Monday, June 22, 2015
Oral Health Inequalities in Africa and the Middle East
Reducing Inequalities in Oral Health in the Africa and Middle East Region
Dentistry is facing many serious challenges and threats. Addressing them will require major changes in strategy. This work outlines the extent of dental disease in the Africa and Middle East Region (AMER) and suggests strategies to reduce inequalities in oral health. The main oral health challenges in the AMER relate to controlling the relentless increase in caries with age. A very conservative estimate of population caries levels suggests that a 5-fold increase in dental personnel would be required just to treat current levels of caries. Hence, we argue that current approaches to control caries in the AMER are both ineffective and unaffordable, and a new model to promote oral health is needed. Unless determinants of noncommunicable diseases are addressed and access to evidence-based minimal intervention dental care is improved, the burden of dental disease will persist. The new oral health promotion model calls for an integrated intersectoral common risk factor approach, namely, "oral health in all policies" (OHiAP). An OHiAP framework will initiate high-level policy initiatives and intersectoral partnerships. Oral health professionals have an important advocacy role in securing the fundamental changes in health strategy needed to control the growing, unjust, and unaffordable burden of oral disease.
Advances in Dental Research current issue http://ift.tt/1eDAWegPrevalence and Severity of Oral Diseases in the Africa and Middle East Region
This review aims to determine the prevalence and severity of oral health diseases in the Africa and Middle East region (AMER). The profile of oral diseases is not homogeneous across the AMER. There are large disparities between groups. Reliable data are scarce. The prevalence and severity of oral diseases appear to be increasing in the African region, as does associated morbidity. There are substantial differences in inequalities in oral health. Dental caries prevalence is less severe in most African countries than in developed countries, but the high rate of untreated caries reflects the limited resources available and difficulties of access and affordability to essential oral health care services. The prevalence of gingival inflammation is very high in all age groups in several African countries. The prevalence of maxillofacial trauma has increased in many countries, with a wide variation of the incidence and high prevalence of traumatic dental injuries in primary and permanent teeth. Orofacial clefts are among the most common birth defects. Annual incidence of oral cancer is estimated as 25 cases per 100,000 people in Africa. Noma is a major public health problem for the Middle East and North African (MENA) region. Data about human immunodeficiency virus/AIDS are limited, particularly in the MENA region. According to the World Health Organization Regional Committee for Africa report, some fundamental key basic knowledge gaps need to be underlined. They include inequalities in oral health, low priority for oral health, lack of adequate funding, inadequate dental student training, obstacles to medical and dental research, and poor databases. There are very few effective public prevention and oral health promotion programs in the AMER. Universal health coverage is not achievable without scientific research on the effectiveness of health promotion interventions.
Advances in Dental Research current issue http://ift.tt/1Gv645vOral Health Inequalities between Rural and Urban Populations of the African and Middle East Region
Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health–related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations.
Advances in Dental Research current issue http://ift.tt/1eDAWe8Determinants of Oral Diseases in the African and Middle East Region
Oral health policies must be developed that emphasize the role of social determinants in health and oral diseases. The aim of this report is to review literature on determinants of oral diseases and apply the concepts to promoting oral health in the African countries in the African and Middle East region (AMER). Structural and proximal determinants of oral diseases are common to those affected by other noncommunicable diseases (NCDs). Oral diseases are also heavily affected by issues of politics, poor health behaviors, underdeveloped health systems, and low oral health literacy. Wide-scale poverty exists in populations in the AMER. Oral health promotion and preventive oral health programs should therefore be integrated with those for general health and use the common risk factor approach (CRFA). Attempts should be made to improve the daily living conditions and reduce the incline of the social gradient. Oral health practitioners should use the CRFA when dealing with determinants of oral diseases and in the design of preventive oral health programs. The detrimental effects of the social determinants of health may be ameliorated by involving both the individual and community. Interventions in health promotion programs in the AMER need more research on the epidemiology of oral diseases and the role played by the social determinants of oral diseases, especially with regard to poverty. The high levels of poverty and low gross domestic product in most countries in the African region make it difficult to fund high-quality, affordable, accessible oral health services.
Advances in Dental Research current issue http://ift.tt/1Gv645rCapacity Building and Financing Oral Health in the African and Middle East Region
Many low- and middle-income countries do not yet have policies to implement effective oral health programs. A reason is lack of human and financial resources. Gaps between resource needs and available health funding are widening. By building capacity, countries aim to improve oral health through actions by oral health care personnel and oral health care organizations and their communities. Capacity building involves achieving measurable and sustainable results in training, research, and provision of care. Actions include advancement of knowledge, attitudes and skills, expansion of support, and development of cohesiveness and partnerships. The aim of this critical review is to review existing knowledge and identify gaps and variations between and within different income levels in relation to the capacity building and financing oral health in the African and Middle East region (AMER). A second aim is to formulate research priorities and outline a research agenda for capacity building and financing to improve oral health and reduce oral health inequalities in the AMER. The article focuses on capacity building for oral health and oral health financing in the AMER of the IADR. In many communities in the AMER, there are clear and widening gaps between the dental needs and the existing capacity to meet these needs in terms of financial and human resources. Concerted efforts are required to improve access to oral health care through appropriate financing mechanisms, innovative health insurance schemes, and donor support and move toward universal oral health care coverage to reduce social inequality in the region. It is necessary to build capacity and incentivize the workforce to render evidence-based services as well as accessing funds to conduct research on equity and social determinants of oral health while promoting community engagement and a multidisciplinary approach.
