4 research outputs found
Pediatric patients’ reasons for visiting dentists in all WHO regions
Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the four oral healthrelated quality of life (OHRQoL) dimensions (4D) or areas in which oral disorders impact pediatric patients. Using their
dentists’ assessment, the study aimed to evaluate whether pediatric dental patients’ oral health concerns ft into the
4D of the Oral Health-Related Quality of Life (OHRQoL) construct.Dentists who treat children from 32 countries and all WHO regions were selected from a web-based
survey of 1580 international dentists. Dentists were asked if their pediatric patients with current or future oral health
concerns ft into the 4D of the Oral Health-Related Quality of Life (OHRQoL) construct. Proportions of all pediatric
patients’ oral health problems and prevention needs were computed
Cross-cultural differences in patients with temporomandibular disorders-pain : a multi-center study
The overall objective of this thesis was to investigate patients with
TMD-pain and TMD-free controls in three cultures (Saudi Arabia,
Sweden, and Italy) to determine the influence of culture on and crosscultural
differences in pain prevalence and intensity, sensitivity to
mechanical and electrical stimulation, pain-related disability for four
comorbid pain conditions (back, head, chest, and stomach pain) in
the last 6 months, and the type of treatment that patients with TMD
pain received.
The specific aims were:
(i) To determine the frequency of TMD pain in Saudi
Arabians (I).
(ii) To compare psychophysical responses to mechanical and
electrical stimuli in female TMD patients and TMD-free
controls, nested within each of three cultures (Saudi,
Italian, and Swedish) (II).
(iii) To assess pain prevalence and intensity, and pain-related
disability associated with comorbid pain conditions by
testing for the interaction effect between three different
cultures and case-status (III).
(iv) To assess the type of treatment that female patients with
TMD-pain in three cultures received, and their beliefs
about the factors that contribute to and aggravate TMD,
as well as the factors that are important to include in TMD treatment (IV). Study (I) material included 325 Saudi Arabian patients (135 males,
190 females) aged 20–40, who were referred to the Specialist Dental
Center at Alnoor Specialist Hospital, Makkah and answered a history
questionnaire. We offered a clinical examination to patients reporting
TMD pain in the last month and assessment according to the Arabic
version of the Research Diagnostic Criteria for TMD (RDC/TMD).
Of these patients, 58 (18%) reported TMD pain and 46
underwent clinical examination. All TMD pain patients had a
diagnosis of myofascial pain, and 65% had diagnoses of arthralgia
or osteoarthritis. The TMD-pain group reported high levels of both
headaches/migraines in the last 6 months (93%) differing significantly
(P < 0.01) from the TMD-pain-free groups.
All pain group were suffering at least from one TMD subdiagnosis
The TMD-pain group had high depression and somatization scores
but low disability grades on the Graded Chronic Pain Scale (GCPS). Studies (II-IV) compared 122 female cases of chronic TMD pain
(39 Saudis, 41 Swedes, and 42 Italians) to equal numbers of agematched
TMD-free controls. The study (II) measured pressure
pain threshold (PPT) and tolerance (PPTo) over one hand and two
masticatory muscles, and electrical perception threshold, electrical
pain threshold (EPT), and electrical pain tolerance (EPTo) between
the thumb and index fingers. Italian females reported significantly
lower PPT in the masseter muscle than the other cultures (P < 0.01)
and in the temporalis muscle than Saudis (P < 0.01). Swedes reported
significantly higher PPT in the thenar muscle than the other cultures
(P = 0.017). Italians reported significantly lower PPTo in all muscles
than Swedes (P < 0.01) and in the masseter muscle than Saudis (P <
0.01). Italians reported significantly lower EPTo than other cultures
(P = 0.01). TMD cases reported lower PPT and PPTo than TMD-free
controls in all three muscles (P < 0.01).
Cultural differences appeared in PPT, PPTo and EPTo. Overall,
Italian females reported the highest sensitivity to both mechanical and
electrical stimulation, while Swedes reported the lowest sensitivity.
Mechanical pain thresholds differed more across cultures than did
electrical pain thresholds. Cultural factors may influence response
to type of pain test. In Study (III), self-report questionnaires assessed back, chest, stomach,
and head pain for prevalence, intensity, and interference with daily
activities in the last 6 months. Logistic regression assessed binary
variables and ANCOVA provided parametric data analysis, adjusting
for age and education.
Back pain was the only comorbid condition that varied in prevalence
across cultures; Headache was the most common comorbid pain
condition in all three cultures; the average head pain intensity was
lower, however, among Swedes compared to Saudis (P = 0.029). The
total number of comorbid conditions did not differ cross-culturally,
but the TMD group reported more comorbid conditions compared
to TMD-free controls (P < 0.01). For both back and head pain,
TMD cases reported higher average pain intensities (P < 0.01) and
interference with daily activities (P < 0.01) than TMD-free controls.
Among TMD patients, Italians reported the highest pain-related
disability (P < 0.01).
This study indicates that culture influences the comorbidity of
common pain conditions with TMD. The cultural influence on pain
expression is reflected in different patterns of physical representation. Study (IV) compared patient characteristics, treatment beliefs, and
type of practitioner advice received before referral for TMD treatment.
Patients responded to a questionnaire that assessed treatments
received, then completed an explanatory model form about their
beliefs regarding which factors contribute to and aggravate TMD,
and what factors are important for treatment to address.
Of the various treatments, Swedes most commonly sought
behavioral therapy and Saudis Islamic medicine (P < 0.01). Swedes
received acupuncture and occlusal appliance therapy significantly
more than Saudis (P < 0.01) or Italians (P = 0.012). Italians were
significantly less likely than Saudis and Swedes (P = 0.042) to believe
that TMD pain treatment should address behavioral factors.
Among Saudi, Italian, and Swedish females with chronic TMD
pain, culture did not influence the type of practitioner consulted before
visiting a TMD specialist or their beliefs about factors contributing
to or aggravating their pain. Overall, the treatments patients received
and beliefs about behavioral factors differed cross-culturally. Islamic
medicine was fairly common among Saudis and acupuncture was common among Swedes
Frequency of Four-dimensional Oral Health Problems across Dental Fields - a Comparative Survey of Slovenian and International Dentists.
Objectives
To compare the frequency of patients' oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions.
Methods
An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients' oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients' problems and prevention needs were calculated together with the significance of Slovenian and international dentists' differences based on dental fields and WHO regions.
Results
Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (<0.1).
Conclusion
According to the dentists' responses, the frequency of patients' oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields
Why Patients Visit Dentists – A Study in all World Health Organization Regions
The dimensions of oral health-related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions