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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 31 October 2024 | Viewed by 18298

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Prof. Dr. Mauro Henrique Nogueira Guimaraes de Abreu

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Department of Community and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais 31270, Brazil
Interests: oral health epidemiology; quantitative methodology; dental public health
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Special Issue Information

Dear Colleagues,

The oral health status of populations involves a complex network of determination. The most recent definition of the World Dental Federation pointed out that social environment and physical environment are determinants of oral health. There is evidence in the scientific literature on the importance of social determinants of health and specifically in oral health. The investigation of environmental factors on oral health needs to progress further. Knowledge of these determinants allows us to propose strategies for overcoming inequalities in oral health. This is one of the challenges of today’s world. This Special Issue will examine studies of social and environmental determinants of oral health.

Prof. Dr. Mauro Henrique Nogueira Guimaraes de Abreu
Guest Editor

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Keywords

Socioeconomic factors
Oral health
Environmental health

Published Papers (7 papers)

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Research

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27 pages, 2173 KiB

Open AccessArticle

Oral Health Workforce in Africa: A Scarce Resource

by Jennifer E. Gallagher, Grazielle C. Mattos Savage, Sarah C. Crummey, Wael Sabbah, Benoit Varenne and Yuka Makino

Int. J. Environ. Res. Public Health 2023, 20(3), 2328; https://doi.org/10.3390/ijerph20032328 - 28 Jan 2023

Cited by 9 | Viewed by 3031

Abstract

The World Health Organization (WHO) African Region (AFR) has 47 countries. The aim of this research was to review the oral health workforce (OHWF) comprising dentists, dental assistants and therapists, and dental prosthetic technicians in the AFR. OHWF data from a survey of all 47 member states were triangulated with the National Health Workforce Accounts and population data. Descriptive analysis of workforce trends and densities per 10,000 population from 2000 to 2019 was performed, and perceived workforce challenges/possible solutions were suggested. Linear regression modelling used the Human Development Index (HDI), years of schooling, dental schools, and levels of urbanization as predictors of dentist density. Despite a growth of 63.6% since 2010, the current workforce density of dentists (per 10,000 population) in the AFR remains very low at 0.44, with marked intra-regional inequity (Seychelles, 4.297; South Sudan 0.003). The stock of dentists just exceeds that of dental assistants/therapists (1:0.91). Workforce density of dentists and the OHWF overall was strongly associated with the HDI and mean years of schooling. The dominant perceived challenge was identified as ‘mal-distribution of the workforce (urban/rural)’ and ‘oral health’ being ‘considered low priority’. Action to ‘strengthen oral health policy’ and provide ‘incentives to work in underserved areas’ were considered important solutions in the region. Whilst utilising workforce skill mix contributes to overall capacity, there is a stark deficit of human resources for oral health in the AFR. There is an urgent need to strengthen policy, health, and education systems to expand the OHWF using innovative workforce models to meet the needs of this region and achieve Universal Health Coverage (UHC). Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

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10 pages, 2049 KiB

Open AccessArticle

Samurai in Japan: Class System-Related Morphological Differences in Maxillofacial Regions in the Edo Period

by Masako Kawada, Yasuhiro Shimizu, Eisaku Kanazawa and Takashi Ono

Int. J. Environ. Res. Public Health 2022, 19(15), 9182; https://doi.org/10.3390/ijerph19159182 - 27 Jul 2022

Viewed by 2243

Abstract

Previous studies have reported that compared to commoners in Japan’s Edo period, samurai had long heads, more dental irregularities, and slightly worn teeth. However, these studies did not measure the mandible or only measured length. Angular analysis is essential to evaluate the maxillofacial morphology, but there are no comparative studies of samurai and commoners. This study explored the differences in maxillofacial morphology between samurai and commoners in the Edo period. Thirty male skeletons (samurai) and thirty-eight male skeletons (commoners) were used as materials from the National Museum of Nature and Science. The selected specimens were adults aged between 20 and 59 years without serious skeletal damage and with stable occlusion of the molars. We used three-dimensional scanning to measure the specimens’ skeletal, alveolar, and facial widths. The mandibular plane angle and the gonial angle were significantly larger in the samurai than in the commoners. The ratio of the intermandibular first molars, interzygomatic arch, and mandibular width was significantly shorter in the samurai than in the commoners. The samurai had a high angle tendency and smaller mandibular width than the commoners, reflecting the class system. Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

