Individual oral symptoms in burning mouth syndrome may be associated differentially with depression and anxiety.

BACKGROUND: Burning mouth syndrome (BMS) is an idiopathic disease characterized by the feeling of burning in the oral cavity. Ten per cent of patients presenting to oral medicine clinics have BMS. Anxiety and depression are common co-morbidities in BMS, but it is not known if they are associated with specific BMS symptoms. OBJECTIVE: In an exploratory analysis, this study examined the association of generalized anxiety and depression with individual BMS symptoms. METHODS: Forty-one patients were recruited from a dental outpatient clinic (30 with BMS and 11 with other oral conditions), evaluating specific BMS symptoms and their intensity. Anxiety and depression symptoms were assessed using a standardized measure (Clinical Interview Schedule-Revised). RESULTS: Taste change (p = 0.007), fear of serious illness (p = 0.011), metallic taste (p = 0.018) and sensation of a film on the gums (p = 0.047) were associated with an excess of psychiatric symptoms. More specifically, metallic taste (coefficient = 0.497, 95% CI = 0.149-0.845; p = 0.006) and sensation of film on gums (coefficient = 0.625, 95% CI = 0.148-1.103; p = 0.012) were associated significantly with higher scores for depressive symptoms; taste change (coefficient = 0.269, 95% CI = 0.077-0.461; p = 0.007), bad breath (coefficient = 0.273, 95% CI = 0.065-0.482; p = 0.012) and fear of serious illness (coefficient = 0.242, 95% CI = 0.036-0.448; p = 0.023) were associated with higher anxiety scores. CONCLUSION: Specific BMS symptoms are associated differentially with generalized anxiety and depression. Dental practitioners should ascertain which BMS symptoms are predominant and be mindful of the association of certain symptoms with anxiety or depression and, where necessary, consider medical consultation.

[Oral health-related quality of life associations to periodontal conditions]. / Az orális egészséghez kapcsolódó életminöség összefüggése a parodontális státusszal.

The clinical form and severity of periodontal of periodontal disorders may have negative effects on oral health related quality of life (OHQoL). The oral health impact profile questionnaire (OHIP-14) is the most frequently used instrument to evaluate the effects of intraoral disorders on the perception of well-being of patients. The modified OHIP-14 was used with 45 people (29 were in the chronic periodontitis and 16 in the control group) to evaluate the effects of periodontal conditions on OHQoL. In the periodontitis group significantly higher level of impact was observed in questions connected to aesthetics, psychological discomfort, physical pain and functional limitation. Higher periodontal probing depth was frequently associated with self-report of pain either in the anterior or posterior dental regions. There was also a significant correlation between the functional limitation and the number of missing teeth, the bleeding on probing and the probing depth. It is concluded that the periodontal disorders may have negative effects on certain parameters of OHQoL, hence during periodontal investigation the dental clinician should ask anamnestic questions in relation to quality of life.

Self-perceived oral health status in institutionalized elderly in Brazil.

This study aims to identify self-perceived oral health status in institutionalized elderly in Brazil, using the Geriatric Oral Health Assessment Index (GOHAI) and to seek associations with objective and subjective conditions and behavior related to oral health, individual traits, and environmental factors. A cross-sectional study using census with institutionalized elderly in Brazil. A total of 1192 individuals were evaluated, and 587 (49.2%) responded to the GOHAI. A questionnaire and an epidemiological survey were applied. The Mann-Whitney, Kruskal-Wallis, Fisher's exact, chi-square, and multiple logistic regression tests were performed. Mean age was 74.98 ± 9.5 years, 51.4% (302) were male. The mean DMFT-index (DMFT=decayed, missing, filled teeth) was 28.8 ± 5.5 and 54.5% (320) of the elderly were toothless. Categorized GOHAI showed that 75% (440) of the individuals had positive self-perception of oral health status. Multiple logistic regression demonstrated that the last visit to the dentist (adjusted prevalence ratio=PR=4.058; confidence interval=CI=1.526-10.789), presence of gingival problems (adjusted PR=5.703; CI=1.754-18.544), and self-rating of teeth, gums, or prosthesis (adjusted PR=19.514; CI=5.075-75.041) remained significant in the model. Predominance of positive self-perception of oral health status was observed despite poor oral conditions. Thus, for the institutionalized population, the present study recommends epidemiological and self-perception surveys to ensure adequate planning of oral health strategies.

The relationship between self-reported oral health, self-regulation, proactive coping, procrastination and proactive attitude.

OBJECTIVES: This cross-sectional study investigated the relationship between self-regulation, proactive coping, procrastination and proactive attitude, perceived oral health and self-reported oral-health behaviours. METHODS: The study sample consisted of 198 first year medical students. The questionnaire included information about socio-demographic factors, behavioural variables, self-reported oral health status, proactive coping (proactive coping subscale of the Proactive Coping Inventory), procrastination (Procrastination Scale) and proactive attitude (Proactive Attitude Scale). RESULTS: Significant differences were found on self-regulation, proactive coping, procrastination and proactive attitude scales between participants who rated their gingival condition as very good/excellent and those who evaluated it as being poor, very poor or normal (p < 0.05). Results revealed significant differences in procrastination level among individuals who never visit their dentist and those who visit their dentist for check-up or for tooth cleaning and scaling (p = 0.001) or when treatment is needed or when in pain (p < 0.05). In multiple linear regression analyses, proactive coping was associated with toothbrushing frequency and reason for dental visiting. CONCLUSIONS: The result suggested that procrastination and proactive coping are important determinants of perceived oral health and self-reported oral-health behaviours.

Influence of oral health and lifestyle on oral malodour.

OBJECTIVE: To assess the influence of oral health and lifestyle on the prevalence of oral malodour among university students. MATERIALS AND METHODS: Self-administered questionnaires. Chi-square test was used to detect any significant association between malodour and various variables. RESULTS: 9% of males and 6% of females complained of malodour, while 36% of males and 31% of females did not complain of malodour. Nevertheless, 12% of the males and 6% of females were unable to decide. The highest percentage of respondents not complaining of malodour were non-smokers (55%). A significant number of respondents were free from caries (48%), gingival disease (55%) and also were not complaining of malodour. Statistically, a significant association was found between malodour and gingival disease (p < 0.05) and between malodour and the use of a toothbrush on a daily basis (p < 0.001). CONCLUSIONS: The results highlight the influence of oral self-care and lifestyle on malodour. Public awareness, diagnosis and treatment of malodour are primarily the responsibility of dentists. Malodour can have a distressing effect and the affected person may avoid socialising.

Associations among sleep disturbance, vitality, fatigue and oral health.

PURPOSE: The objective of the present study was to explore the moderating effects of sleep disturbance, fatigue and vitality on self-reported oral-health status and oral-health related behaviours. MEASUREMENTS AND RESULTS: The present study sample consisted of 213 first-year dental students at the University of Medicine and Pharmacy 'Carol Davila', Bucharest, Romania. The questionnaire included information about sociodemographic factors, behavioural variables and self-reported oral-health status. Subjective Vitality Scale, Fatigue Assessment Scale and Karolinska Sleep Questionnaire were used to assess quality of sleep, vitality and fatigue. The duration of sleep in 41.2% of students was < 7 h per night. It was revealed that 11.7% of the students experienced daily disturbed sleep, 20.4% had daily premature awakening and 50.5% presented frequent difficulties awakening. Significant differences were found among disturbed sleep, impaired awakening, vitality and fatigue scales according to several variables: perceived dental health, satisfaction by appearance of own teeth, self-reported gingival condition, mouth rinse frequency and reason for the dental visit, while multiple linear regression analyses revealed that vitality and impaired awakening were independent determinants of self-rated oral and gingival health status. Disturbed sleep index, impaired awakening, fatigue and vitality were positively associated with oral-health related behaviours. CONCLUSIONS: The authors concluded that the disturbed sleep index, impaired awakening, fatigue and vitality were associated with oral-health status and behaviour.

