Obesity and Dental Caries in Children in Plymouth

Background: Obesity and dental caries are two of the most common conditions affecting children and both have significant implications on children’s wellbeing and future health. Even though research into the relationship between the two conditions has been conducted for many years, results to date remain equivocal. Furthermore, the majority of the studies only examined individual-level determinants of the two conditions. Aim: The current work aimed to examine the nature, direction and effect size of the relationship between obesity and caries in children in Plymouth, United Kingdom. It also aimed to better understand the individual and the broader environmental determinants of the two conditions. Methods: The study was divided into three parts: a systematic review examining the relationship between the two conditions in children and adolescents using a validated and study design specific tool; an analysis of extant data concerning Plymouth children’s weight status and dental caries using a spatial approach; and lastly a school survey of local children aged four to six years, where different types of obesity were examined in relation to dental caries. In the latter survey, several neighbourhood-level and individual characteristics were also examined in relation to the two conditions. Results: The systematic review indicated that there was no consistent association between high Body Mass Index and caries in individuals less than 18 years old. The ecological study identified spatial clusters of obesity and caries in Plymouth children and the results supported the importance of developing geographically focused prevention and intervention strategies which take into account the presence of spatial heterogeneity. The school survey did not find evidence of a relationship between any type of obesity and caries in Plymouth children but identified several indicators that affect the distribution of the two conditions. Conclusions: This work has given insight into the nature, direction and size of the relationship between obesity and caries in Plymouth children and has highlighted several indicators which need to be considered when developing local public health interventions.Plymouth University Peninsula Schools of Medicine & Dentistry (PU PSMD

Is there an association between oral health-related quality of life and Alzheimer's disease?

Data sources PubMed, Medline, Embase, CINAHL, Cochrane Library database and ProQuest databases were searched.Study selection Observational and non-randomised studies in English language were considered for inclusion. Two reviewers independently selected the relevant studies. Any disagreement was resolved by discussion with a third reviewer. The outcome of interest for this review was oral health-related quality of life (OHRQoL) in patients with Alzheimer's disease.Data extraction and synthesis Data extraction was conducted independently by two reviewers. Critical appraisal was conducted by two reviewers using the Joanna Briggs Institute 'Meta-Analysis of Statistics Assessment and Review Instrument'.Results Six studies were included in the review, of which five were cross-sectional and one was a non-randomised controlled trial. OHRQoL was measured by the Oral Health Impact Profile (OHIP) in one study and the Geriatric Oral Health Assessment Index (GOHAI) in the other five included studies. All six studies were judged as methodologically strong. When the results of four studies which used the GOHAI were pooled together in a meta-analysis, no statistically significant differences in the GOHAI scores between patients with Alzheimer's disease and controls were found (SMD = 0.09; 95%CI: -0.66 to 0.85).Conclusions The results of this review showed no significant difference in OHRQoL between patients with Alzheimer's disease and healthy controls

A Dental Student Perspective on the Impacts of an Inter-professional Engagement Module

Community engagement, defined as the process of getting communities involved in decisions that affect them (NICE, 2008), is paramount to the development and governance of services and activities that promote health and target inequalities (Buck, Baylis, Dougall, & Robertson, 2018; NICE, 2008). The inter-professional engagement module is an integral part of the curriculum of Peninsula Dental School, University of Plymouth, United Kingdom. It enables second-year undergraduate dental and dental therapy and hygiene students to develop and deliver an oral health intervention targeted at disadvantaged groups in the community. These groups commonly experience higher levels of dental disease (Public Health England, 2018; Office of the Director of Public Health, Plymouth City Council, 2018). As part of this module, we, a second-year group of undergraduate dental students, worked alongside the Family Intensive Intervention Project (FIIP) and its beneficiaries to improve vulnerable families’ awareness of oral and general health, and to break down barriers toward accessing dental care. FIIP provides holistic support to families with complex needs who may have difficulties with issues such as substance misuse, mental health and evidence of neglectful parenting (W. Kirby, personal communication, 2018)

Levels of physical dependence on tobacco among adolescent smokers in Cyprus

PURPOSE: The purpose of this study is to assess tobacco dependence among Cypriot adolescents and examine its association to cigarette consumption and attitudes towards smoking. METHODS: The current study used cross-sectional data from the 2011 Cyprus Global Youth Tobacco Survey which adopted multistage cluster sampling methods to select adolescents registered in middle and high schools in Cyprus. Tobacco use, physical dependence on tobacco, and attitudes towards tobacco use were measured in 187 adolescents aged 13-18years old who reported that they had smoked at least once in the preceding 30 days. Physical dependence was assessed using the Levels of Physical Dependence scale. RESULTS: Physical dependence was present in 86% of the adolescent smokers. The mean latency to needing among smokers in the highest dependence group was 101h. Significant associations were observed between physical dependence and the perceived difficulty in quitting (OR=13.1, 95% CI: 4.0, 43.0) as well as the expectation to continue smoking for the next five years (OR=3.3, 95% CI: 1.3, 8.4). Significant associations were also observed between physical dependence and the number of smoking days per month, daily smoking, daily cigarette consumption, lifetime cigarette consumption, and perceived difficulty in abstaining from smoking for one week. CONCLUSIONS: Physical dependence provides a symptom-based approach to assess dependence and it is a strong predictor of adolescents\u27 perceptions of their ability to quit or to refrain from smoking for a week. Physical dependence on tobacco was highly prevalent among adolescent smokers in Cyprus and it was associated with greater perceived difficulty in quitting. Interventions targeting adolescent smoking must account for the high prevalence of physical dependence

