Caries status in 12-year-old children, geographical location and socioeconomic conditions across European countries: A systematic review and meta-analysis.

BACKGROUND: Understanding of socioeconomic context might enable more efficient evidence-based preventive strategies in oral health. AIM: The study assessed the caries-related socioeconomic macro-factors in 12-year-olds across European countries. DESIGN: This systematic review involved epidemiological surveys on the caries status of 12-year-olds from 2011 to 2022. DMFT was analyzed in relation to gross national income (GNI), United Nations Statistical Division geographical categorization of European countries (M49), unemployment rate, Human Development Index (HDI), and per capita expenditure on dental health care. A meta-analysis was performed for countries reporting data on DMFT, stratified by GNI, and geographical location of European countries, using a random-effects model. RESULTS: The study involved 493 360 children from 36 countries in the geographic region of Europe. The analysis confirmed a strong negative correlation between income and caries experience (p < .01). Children living in higher-income countries showed 90% lower odds of poor oral health than in middle-income countries. Children living in West Europe showed 90% lower odds of poor oral health than children living in East Europe. CONCLUSION: The strong effect of macro-level socioeconomic contexts on children's oral health suggests favoring upstream preventive oral health strategies in countries with economic growth difficulties, Eastern and Southern parts of Europe.

Evaluation of the Association of Chewing Function and Oral Health-Related Quality of Life in a Population of Individuals Aged ≥ 45 Years and Residing in Communities in Switzerland: A Cross-Sectional Study.

PURPOSE: To analyse the association of masticatory performance and oral health-related quality of life in a representative population of individuals residing in communities in Switzerland aged ≥ 45 years. MATERIALS AND METHODS: In total, 100 subjects completed two dedicated and validated questionnaires on their demographic data and the Geriatric Oral Health Assessment Index. A mixing ability test was performed for assessing masticatory performance. The qualitative analysis of the test was performed by categorizing the images into five categories, while the quantitative analysis was performed via a validated custom-made software. RESULTS: Sixty-six samples could be analysed. Participants younger than 65 years of age showed significantly less frequent chewing deficiencies (17%) compared to those 65 years and older (50%, p < 0.01). However, retired participants had chewing deficiencies significantly more frequently (8%) compared to workers (51%, p < 0.01). A statistically significant positive association of having chewing deficiency was found between employment status (p < 0.01) and the presence of restorations (p = 0.04), while GOHAI did not show any statistically significant association. Overall, the enrolled subjects displayed moderate chewing function. Masticatory performance was positively associated with the number of present restorations. CONCLUSIONS: The enrolled subjects residing in communities in Switzerland aged ≥ 45 years displayed moderate chewing function. Their masticatory performance was positively associated with the number of present restorations but not associated with oral health related quality of life (GOHAI).

Evaluation of the Oral Health Conditions and Oral Health-Related Quality of Life in a Community-Dwellers Population Aged ≥ 45 Years in the Canton of Bern: A Preliminary Pilot Study.

OBJECTIVE: To evaluate oral health conditions and oral health-related quality of life in community-dwellers aged ≥ 45 years in the Canton of Bern, Switzerland. MATERIALS AND METHODS: One hundred subjects (63% males; mean age: 73 years), selected randomly using a cluster procedure within the Canton of Bern, underwent a clinical oral examination after completing questionnaires on socio-economic level, medical history, oral health behaviour, and Geriatric Oral Health Assessment Index (GOHAI). Descriptive analyses and multinomial regression models were applied to investigate the association between oral health diseases (dental caries and periodontitis) and specific participant characteristics. RESULTS: The mean number of decayed, missing, and filled teeth (DMFT) was 0.30, 4.20, and 8.75, respectively; the mean DMFT score = 13.35. Dental caries prevalence (ICDAS > 0) was 15% and periodontitis prevalence was 46%. Logistic regression models revealed that living in an urban area was associated with lower odds (OR 0.03, 95%CI 0.00-0.36) of having periodontal disease. Male gender was associated with lower odds for dental caries (OR 0.31, 95%CI 0.09-1.01) and total lack of professional tooth cleaning was associated with higher odds for dental caries (OR 41.99, 95%CI 0.01-0.38). Ordinal logistic regression revealed that both the presence of dental caries (RR 12.80, 95%CI 1.47-111.20) and periodontal disease (RR 6.91, 95%CI 1.16-84.00) were statistically significantly associated with rheumatoid arthritis. CONCLUSION: Within the study limitations, untreated dental caries and periodontal disease are prevalent in the Swiss population, despite the high level of self-performed oral hygiene and access to the dental care system.

Delivery of mobile dental services to dependent elderly people: results from a pilot study in rural Switzerland.

The objective of this pilot study was to provide data on the oral health status and oral health behaviour of care-dependent elderly people in the canton of Uri. The study aimed at assessing whether age and duration of living in a nursing home is associated with dental attendance, whether there is a relationship between age and the DMF-T index, and how high the risk was for participants to develop oral health problems. The study offered mobile dental services to people residing in nursing homes (NHG) and to community dwellers (CDG). Data was collected on demographics, medical history, presence of pain, ability to eat and oral health behaviour by means of a questionnaire. A clinical examination was performed and data on the oral status was collected. Statistical methods were: median tests, linear regressions and descriptive statistics. Uptake of the programme was low. 56 participants were examined. 47 participants (24 females, 23 males, average age 86.3 ± 7.36 years) resided in nursing home, nine participants (seven females, two males, average age 76 ± 12.8 years) were community dwellers. No significant differences were found between frequency of dental attendance and age (p = 0.35) or duration of stay in a nursing home (p = 0.55). The number of decayed teeth (p=0.005), missing teeth (p=0.01), and the DMF-T index (average in NHG = 26.5, CDG = 20.2, p < 0.001) increased, the number of filled teeth (p=0.02) decreased as age increased. Upon calculation of the 'Teamwerk-index', which takes into account oral health behaviour, dental caries, periodontal status, the majority of participants had a medium risk of developing oral health problems. Our pilot study in rural Switzerland provides first results of the oral health status in dependent elderly people. As people age, oral health deteriorates. More attention should be given in order to achieve better oral hygiene maintenance and more regular dental visits, to ensure a better oral health status in dependent elderly people.

The provision of mobile dental services to dependent elderly people in Switzerland.

OBJECTIVE: This work aimed at describing mobile dental services provided by both the private sector and the universities in Switzerland to dependent elderly people. It also aimed at presenting the views of both sectors on the current status of these services. BACKGROUND: As people age and become more care-dependent, their oral health requirements increase, as access to dental care decreases. METHOD: A survey was sent to practitioners who potentially provided a mobile dental service (n = 253). Five interviews were conducted with six individuals who have a leading role in Geriatric dentistry in the four universities in Switzerland that provide dental training. RESULTS: The private sector provides a mobile dental service to the elderly mainly through the use of portable equipment, while university services are provided by different models. The interviewees discussed the reasons as to why these services were set up. They discussed the challenges associated with treating dependent elderly patients, which often makes work in this field hard and unattractive. Both sectors see the need for better collaboration with other professionals. CONCLUSION: The private sector in Switzerland provides a mobile dental service to elderly people mostly through the use of portable equipment, while university services are provided in a variable configuration of models. Better collaboration is required to improve dental care and service delivery to dependent elders. There is a potential for improvement of these services, in order to meet the demand of an ageing population, catering for both the institutionalised elders and those living at home.