Development of the Oral Health Literacy Profile (OHLP)-Psychometric properties of the oral health and dental health system knowledge scales.

OBJECTIVES: Current oral health literacy (OHL) instruments vary in focus, methodology, administration time and burden. The widely used word recognition tests fail to encompass important OHL domains, while others exceed time frames for use in practical settings, require an interviewer or mainly measure self-assessments. This paper describes the development of the Oral Health Literacy Profile (OHLP), introduces its components and evaluates the psychometric properties of its two core modules, the knowledge tests. METHODS: A preliminary version of the questionnaire was developed and assessed for content validity, relevance and redundancy by an expert panel. It was tested in a convenience sample (n = 95) leading to the creation of a 28-item questionnaire, which was afterwards tested in a second convenience sample (n = 193). Item difficulty, discrimination, internal reliability and construct validity were assessed for the oral health knowledge (OHK) and dental health system knowledge (DHSK) modules. RESULTS: The items showed acceptable range of difficulty (ideal: 7 items; easy: 5 items; and difficult: 3 items) and good to very good discriminatory power (the point-biserial index (PBI) > 0.30: all items). Construct validity was considered to be fulfilled when 75% of the hypotheses of expected group differences were met. Satisfactory internal reliability was observed. CONCLUSION: With all its components, the OHLP is a suitable short instrument to assess the most relevant dimensions of the multifaceted construct of OHL. PRACTICE IMPLICATION: The OHLP can be widely used in research, especially suitable in practical settings, and thereby identify patients who may benefit from oral health education.

[Oral health literacy of persons with migration background-first results of the MuMi study]. / Mundgesundheitskompetenz von Menschen mit Migrationshintergrund ­ Erste Auswertungen der MuMi-Studie.

BACKGROUND: First investigations indicate a migration background of residents in Germany as a discrete risk factor for poor oral health. A lower level of oral health literacy among people with a migration background is considered a reason worthy of being investigated. AIM: This article presents results on oral health literacy and oral health gained from the MuMi study (promoting oral health and oral health literacy of people with a migration background). METHODS: The oral health and oral health literacy as well as the sociodemographics of patients with and without migration background were examined in 40 dental surgeries in Hamburg, Germany. Associations between migrant status, oral health, and oral health literacy were analyzed with logistic regressions. Potential confounders were gradually integrated into the multivariate analyses. RESULTS: Patients with and without a migration background differed significantly in oral health literacy and clinical parameters of oral health (approximal plaque index and degree of caries restoration). The logistic regression analysis revealed highly significant associations between migration background, oral health literacy, and oral hygiene, while also accounting for education and socioeconomic status. DISCUSSION: Migration background constitutes a discrete risk factor for lower oral health and oral health literacy for these relevant population groups. This fact needs stronger reflection in further research and political decision-making in order to promote equality of oral health opportunities.

Postponed Dental Appointments Due to Costs Are Associated with Increased Loneliness-Evidence from the Survey of Health, Ageing and Retirement in Europe.

As is already well known, demographic changes will presumably lead to a rising number of old aged individuals and loneliness is a tremendous concern in aging populations. Poor health can be a potential consequence of loneliness, as well as a determining factor. Thus, the objective of the current study was to determine whether postponed dental appointments due to costs affect loneliness longitudinally. Focusing on Germany, data from two waves (waves 5 and 6) of the "Survey of Health Ageing, and Retirement in Europe" (SHARE) were analyzed (n = 7703). The three-item loneliness scale (modified version of the revised UCLA Loneliness scale) was used to quantify loneliness. The presence of postponed dental appointments due to costs in the past 12 months (no; yes) served as a key independent variable. Socioeconomic factors as well as health-related factors were adjusted in the longitudinal regression analysis. After adjusting for confounding variables, regression analyses revealed that loneliness increased with decreases in self-rated health among men. Among women, loneliness increased when self-rated health decreased, when fewer chronic diseases and postponed dental appointments due to costs were reported. Among older women, postponed dental appointments due to costs are associated with feelings of loneliness. The study results add evidence that proper dental care (i.e., regular and appropriate visits to the dentist) is vital not only to one's oral health, but also plays a role in one's physical and emotional health.

Do postponed dental visits for financial reasons reduce quality of life? Evidence from the Survey of Health, Ageing and Retirement in Europe.

BACKGROUND: There is a lack of studies investigating the impact of postponed dental visits due to financial constraints on quality of life. AIMS: The aim of this study was to identify whether these factors are associated longitudinally. METHODS: Data were derived from waves 5 and 6 of the "Survey of Health Ageing and Retirement in Europe" (SHARE). The analysis focused on Germany (n = 7506). The widely used CASP-12 was used to quantify the quality of life. Postponed dental visits for financial reasons in the preceding 12 months (no, yes) were used as the main explanatory variable. Socioeconomic and health-related covariates were included in regression analysis. RESULTS: Gender stratified regression analysis showed that quality of life decreased with the presence of postponed dental visits due to financial reasons in men. Furthermore, quality of life decreased with the worsening of self-rated health in both men and women. The outcome measure was not associated with age, marital status, income, and chronic diseases in both sexes. DISCUSSION: Study findings suggest that postponing dental visits due to financial constraints contributes to a decreased quality of life among older men. CONCLUSION: Efforts to avoid these circumstances might help to maintain the quality of life in older men.

Determinants of dental treatment avoidance: findings from a nationally representative study.

