had good gingival health, with low reported levels of bleeding on probing. Participants with low reported self-efficacy had higher disease levels and were less satisfied with their oral health. CLINICAL SIGNIFICANCE: Self-efficacy in relation to oral hygiene practices is variable, and participants with low self-efficacy had higher gingival bleeding scores. However, willingness to pay for preventive advice is low, and further work is required to increase the value proposition of preventive care to older adults.

Willingness to Pay for Preventive Dental Care Amongst Older Adults.

OBJECTIVE: The aims of this study were (1) to investigate willingness to pay (WTP) for preventive and curative dental care procedures and (2) to determine the factors that influence older adults' WTP for dental care. METHODOLOGY: Older, independently living adults from Singapore aged 60 years and older and eligible for government-subsidised dental care were nonrandomly recruited for this study. Data were collected using questionnaires and a clinical examination which recorded details of caries experience, number and distribution of posterior occluding contacts, prosthodontic status, and periodontal status. Using a contingent valuation method, participants were asked to rate WTP in Singapore dollars [SGD$] for 4 aspects of care: dental fillings, dental scaling, dental extraction, and disease prevention advice. Negative binomial regression was used to assess the relationship between the predictor variables associated with WTP for dental fillings, scaling, extraction, and preventive advice. RESULTS: The mean value of WTP for a dental filling was SGD$30.23 (SGD$31.05), for scaling was SGD$30.28 (SGD$29.46), for dental extraction was SGD$35.08 (SGD$58.54). In a multivariate model, factors associated with higher WTPfees were as follows: (1) dental filling: age (younger), level of education (higher), and frequency of dental visits (regular); (2) scaling: level of education (higher), agree that dental problems affect overall health, and frequency of dental visits (regular); (3) dental extractions: age (younger), level of education (higher), frequency of dental visits (regular), and prosthodontic status (not wearing); (4) preventive advice: age (younger), gender (male), ethnicity (Chinese), level of education (higher), marital status (married), self-perceived oral health (good), and dental visits (regular). CONCLUSIONS: The findings of our study suggest that older adults are willing to pay most for extraction and least for preventive advice.

Keystone Species in Pregnancy Gingivitis: A Snapshot of Oral Microbiome During Pregnancy and Postpartum Period.

It is well known that pregnancy is under the constant influence of hormonal, metabolic and immunological factors and this may impact the oral microbiota toward pregnancy gingivitis. However, it is still not clear how the oral microbial dysbiosis can modulate oral diseases as oral microbiome during pregnancy is very poorly characterized. In addition, the recent revelation that placental microbiome is akin to oral microbiome further potentiates the importance of oral dysbiosis in adverse pregnancy outcomes. Hence, leveraging on the 16S rRNA gene sequencing technology, we present a snapshot of the variations in the oral microbial composition with the progression of pregnancy and in the postpartum period and its association with pregnancy gingivitis. Despite the stability of oral microbial diversity during pregnancy and postpartum period, we observed that the microbiome makes a pathogenic shift during pregnancy and reverts back to a healthy microbiome during the postpartum period. Co-occurrence network analysis provided a mechanistic explanation of the pathogenicity of the microbiome during pregnancy and predicted taxa at hubs of interaction. Targeting the taxa which form the ecological guilds in the underlying microbiome would help to modulate the microbial pathogenicity during pregnancy, thereby alleviating risk for oral diseases and adverse pregnancy outcomes. Our study has also uncovered the possibility of novel species in subgingival plaque and saliva as the key players in the causation of pregnancy gingivitis. The keystone species hold the potential to open up avenues for designing microbiome modulation strategies to improve host health during pregnancy.

Nurturing healthy dietary habits among children and youth in Singapore.

Healthy diet is a key tenet in the prevention of many chronic diseases. Nurturing healthy dietary habits is especially important in childhood as this is a critical period of growth and development. Furthermore, dietary habits are shaped from an early age with many of them forming even below the age of 5 years. Therefore, the importance of nurturing healthy dietary habits during a child's formative years cannot be underestimated. Reducing fat, salt and sugar intake and at the same time, advocating the consumption of adequate whole-grains, fruit and vegetables among the population remain the cornerstone of the Singapore Health Promotion Board's (HPB) key nutrition initiatives. To achieve this, HPB adopts a multi-pronged approach comprising various strategies to promote healthy eating among children and youth in Singapore. This article provides an overview of these strategies and the broad range of nutrition education efforts targeted at the young.