Self-control and self-confidence: their relationship to self-rated oral health status and behaviours.

PURPOSE: The aim of this study was to examine the relationship between self-control and self-confidence, and students' self-rated oral health and oral-health-related behaviours. MATERIALS AND METHODS: The present study sample consisted of 178 first-year medical students. The questionnaire that was used in this study included information about sociodemographic factors, behavioural factors, self-reported oral health status, self-control and self-confidence. RESULTS: The results showed that mean levels of self-confidence in individuals with current extracted teeth and with poor/very poor perceived gingival condition were statistically significant and lower than those with no current extracted teeth and with self-rated excellent gingival health (P < 0.05). Also participants with self-reported gingival bleeding showed lower values of self-control compared with those with healthy non-bleeding gingiva (P < 0.05). When oral health behaviour was evaluated, it was shown that students with higher scores of self-control were more likely to use everyday mouthrinses (P < 0.05). The multiple linear regression analyses showed, for self-rated oral and gingival health status as dependent variable, a strong association with students' self-confidence level (P < 0.05). CONCLUSIONS: The results support the view that self-confidence is related with oral health status, and individuals with impaired oral and gingival health have a low self-confidence level.

Factors affecting oral health-related quality of life among pregnant women.

OBJECTIVES: To assess oral health status and to describe the possible factors that could affect the oral health-related quality of life (OHRQoL) among a group of pregnant rural women in South India. MATERIALS AND METHODS: A total of 259 pregnant women (mean age 26 +/- 5.5 years) who participated in the cross-sectional study were administered the Oral Health Impact Profile (OHIP-14) questionnaire and were clinically examined for caries and periodontal status. RESULTS: The highest oral impact on quality of life was reported for 'painful mouth' (mean: 1.7) and 'difficulty in eating' (mean: 1.1). On comparing the mean OHIP-14 scores against the various self-reported oral problems, it was seen that the mean OHIP-14 scores were significantly higher among those who reported various oral problems than those who did not. Those with previous history of pregnancies had more severe levels of gingivitis than those who were pregnant for the first time. Also gingival index scores, community periodontal index of treatment needs scores and previous pregnancies was associated with poorer OHRQoL scores. CONCLUSION: Increased health promotion interventions and simple educational preventive programmes on oral self-care and disease prevention during pregnancy can go a long way in improving oral health and lessening its impact on the quality of life in this important population.

Investigating the relationship among self-reported oral health status, oral health-related behaviors, and self-consciousness in Romanian dental patients.

BACKGROUND: The purpose of this study was to investigate whether self-consciousness, self-reported oral health status, and oral health-related behaviors were associated in a Romanian population. METHODS: A cross-sectional study design was used. Data were collected between January and March 2008. The sample consisted of 180 Romanian adults (mean age: 35.8 years; 72.6% women; 57% married) who were a random population drawn consecutively from the registry file of a private dental practice in the Iasi area. The questionnaire included information about demographic, psychologic, self-reported oral health, and oral health-related behavior items. The self-consciousness (SC) scale with three subscales (public SC, private SC, and social anxiety) was applied. RESULTS: Significant differences were found on the public SC scale in relation to denture/removable false teeth and on the total SC scale in relation to periodontal problems. When oral health behaviors were analyzed, private SC was associated with oral health behaviors (flossing, use of mouthrinse, and dental visit frequency). There was no association between toothbrushing frequency and the self-consciousness subscales. CONCLUSION: The moderating effects of self-consciousness should be considered when evaluating risk-reduction interventions and tailoring intervention efforts to oral health promotion.

Validity of self-assessment of oral health among 15-year-olds in Tehran, Iran.