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10 pages, 736 KiB

Open AccessArticle

The Intersections of Ethnicity, Nativity Status and Socioeconomic Position in Relation to Periodontal Status: A Cross-Sectional Study in London, England

by Syeda Ammara Shaharyar, Eduardo Bernabé and Elsa Karina Delgado-Angulo

Int. J. Environ. Res. Public Health 2021, 18(19), 10519; https://doi.org/10.3390/ijerph181910519 - 7 Oct 2021

Cited by 9 | Viewed by 2062

Abstract

The role of migration as a social determinant of periodontitis has been overlooked. Intersectionality theory could help understand how immigration status interacts with other social determinants of health to engender inequalities in periodontitis. The objective of the present study was to evaluate whether ethnicity, nativity status and socioeconomic position intersect to structure social inequalities in periodontal status. Data from 1936 adults in a deprived and multi-ethnic area of London were analysed. The numbers of teeth with probing depth and clinical attachment loss were determined from clinical examinations. A matrix with 51 intersectional strata, defined according to ethnicity, nativity status and education, was created. A cross-classified multilevel analysis, with participants clustered within intersectional social strata, was performed to assess the extent to which individual differences in periodontal measures were at the intersectional strata level. A complex pattern of social inequalities in periodontal status was found, which was characterised by high heterogeneity between strata and outcome-specificity. The variance partition coefficient of the simple intersectional model, which conflated additive and interaction effects, indicated that 3–5% of the observed variation in periodontal measures was due to between-stratum differences. Moreover, the percentual change in variance from the simple intersectional to the intersectional interaction model indicated that 73–74% of the stratum-level variance in periodontal measures was attributed to the additive effects of ethnicity, nativity status and education. This study found modest evidence of intersectionality among ethnicity, nativity status and education in relation to periodontal status. Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

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13 pages, 1136 KiB

Open AccessArticle

Sociodemographic, Behavioral and Oral Health Factors in Maternal and Child Health: An Interventional and Associative Study from the Network Perspective

by Juliana Ribeiro Francelino Sampaio, Suely Arruda Vidal, Paulo Savio Angeiras de Goes, Paulo Felipe R. Bandeira and José Eulálio Cabral Filho

Int. J. Environ. Res. Public Health 2021, 18(8), 3895; https://doi.org/10.3390/ijerph18083895 - 8 Apr 2021

Cited by 5 | Viewed by 2980

Abstract

Oral healthcare during pregnancy needs to be part of the assistance routine given to pregnant women by health professionals as a way to encourage self-care and strengthen the general health of the mother and the baby. The aim of this study was to evaluate the effectiveness of an integrated oral healthcare intervention for pregnant women and to analyze the association of sociodemographic, behavioral, oral health and general maternal and child health factors in prenatal care at usual risk in primary care in a city in the northeast of Brazil, in 2018–2019. A controlled, randomized, single-blinded community trial was conducted. The intervention group (IG) received dental assistance and collective health education actions in conversation circles, while the control group (CG) received the usual assistance. All pregnant women (146 in total, 58 from IG and 88 from CG) that took part in the trial answered a questionnaire and underwent a dental examination at the beginning of prenatal care and at the puerperal visit. To assess the effect of the intervention, a network analysis was used. The results have shown that being in the control group was associated with neonatal complications (0.89) and prematurity (0.54); the use of tobacco and alcohol are associated with high risk in initial and final oral health; lower educational level of the pregnant women implicates high risk for initial oral health (−0.19), final oral health (−0.26), pregnancy complications (−0.13), low birth weight (−0.23), prematurity (−0.19) and complications in the newborn (−0.14). Having a low family income (≤261.36 USD) has shown a high risk for initial oral health (−0.14), final oral health (−0.20) and prematurity (−0.15). The intervention based on integrated oral healthcare for pregnant women indicated that socioeconomic and behavioral factors must be considered as determinants for the quality of women and children’s health and that multi-professional performance during prenatal care contributes to the positive outcomes of pregnancy. Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

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10 pages, 352 KiB

Open AccessArticle

The Role of Organizational Factors and Human Resources in the Provision of Dental Prosthesis in Primary Dental Care in Brazil

by Maria Aparecida Cunha, Mario Vianna Vettore, Thiago Resende dos Santos, Antônio Thomaz Matta-Machado, Simone Dutra Lucas and Mauro Henrique Nogueira Guimarães Abreu

Int. J. Environ. Res. Public Health 2020, 17(5), 1646; https://doi.org/10.3390/ijerph17051646 - 3 Mar 2020

