Shahrukh Khan

Objective: To investigate the association between oral health status and all‐cause mortality in older adults using prospective cohort study design.Setting and participants: In total, 12 809 adults aged ≥70 years (54.3% females) were participants of the ASPREE Longitudinal Study of Older Persons (ALSOP).Methods: Participants self‐reported the presence of natural teeth and oral health status. The association of self‐reported oral health, edentulism and the integrative measure of the two with all‐cause mortality were explored using the Cox‐regression models adjusted for age, gender, socio‐economic status, health‐related behaviours, weight status, aspirin and polypharmacy. Hazard ratios (HRs) and 95% confidence intervals (CIs) were reported.Results: In total, 22.2% of participants reported edentulism and 13.8% had fair/poor oral health. After adjustment for confounders, risk of all‐cause mortality was higher among those with edentulism (vs. no edentulism) HR (95% CI) 1.43 (1.18, 1.73); and those with edentulism and reporting poor/fair oral health HR (95% CI) 1.69 (1.02, 2.82), or with no edentulism but reporting poor/fair oral health HR (95% CI) 1.46 (1.19–1.80) vs. no edentulism and reporting good/very good/excellent oral health. No association was observed between self‐reported oral health alone and all‐cause mortality.Conclusions: The risk of all‐cause mortality was 69% higher among older adults reporting both edentulism and poor/fair oral health compared with those with teeth and more favourable self‐reported oral health. © 2023 Australian Dental Association.

Introduction: This study examines the main characteristics of dental informatics research using bibliometric analysis of articles in the online journal database PubMed, to identify the main trends of research in dental informatics. The study aims to identify trends, geographic distribution of papers and authors, rates of collaboration, and performances of journals and institutions. Methods: Information on dental informatics was extracted solely from the PubMed online journal database from January 1989 to September 2019. A three-phase search approach was employed. Bibliometrics was used to examine the growth and progress of dental informatics over time. Results: A total of n=236 papers on dental informatics were identified, with an average of 7.9 papers per year. The trend of papers published increased over time with 41 countries represented in this study. There were only 15 countries which had 10 or more representatives, seven of which came from Europe. North America produced the most research in dental informatics, with 149 paper affiliations and ten were cross regional, in 61% of the total papers. Discussion: The topic of dental informatics began in the mid to late 1980s, with the most productive years in the last decade, reaching a high point in the mid 2010s. There was a low level of international collaboration, and few conducted across different continents. Conclusion: There is steady increase in the pace of research in dental informatics, with growing interest in exploring various implementation methods. Collaboration has become a product of a globalised world, with the potential to share data and exchange ideas using cutting-edge technologies. As these trends continue, the field of dental informatics may see further growth and development, with more technology available to provide communication and share data points and methods becoming widespread.

Objective: To evaluate the level of Post-amputation anxiety among patients reporting to rehabilitation centers in Quetta Methodology: This Cross-sectional research was done in Quetta at the three rehabilitation centres from May-July 2018. Clients with amputations were included, and then data collected through a structured-adopted questionnaire for "Hospital Anxiety and Depression Scale". 54 subjects were involved, according to inclusion & exclusion criteria. Frequencies and percentages were described for categorical variables, and data was stratified by reason for amputation, gender, level of education, and marital status with respect to an outcome variable, anxiety. The collected data was then tabularized & analyzed by using Chi-square test. Results: Out of 54 participants, 47 were men while 7 were women. Data displayed that 30 (55.6%) were normal & 24 (44.4%) had anxiety. 49(91%) & 5(9%) participants were having lower & upper limb amputations, respectively. Results indicate that level of anxiety among participants had a statistically non significant relationship with a level/type of amputation. Conclusion: Anxiety and amputation have significant impacts on functional impairment, psychological reactions, and quality of life. The research highlights the association between amputation and anxiety, providing insight to healthcare providers that anxiety is a common occurrence in the context of amputation. The findings of this study can be valuable for prevention strategies.

Background: This paper investigated the associations between oral health with behavioural, demographic, periodontitis risk, financial and access to dental care barriers and compared the results in three Australian regional areas.Methods: Data were obtained from the Australian National Study of Adult Oral Health (2017–18). Oral health status was measured using DMFT‐score, and mean numbers of decayed, missing or filled teeth and periodontitis prevalence using the Center for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) Periodontal Classification. The analysis included these dependent variables by three regional areas, seven socio‐demographic variables, two periodontal disease risk factors, two preventive dental behaviours, two barriers to dental care and three access to dental care variables.Results: Of the 15,731 people interviewed, 5,022 were examined. There was no significant difference in periodontitis prevalence between the regions. All the socio‐demographic characteristics, periodontal disease risk factors and preventive dental behaviours were significantly associated with at least one of the dental caries indicators. In multivariable analysis, there was no significant association between regional location with any of the four clinical dental caries variables.Conclusion: Poorer oral health outside major cities was associated with household income, education level, higher smoking, usual reason for and frequency of dental visiting.