Advances in Dental Research current issue http://ift.tt/1eDAVXEStrategies for Oral Health Research in Africa and the Middle Eastern Region
The highest burden of diseases worldwide is in low- and middle-income countries, but due to lack of capacity and inadequate infrastructure, research output from these countries is unable to address existing and emerging challenges in health care. Oral health research has particularly been hampered by low prioritization, resulting in insufficient development of this sector. There is an urgent need for research correlating oral health to upstream social and environmental determinants and promoting the common risk factor approach for prevention of noncommunicable diseases. Population-wide preventive measures for oral health care are more effective than purely curative approaches, especially for vulnerable groups who have limited access to information and appropriate health care. This article identifies priorities and proposes strategies for researchers, stakeholders, and policy makers for the initiation and sustenance of appropriate oral health care research. The proposed interventions are intended to promote collaboration, capacity building, and health advocacy. Local ownership in multinational research projects in low- and middle-income countries, complemented by skills transfer from high-income countries, is encouraged to ensure that regional health needs are addressed. Emphasis is placed on a shift toward translational research that has a direct impact on oral health care systems.
Advances in Dental Research current issue http://ift.tt/1Gv62dQMonday, June 8, 2015
Prevalence of Untreated Tooth Decay
Take a look a Jude Fabiano’s newest blog post!
In recent years, the oral health of Americans has improved significantly, although the vast majorities of adults in the US had cavities in 2011-2012, and according to a new data brief from the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS). Having good oral health is important for healthy aging, and poor oral health impacts the quality of life by causing pain and limiting food choices. Many people will even avoid social interactions due to perceived poor oral health. While oral health among adults has dramatically improved since the 1960s, dentists point out that there still need to be more progress in improving oral health for all adults in the US.
Cavities and tooth loss are both important oral health indicators for adults, and serve as key measures for monitoring progress toward health promotion. The recent data brief describes US adult dental caries and tooth loss by age and race for 2011-2012, based on data from the National Health and Nutrition Examination Survey. During this period, around 91% of adults aged 20 to 64 had dental caries in permanent teeth, with a higher prevalence in adults between 35 and 64 years old (94% to 97%) compared with adults aged 20 to 34 (82%), according to the report. The prevalence of cavities was lower for Hispanic, Asian and black adults (85%, 85% and 86%, respectively) when compared with non-Hispanic white adults (94%). Overall, 27% of adults between 20 and 64 years old had untreated tooth decay, as well as 19% of adults 65 or older. Untreated tooth decay disproportionately affects some ethnic groups in the US, with a higher prevalence in Hispanic and black adults (36% and 42% respectively) when compared with non-Hispanic white and Asian (22% and 17%) adults.
Nearly 19% of adults 65 or older had no natural teeth remaining, with negligible difference between men and women. Edentulism was twice as prevalent among adults 75 or older when compared with their peers between 65 and 74. Among those 65 or older, complete tooth loss was lower for older Hispanic (15%) and non-Hispanic white (17%) adults when compared with older non-Hispanic black adults (29%). In addition, in the period of 2011-2012, 48% of adults between 20 and 64 hadn’t lost a tooth to dental disease. However, tooth decay also remains a problem in US children, especially teenagers, and more than half of children between 12 and 19 have one or more cavities in adult teeth.
Jude Fabiano DDS Personal Interests http://ift.tt/1B1p3Iw
Diagnosing Diabetes at the Dentist
Check out the latest from Jude Fabiano!
New research, published online this February in the American Journal of Public Health, has revealed that screening patients for high glycemic levels through oral blood collected during a routine dental procedure gives just as accurate a reading in HbA1c as traditional finger-stick readings, and can even identify a large number of patients who don’t yet know that they have diabetes. According to the lead author of the study, Dr. Shiela Stauss, there are over 8 million adults in the US alone who have diabetes but aren’t yet diagnosed. While there are other places that offer diabetes screening, such as churches, ophthalmology offices and health fairs, the dental office offers a particularly good place, since it’s possible to collect blood from the gums that can be used for accurate diabetes screening.
Since an average of 70% of Americans seek some kind of dental care at least once a year, diabetes screening at the dentist could be very successful. Only about one in ten people with prediabetes know it, and around one quarter to one third of diabetics are undiagnosed, so it’s important to increase awareness and get people diagnosed.
The study recruited adult patients from NYU’s College of Dentistry who had indicated that their gums bled while brushing or flossing their teeth or were told by a healthcare provider that they had diabetes or were at risk of developing it. The 408 people who participate all had paired HbA1c values from a finger-stick blood sample, as well as a gingival crevicular blood (GCB) specimen taken from the gums while seated in the dental chair. HbA1c values assessed with finger-stick blood and GCB were nearly identical, with a correlation of .991. Finger-stick blood HbA1c ranged from 4.2% to 10.8%, while GCB HbA1c ranged from 4.1% to 10.9%. Regardless of the blood source analyzed, around half of the study sample had HbA1c levels in the prediabetes range.