Cited by 11 | Viewed by 2366

Abstract

This study aimed to investigate factors associated with dental prosthesis procedures by oral health teams (OHTs) in the Brazilian primary health care in 2013–2014, who participated in the National Program for Improving Access and Quality of Primary Health Care (PMAQ-AB). This is an analytical cross-sectional study using a questionnaire with dichotomous questions applied in 18,114 OHTs. The dependent variable studied was making any type of prosthesis (removable or fixed). Independent variables involved issues related to human resources and health service management. Data were submitted to simple and multiple binary logistic regression with odds ratio calculation, 95% confidence intervals, and p-values. Most OHTs (57%) do not perform any dental prosthesis. The teams that are more likely to perform dental prostheses have human resources-related characteristics, such as professionals admitted through public examinations (OR 1.25, 95% CI 1.14–1.36) and those involved in permanent education (OR 1.13, 95% CI 1.02–1.26). Moreover, OHTs with a more organized work process and that receive more significant support from municipal management are more likely to perform dental prostheses (p < 0.05). The oral health teams which tended to provide the most dental prostheses to benefit patients were; hired as civil servants, had a municipal career plan, involved all members of the oral health team, and trained undergraduate dental students from outreach programs. Better organizational support and improved work incentives may be needed to get the majority of oral health teams to start providing dental prostheses to their patients. Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

Review

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10 pages, 987 KiB

Open AccessFeature PaperReview

Providing Oral Healthcare to Older Patients—Do We Have What It Takes?

by Cristiane da Mata and Patrick Finbarr Allen

Int. J. Environ. Res. Public Health 2023, 20(13), 6234; https://doi.org/10.3390/ijerph20136234 - 27 Jun 2023

Cited by 2 | Viewed by 1808

Abstract

Over the past decades, there has been an increase in the number of natural teeth that are maintained into older age, and this has represented an increase in the need for more complex dental treatment for this population. A trained workforce is needed in order to provide dental care to the different groups of elderly. Currently, the undergraduate training in gerodontology offered by dental schools seems to be limited, with great variation among dental schools worldwide. Given the heterogeneity of elderly groups, it is unlikely that new graduates from dental schools can be deemed competent to deal with the different groups of elderly. In this article, barriers to oral healthcare’s provision to older adults are discussed, including the lack of appropriately trained dental professionals. Training pathways are discussed, including the preparation of undergraduate education to provide a suitable foundation to be developed further in postgraduate education. It is also proposed that older adults are classified according to their dependency level and each level is managed by properly trained dental professionals. In order to upskill general dental practitioners to care for these patients, postgraduate certification programmes could be structured to provide additional training. Furthermore, the development of geriatric oral health educational programmes for non-dental healthcare workers is recommended. Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

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Other

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11 pages, 585 KiB

Open AccessProtocol

The Indigenous Adolescent Oral Health Partnership Study: A Co-Design Study Protocol

by Zac Calvin, John Skinner, Yvonne Dimitropoulos, Gabriela Stan, Julie Satur, Susan Cartwright, Richard P. Widmer, Tiarnee Schafer, Rachel Williams, Woosung Sohn, Sarah Raphael, Bradley Christian, Carmen Parter, Lauren Blatchford, Boe Rambaldini, Stephanie R. Partridge, Elyse Cain and Kylie Gwynne

Int. J. Environ. Res. Public Health 2022, 19(15), 9104; https://doi.org/10.3390/ijerph19159104 - 26 Jul 2022

Cited by 2 | Viewed by 2044

Abstract

Background: in this protocol we outline a method of working alongside Aboriginal communities to learn about and facilitate improvement in the oral health habits in Aboriginal adolescents. By facilitating positive oral health in Aboriginal adolescents, we hope to achieve lifelong improvement in oral health and general wellbeing. Methods: this paper outlines a co-design methodology through which researchers and Aboriginal communities will work together to create a custom oral healthcare program aimed at Aboriginal adolescents. Researchers, a youth advisory group, Aboriginal community-controlled health services and three regional NSW communities will together devise an oral health strategy focused on five components: application of topical fluoride, increasing water consumption, improving nutrition, daily toothbrushing, and enhancing social and emotional wellbeing. Capacity building is a key outcome of this program. Discussion: as the gap in health status between Aboriginal and non-Aboriginal people remains wide, it is clear that new approaches and attitudes are needed in Aboriginal public health research. This protocol is representative of this shifting approach; giving power to Aboriginal communities who seek to have sovereignty and self-determination over their healthcare. Trial registration: TRN: ISRCTN15496753 Date of registration: 20 October 2021. Full article

(This article belongs to the Special Issue Perspectives on Social and Environmental Determinants of Oral Health)

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