Aims: Evidence suggests there are geographical variations in child oral health and this has prompted research into determinants of that variation. This study aimed to investigate factors attributable to the difference in child oral health between urban and rural areas in Australia.Method: Data were from the National Child Oral Health Study 2012‐14, a population‐based study of 5‐ to 14‐year‐old children, who underwent oral epidemiological examinations by trained examiners. Caries prevalence (dmfs/DMFS > 0) and experience (dmfs/DMFS count) in the primary dentition (5‐ to 8‐year‐old) and permanent dentition (9‐ to 14‐year‐old) were calculated. Children were grouped by residential location (urban or rural areas). A parental questionnaire collected information on family socio‐economic factors, and individual health behaviours (dental access, sugar consumption and toothbrushing). Residential history was used to calculate lifetime exposure to water fluoridation (WF). Analyses were weighted to produce population‐representative estimates. The primary outcomes were assessed separately for the two groups in regression models with robust standard error estimation to estimate prevalence ratios and mean ratios and their 95% confidence intervals. Population Attributable Fractions were calculated using the population distribution of the exposures and their adjusted estimates.Results: 10 581 5‐ to 8‐year‐old and 14 041 9‐ to 14‐year‐old children were included. Caries prevalence was higher in rural than in urban areas. In multivariable models, exposure to fluoridation, reason for dental visit and consumption of sugary beverages were consistently associated with caries prevalence and experience. WF coverage attributed to differences in caries prevalence (10% vs 21%) and experience (14% vs 35%) in the permanent dentition. High consumption of sugary beverages attributed to a higher primary and permanent dental caries experience in rural than in urban areas. Dental access was also attributed to the differences between the two areas.Conclusion: Factors at both community and individual levels attributed to the observed differences in child caries prevalence and experience between urban and rural areas.

Aim: Modern lifespan oral health research focuses on understanding the impact of periodontitis (or therapy) on clinical and patient‐based outcome measures to provide effective care, improve patient safety according to the quality standards. For better targeted intervention and effective disease management, this systematically review aimed to investigate the relationship between non‐surgical periodontal therapy and patient‐based outcomes using OHIP‐14.Methods: Seven Databases were searched for studies on patient‐based outcomes responses to periodontal treatment. The time‐period defined from search was from January 1977 to January 2019. Two independent reviewers carried out data search, selection of studies, data extraction and quality assessment using Mixed Method Appraisal Tool. Prospective cohort studies, intervention studies and observational studies written in English demonstrating non‐surgical periodontal therapy response on the patient‐reported outcomes (using Oral Health Impact Profile 14) were included in the review.Results: Thirteen studies were included in the review, which comprised of three randomised control trials, nine case series, and one was a quasi‐experimental study. Eleven out of the 13 studies reported significant improvement in OHIP‐14 scores amongst participants who had undergone non‐surgical periodontal therapy. Physical disability, psychological discomfort and functional limitation were domains that improved significantly after non‐surgical periodontal therapy in these studies. Physical pain was a common finding in short‐term follow‐up but improved significantly in long‐term follow‐up studies.Conclusion: Based on clinical and patient‐based outcomes measurement, it is recommended that non‐surgical periodontal therapy is a “gold standard” approach towards improving patient‐based outcomes, reducing co‐morbidities and enhancing patient safely immediately and in long term.

Objective: To describe the characteristics of hospital admissions for dental conditions, by Australian Statistical Geography Standard remoteness area for the 5 years 2010/2011 to 2014/2015.Design: Retrospective analysis of preventable hospital admissions due to dental conditions.Setting: National data set provided by the Australian Institute of Health and Welfare.Participants: Every hospital admission for patients who were admitted for dental conditions over five financial years, from 2010/2011 to 2014/2015.Main outcome measures: The number (and rate per 1000 population) of hospital admissions due to dental conditions in each Australian Statistical Geography Standard remoteness area (major city, inner regional, outer regional, remote and very remote).Results: There were 316 937 hospital admissions for dental conditions over the 5‐year period. The rate of potentially preventable dental hospital admissions ranged from an average of 2.5 per 1000 population in major cities to 3.2 in inner regional areas, 3.1 in outer regional areas, and 4.1 per 1000 in remote and very remote areas. The rate of admissions was highest among those aged 0‐14 years living in remote (9.0‐10.0 per 1000) and very remote (9.8‐12.5 per 1000) areas. Dental caries was the most common reason for admissions.Conclusions: There is an urgent need to address the social determinants of oral health in children aged 0‐14 years living in remote and very remote Australia. The delivery of mobile primary dental care services needs to be expanded in remote and very remote areas to prevent and treat dental caries.