Jude Fabiano DDS http://ift.tt/1Gv7FhN
3 Smart Drink Choices for Healthy Teeth
Be sure to get a couple swigs!
Originally posted on Christopher and Anne Thompson, DDS:
One of the biggest contributors to tooth decay is the choice we make when we pick up something to drink. According to the Centers for Disease Control, almost one-fifth of Americans reach for a sugary soda at least once a day. This seemingly innocuous habit has far-reaching health implications beyond oral health too. In this week’s post, we are going to help you think about a few better choices next time you need to quench your thirst. Here are healthier drink choices for your oral health:
Water
Most estimates place the recommended amount of water you should drink daily at about a half gallon to a gallon. The majority of our bodies exist as water, which makes it a vital part of our health. Many people, however, are unaware of the oral health benefits of drinking a lot of water.
Drinking water before, during, and after a meal is smart…
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5 Surprising Things That Are Ruining Your Teeth
Watch out everybody!
Originally posted on TIME:
We all know that candy and soda aren’t good for our teeth, but the sugars and acids lurking in other, seemingly innocuous (and even healthy) foods can also do a number on your dental hygiene. We got New York City-based cosmetic dentist Marc Lowenberg, DDS, to give us real talk on five culprits you didn’t realize were hurting your choppers, and how to prevent the damage.
Juicing
Say it ain’t so: While bottles of the cold-pressed stuff may be chock-full of good-for-you nutrients, juices also have such a high sugar content (some have even more than smoothies or soft drinks) that drinking them isn’t far off from bathing your teeth in chocolate, Lowenberg says. This sugar is consumed by the bacteria in our mouths and converted into acid that wears away enamel and can cause cavities.
The solution: Sip juice through a straw to help keep it away from…
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How Sedation In Dentistry Came About | Fun Trivia Guru
Interesting article!
Originally posted on Jean MIchies Blog:
Visiting a dentist can be a huge source of stress. But thanks to the invention of sedation industry, things indeed have greatly changed. Today, patients can already relax as well as experience pain-free dentistry. Story Behind The Emergence Of Sedation Industry Since the 19th century, dentists have already been working on how to ease discomfort…
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Ha ha, that’s adorable!
Everything You Ever Wanted
Originally posted on Longreads Blog:
Jillian Lauren | Plume | May 2015 | 11 minutes (2,636 words)
Below is an excerpt from Jillian Lauren’s memoir, Everything You Ever Wanted, as recommended by Longreads contributor Sari Botton. Read her interview with Lauren about memoir and family.
* * *
In a one-bedroom apartment in West Orange, New Jersey, late winter 1973, my mother, Helene, is home in the middle of the day, dancing to the Hair soundtrack while cleaning the house, when she gets a call from an old college friend named Jillian. Jillian married a fertility specialist after graduation and lives in Chicago now. My mother called her years before, seeking advice. Helene is on a list for a study in experimental fertility drugs, but the process seems to be dragging on forever. After nearly four years of trying to conceive, her diagnosis is unexplained infertility.
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Medical News Today: Fusion of normal cells may trigger genetic changes leading to cancer
The latest dentistry news from Medical News Today! A new study shedding light on cancer development suggests when two normal cells fuse with one another, they can trigger a ‘genomic catastrophe’ that can turn these cells cancerous. Featured Health News from Medical News Today http://ift.tt/1RXIbM2
Medical News Today: Marijuana exposure rising among young children
The latest dentistry news from Medical News Today! Researchers have found that rates of marijuana exposure have increased steeply in recent years among children younger than 6, particularly in states that have legalized marijuana. Featured Health News from Medical News Today http://ift.tt/1eXFHyW
Medical News Today: Hepatitis C: causes, symptoms, treatments, prevention
The latest dentistry news from Medical News Today! Hepatitis C is a virus that can infect and damage the liver. It is spread by blood-to-blood contact with an infected person and is the most common blood-borne disease in the US. Featured Health News from Medical News Today http://ift.tt/1G65wpD
Medical News Today: Rabbit virus could make bone marrow transplants safer
The latest dentistry news from Medical News Today! Researchers discover that the myxoma virus could kill cancer cells and reduce the risk of white blood cells attacking the body in bone marrow transplant patients. Featured Health News from Medical News Today http://ift.tt/1QhbonD
Medical News Today: General anesthesia in young children linked to poorer intelligence, language development
The latest dentistry news from Medical News Today! Children who undergo surgical anesthesia under the age of 4 may have poorer language development and a lower IQ, according to new research from Cincinnati Children’s Hospital. Featured Health News from Medical News Today http://ift.tt/1Ip2i13
Medical News Today: Many African-American women ‘silent and alone’ with infertility
The latest dentistry news from Medical News Today! Researchers interviewing African-American women about their experiences with infertility have found that many had to cope with their condition in silence and isolation. Featured Health News from Medical News Today http://ift.tt/1T6BLvE