PURPOSE: The objective of the present study was to compare the self-assessed and the clinically determined findings of oral health and their determinants among 15-year-olds in Tehran, Iran. MATERIALS AND METHODS: A cross-sectional study based on World Health Organization criteria and the methods of the Second International Collaborative Study was carried out among the 15-year-olds (N = 509). The data were based on a self-administered questionnaire and a clinical dental examination. RESULTS: Altogether 78% of the 15-year-olds assessed their oral health as good or better. Based on self-assessment, 46% reported gingival bleeding, 28% reported the need for a filling and 23% for teeth straightening. Clinical examinations showed that 40% of the students had sound dentition (decayed, missing or filled teeth, DMFT = 0), 40% had current caries (decayed teeth, DT > 0), 92% had gingival bleeding and 26% had a definite need for orthodontic treatment. Most of those with DMFT = 0 and DT = 0 assessed their oral health as good or better. Compared with clinical findings, sensitivity for self-assessed need for fillings, gingival bleeding and the need for teeth straightening were 42%, 49% and 37%, respectively, whereas the corresponding specificities were 82%, 80% and 81%, respectively. Good or better self-perceived oral health was more likely among those with sound dentition (odds ratio, OR = 2.1, P = 0.01), with no self-assessed need for fillings (OR = 2.1, P = 0.01), with a self-assessed absence of gingival bleeding (OR = 2.9, P < 0.001) or with highly educated parents (OR = 1.2, P = 0.007). CONCLUSIONS: When compared with clinical evaluations, the students most accurately detected healthy conditions. Educating the students on the signs of dental diseases could increase the reliability of self-assessment to provide a useful method for reporting oral conditions, especially in countries with developing oral health care systems.

Perceptions of patients' smiles: a comparison of patients' and dentists' opinions.

BACKGROUND: Little information has been published regarding the difference between how patients perceive their own smiles and how dentists view them. METHODOLOGY: The authors interviewed 78 consecutively seen patients in a general dental practice in Norway about esthetic features of their faces. The patients were not actively seeking esthetic treatment. Patients rated themselves using a 100-point visual analog scale (VAS), and then two dentists (the patients' regular dentist and an independent periodontist), working with photographs of the patients, used the same VAS in rating the patients' smiles. RESULTS: The average age of the patients was 51.2 years (range, 22-84 years). There were 50 women (average age, 51.5 years; range, 22-84 years) and 28 men (average age, 52 years; range, 30-78 years). Patients' satisfaction with their own smiles reached an average of 59.1 (standard deviation [SD], 21.1; range, 5-100) on the VAS. The dentists' scores (38.6 and 40.7) were significantly lower than the patients' scores. The authors observed poor correlation between the periodontist's scores of dentogingival features and the patients' scores. Patients were most satisfied with the gingiva when smiling and least satisfied with tooth shade. Patients younger than 50 years were most satisfied with their smiles. Patients rated teeth and eyes as the most important features in an attractive face. Women gave teeth and hair significantly higher scores and head shape lower scores than did men. CONCLUSION: Patients' opinions of their own smiles were significantly higher than the two clinicians' assessments of their smiles. Dentists should be aware that patients who seek esthetic services may have different perceptions of their smiles than may patients who do not express such desires.

Perceptions of oral illness among Chinese immigrants in Montreal: a qualitative study.

Providing culturally competent care has been a growing concern for health care professionals in recent years. Being culturally competent means taking into account the culture of patients in order to provide high-quality services. Accordingly, the objective of this study was to better understand how oral illness was perceived by the largest visible minority group in Canada: Chinese immigrants. We conducted qualitative research based on in-depth interviews with twelve Chinese immigrants in Montreal, Canada. The participants had a high level of education and had lived in Canada for thirteen years or less. The interviews were transcribed, and thematic analyses were then performed. Among the participants, traditional beliefs coexisted with scientific dental knowledge. On the one hand, the subjects had a fairly good understanding of dental caries in terms of etiology, process, prevention, and treatment. On the other hand, they held strong traditional beliefs concerning gingival swelling and bleeding, which had an influence on their attitudes toward dental care and professional services. Oral health care professionals should be informed about Chinese immigrants' oral health beliefs and the acculturation process in order to understand their patients better and provide culturally competent care.