BACKGROUND: Oral health care of older adults is of rising importance due to ongoing demographic changes. There is a lack of studies examining the determinants of dental treatment avoidance in this age group. Therefore, the objective of this study was to identify those determinants. METHODS: Cross-sectional data were drawn from the second wave (year 2002) of the German Ageing Survey which is a population-based sample of community-dwelling individuals ≥ 40 years in Germany (n = 3398). Dental treatment avoidance was quantified using the question "Did you need dental treatments in the past twelve months, but did not go to the dentist?" [no; yes, once; yes, several times]. Socioeconomic and health-related determinants were adjusted for in the analysis. Multiple logistic regressions were performed. RESULTS: In terms of need, 6.7% of individuals avoided dental treatment in the preceding twelve months. Multiple logistic regressions revealed that dental treatment avoidance was associated with younger age (total sample [OR 0.978; 95% CI 0.958-0.998] and men [OR 0.970; 95% CI 0.942-0.999]), unemployment (total sample [OR 1.544; 95% CI 1.035-2.302] and men [OR 2.004; 95% CI 1.085-3.702]), lower social strata (women [OR 0.814; 95% CI 0.678-0.977]), increased depressive symptoms (men [OR 1.031; 95% CI 1.001-1.062]), and increased physical illnesses (total sample [OR 1.091; 95% CI 1.006-1.183] and men [OR 1.165; 95% CI 1.048-1.295]). The outcome measure was not associated with income poverty, marital status and physical functioning. CONCLUSIONS: The present study highlights the association between dental treatment avoidance and different socioeconomic and health-related factors. These results suggest that it is necessary to promote the importance of dental visits.

Association between Subjective Well-Being and Frequent Dental Visits in the German Ageing Survey.

The relationship between subjective well-being (SWB) and frequent attendance is understudied. This study used data from a large German sample of non-institutionalized individuals aged 40+ in 2014 (n = 7264). SWB was measured using the Satisfaction with Life Scale (SWLS) and the Positive and Negative Affect Schedule (PANAS). Number of self-reported dental visits in the past twelve months was used to measure the utilization frequency of dental services. Individuals with at least four dental visits in the preceding year (highest decile) were defined as frequent dental visits. Robustness checks were performed using alternative cut-offs to define frequent dental visits. Multiple logistic regressions showed that frequent dental visits (highest decile) were associated with less satisfaction with life [OR: 0.89, 95%-CI: 0.80-0.99] and higher negative affect [OR: 1.41, 95%-CI: 1.22-1.64], whereas it was not significantly associated with positive affect. Both associations depended on the cut-off chosen to define frequent dental visits. The present study highlights the association between SWB (particularly negative affect and low life satisfaction) and frequent dental visits. Further studies evaluating patients' motivation for high dental service use are necessary to check the robustness of our findings.

Determinants of Postponed Dental Visits Due to Costs: Evidence from the Survey of Health, Ageing, and Retirement in Germany.

High costs are an important reason patients postpone dental visits, which can lead to serious medical consequences. However, little is known about the determinants of postponing visits due to financial constraints longitudinally. Thus, the purpose of this study was to examine the determinants of postponing dental visits due to costs in older adults in Germany longitudinally. Data from wave 5 and 6 of the Survey of Health, Ageing, and Retirement in Europe was used. The occurrence of postponed dental visits due to costs in the last 12 months served as the outcome measure. Socioeconomic and health-related explanatory variables were included. Conditional fixed effects logistic regression models were used (n = 362). Regressions showed that the likelihood of postponing dental visits due to costs increased with lower age, less chronic disease, and lower income. The outcome measure was neither associated with marital status nor self-rated health. Identifying the factors associated with postponed dental visits due to costs might help to mitigate this challenge. In the long term, this might help to maintain the well-being of older individuals.

Psychometric performance of the Quality of Life in Short Stature Youth (QoLISSY) questionnaire in a randomized open-label comparator trial in idiopathic short stature.

Background In addition to increasing linear growth, improvement in health-related quality of life (HRQOL) is an important endpoint in the treatment of short statured youth. Hence, condition-specific psychometric valid instruments that adequately assess HRQOL are needed. We aimed to confirmatorily examine the psychometric performance of the Quality of Life in Short Stature Youth (QoLISSY) questionnaire used in a previously reported prospective randomized open-label trial. Methods This trial compared treatment of idiopathic short stature (ISS) in 76 adolescent males with either oral aromatase inhibitors (AIs), subcutaneous daily growth hormone (GH) or a combination treatment (AI/GH) for at least 2 years, demonstrating improvements in HRQOL with the GH and AI/GH interventions. HRQOL was assessed from the child's and parent's perspectives with the short stature-specific QoLISSY and the generic KIDSCREEN questionnaires before and 24 months into treatment. Scale scores and psychometric properties were examined regarding reliability and validity of the QoLISSY questionnaire using the dataset from the published trial. Results The QoLISSY questionnaire showed high internal consistency and satisfactory criterion, convergent and known-groups validity. Scale scores were evenly distributed with no major floor or ceiling effects. Responsiveness analyses suggest that the QoLISSY questionnaire detects significant changes in HRQOL after 2 years of treatment with growth-promoting therapies in children with short stature from both the child's and parent's perspectives. Conclusions The QoLISSY questionnaire is a psychometrically sound, reliable and valid instrument that can explore the experiences associated with short stature, track HRQOL changes over time and in response to treatment, and highlight HRQOL domains that can be improved through intervention.