Perceptions of dental care need among African-American elders: implications for health promotion.

The aim of this study was to assess perceived dental care need, actual clinical need and the relationship between these variables and care-seeking behavior among community residing African-American elders. A convenience sample of 146 elders responded to a survey and participated in oral screenings at six senior centers. Elders were categorized as needing routine dental care, some dental care, or urgent dental care. Most (61%) required dental care with one-fourth having urgent dental care needs. Elders reporting a problem tended to seek dental care more often within a year (38%) than those not reporting a problem (27%). Sixty-four percent did not currently have a dental provider. The majority (83%) rated their general health as being fair or good and few (9%) reported oral pain. These findings suggest developing health promotion programs that emphasize non-painful oral signs and symptoms, accompanied by associated general health implications that may compromise overall health.

Self-efficacy perspective on oral health among Turkish pre-adolescents.

OBJECTIVE: To assess the association between toothbrushing and dietary self-efficacy and oral health status and behaviour related to it among Turkish pre-adolescents. MATERIALS AND METHODS: A cross-sectional study of Turkish school pre-adolescents aged 10 to 12 (n = 611) by oral health examinations (OHE) and self-administered health behaviour questionnaire (PHBQ). The PHBQ, including new Toothbrushing (TBSES), and modified Dietary Self-Efficacy (DSES), was designed to survey pre-adolescents' oral, dietary and general hygiene behaviour by psychosocial factors. An OHE based on World Health Organization criteria was implemented. The participation rate was 97% (n = 591), and 95% (n = 584) for PHBQ and OHE. Multiple linear regression analysis, descriptive statistics, factor and item analysis, Pearson correlation coefficient, chi-square test, and Student t-test were applied. RESULTS: Pre-adolescents, mostly with regular toothbrushing habits (69% at least once a day) and high levels of irregular dental visits (79%) had as their mean DMFS figure 3.77 +/- 3.37. Principal component analysis for TBSES and DSES revealed that four factors met the Kaiser Criteria, accounting for 50.2% of total variance. Scales with good internal consistency and test-retest stability were associated with professionally (DMFS) and self-assessed dental health (p < 0.05). A similar tendency appeared between self-assessed gingival health and DSES (p < 0.05). CONCLUSION: Self-efficacy beliefs were associated with oral health and related behaviour among pre-adolescents. Further research is needed for implementation of scales to enhance oral health.

A cross-cultural comparison of dental health attitudes and behaviour among freshman dental students in Japan, Hong Kong and West China.

OBJECTIVE: To clarify the differences in dental health attitudes/behaviour among freshman dental students. DESIGN: Cross-cultural differences. SETTING: Japan, Hong Kong and West China. PARTICIPANTS AND METHODS: The original version of the Hiroshima University-Dental Behavioural Inventory (HU-DBI) was written in Japanese. After testing the validity of both English and Chinese versions, the original version of the HU-DBI was administered to 58 freshman Japanese dental students, the English version to 43 Hong Kong Chinese peers and the Chinese version to 39 West Chinese peers. RESULTS: Significant cultural differences were found for 16 items out of 20. The most striking result was that the Japanese students were more likely to have used a dye to see how clean their teeth were, compared to their Chinese peers (P<0.001). The Chinese students were less likely to have a belief that they could clean their teeth well without using toothpaste (P<0.001), whereas higher percentages of the Chinese students worried about having bad breath (P<0.001). A higher percentage of the Hong Kong students reported that they regularly checked their teeth in a mirror than did their West Chinese or Japanese peers (P<0.05). CONCLUSIONS: There were considerable differences in dental health attitudes/behaviour among freshman dental students in the three cultural groups.

Oral health attitudes/behavior and gingival self-care level of Korean dental hygiene students.

The purpose of this study was to examine oral health attitudes/behavior and gingival self-care levels of Korean dental hygiene students (n = 271). A questionnaire known as HU-DBI (Korean version) was administered to each class. Higher scores of the HU-DBI indicate better oral health attitudes/behavior. The student's gingival self-care level was scored as excellent (+2), good (+1), questionable (0), poor (-1), or very poor (-2) according to the criteria of the Oral Rating Index (ORI) for youth. The mean score of the HU-DBI was 6.40, and that of the ORI was +0.12. Most samples scored 0 or +1. The mean HU-DBI scores of year-2 and year-3 students (7.06, and 7.61 respectively) were significantly greater than that of year-1 students (5.23) (P<0.001). Twenty-three percent of the students reported a belief that they may eventually require false teeth. Half stated that they put off going to the dentist until they had toothache. Year-1 students were more likely to have this attitude compared to year-3 students. HU-DBI scores were significantly associated with ORI scores (r = 0.315; P<0.001). The differences in the HU-DBI and ORI scores across the level of education were highly significant.

Present state of dental health knowledge, attitudes/behaviour and perceived oral health of Japanese employees.

The aim of this survey was to assess the present state of dental health knowledge, attitudes/behaviour and perceived oral health of Japanese employees. A 60-item questionnaire was used in a dental health project in the work place. The subjects comprised 77,845 employees, 76 per cent of whom reported delaying a dental visit until they had toothache, with about 60 per cent delaying even when they discovered a decayed tooth. The majority did not regard decayed teeth as a disease and only a minority reported regular dental visits. About three quarters reported bleeding gums on brushing, although more than half had never been taught professionally how to clean their teeth and less than 5 per cent flossed daily. More than half believed that false teeth were inevitable in old age, and that their teeth were getting worse despite daily brushing. About 70 per cent of the employees thought that it was impossible to prevent gum disease with toothbrushing alone, and nearly half believed a toothpaste with fluoride was effective in preventing periodontal disease. Reorientation of oral health care in Japan, therefore, is urgently needed and dental services have to be provided for the implementation of systematic oral health promotion for employees in the workplace.

Management of gingival vitiligo with the use of a tattoo technique.

The purpose of this report is to describe the management of gingival vitiligo in a black female. This patient was referred by her psychiatrist to the Mount Sinai Hospital Dental Department (Toronto) for assessment of progressive loss in gingival pigmentation. According to her psychiatrist this loss of pigmentation, which the patient indicated may be considered in Africa as a hallmark of HIV infection, was a significant exogenous factor in relation to the patient's ongoing clinical depression. After obtaining informed consent, a modification of a tattooing method used for skin was applied to the patient's attached gingival tissues. Test sites were tattooed prior to performing full gingival tattooing under local anaesthesia. The results demonstrate that it was possible to restore this patient's gingival pigmentation in a highly esthetically acceptable manner. The resulting coloration was reminiscent of the patient's natural pigmentation that had been lost ostensibly because of her systemic disorder. Our findings also showed that the artificial pigmentation established via the tattoo method was stable 4 months postoperatively and continues to be stable, as expected. A profound improvement in the patient's mood was noted.

Dental survey: patient attitudes in Jordan.

A questionnaire was used to assess the attitude of family members in Jordan to the state of their teeth, their personal oral hygiene and their acceptance of dental care. The questions were formulated to provide information without the need for dental examination. In industrial societies there is evidence of a reduction in the rate of dental decay whereas in countries such as Jordan the reverse is true. Consideration of this trend, in combination with the results of this survey, provides a strong indication that instruction in oral hygiene must be given together with increased facilities for treatment.