Investigating the effectiveness and acceptability of oral health and related health behaviour interventions in adults with severe and multiple disadvantage:Protocol for a mixed-methods systematic review

Increasing numbers of people in England experience homelessness, substance use, and repeated offending (known as ‘severe and multiple disadvantage’; SMD). Populations experiencing SMD often have extremely poor oral health, which is closely inter-linked with high levels of substance use, smoking, and poor diet. This study aims to undertake an evidence synthesis to identify the effectiveness, resource requirements, and factors influencing the implementation and acceptability of oral health and related health behaviour interventions in adults experiencing SMD. Two systematic reviews will be conducted using mixed-methods. Review 1 will investigate the effectiveness and resource implications of oral health and related health behaviours (substance use, smoking, diet) interventions; Review 2 will investigate factors influencing the implementation of such interventions. The population includes adults (≥18 years) experiencing SMD. Standard review methods in terms of searches, screening, data extraction, and quality appraisal will be conducted. Narrative syntheses will be conducted. If feasible, a meta-analysis will be conducted for Review 1 and a thematic synthesis for Review 2. Evidence from the two reviews will then be synthesised together. Input from people with experience of SMD will be sought throughout to inform the reviews. An initial logic model will be iteratively refined during the review.</jats:p

A preliminary assessment of low level arsenic exposure and diabetes mellitus in Cyprus

<p>Abstract</p> <p>Background</p> <p>A preliminary study was undertaken in a community of Cyprus where low-level arsenic (As) concentrations were recently detected in the groundwater that was chronically used to satisfy potable needs of the community. The main objective of the study was to assess the degree of association between orally-ingested As and self-reported type-2 diabetes mellitus (DM) in 317 adult (≥18 years old) volunteers.</p> <p>Methods</p> <p>Cumulative lifetime As exposure (CLAEX) (mg As) was calculated using the median As concentrations in water, individual reported daily water consumption rates, and lifetime exposure duration. Logistic regression models were used to model the probability of self-reported DM and calculate odds ratios (OR) in univariate and multivariate models.</p> <p>Results</p> <p>Significantly higher (p <it><</it> 0.02) CLAEX values were reported for the diabetics (median = 999 mg As) versus non-diabetics (median = 573 mg As), suggesting that As exposure could perhaps be related to the prevalence of DM in the study area, which was 6.6%. The OR for DM, comparing participants in the 80^th versus the 20^th percentiles of low-level As CLAEX index values, was 5.0 (1.03, 24.17), but after adjusting for age, sex, smoking, education, and fish consumption, the As exposure effect on DM was not significant.</p> <p>Conclusions</p> <p>Further research is needed to improve As exposure assessment for the entire Cypriot population while assessing the exact relationship between low-level As exposure and DM.</p

Obesity and caries in four-to-six year old English children: a cross-sectional study.

BACKGROUND: Obesity and caries are common conditions in childhood and can have significant implications on children's wellbeing. Evidence into their association remains conflicting. Furthermore, studies examining the ssociation between obesity and caries commonly focus on individual-level determinants. The present study aimed to examine the association between obesity and caries in young English children and to determine the impact of deprivation and area-level characteristics on the distribution of the two conditions. METHODS: This was a cross-sectional study among children in Plymouth city aged four-to-six years. Anthropometric measurements included weight and height (converted to Body Mass Index centiles and z-scores), and waist circumference. Caries was assessed by using the sum of the number of teeth that were decayed, missing or filled. A questionnaire was used to obtain information on children's demographic characteristics, oral hygiene, and dietary habits. The impact of deprivation on anthropometric variables and caries was determined using Linear and Poisson regression models, respectively. Multiple logistic regression was used to assess the association between different anthropometric measures and caries. Logistic regression models were also used to examine the impact of several demographic characteristics and health behaviours on the presence of obesity and caries. RESULTS: The total sample included 347 children aged 5.10 ± 0.31 (mean ± SD). Deprivation had a significant impact on caries and BMI z-scores (p < 0.05). Neither BMI- nor waist circumference z-scores were shown to be significantly associated with dental caries. Among the neighbourhood characteristics examined, the percentage of people dependent on benefits was found to have a significant impact on caries rates (p < 0.05). Household's total annual income was inversely related to caries risk and parental educational level affected children's tooth brushing frequency. CONCLUSIONS: No associations between any measure of obesity and caries were found. However, deprivation affected both obesity and caries, thus highlighting the need to prioritise disadvantaged children in future prevention programmes

A partnership between occupational therapy and dentistry

File replaced (docx to pdf) on 14.8.23 by NK (LDS

The lifestyles of affluent young people ages 9 to 15 years: a case study

BACKGROUND:There are concerns about the future health of young people due to inactive lifestyles. However, evidence about their physical activity levels is not extensive, especially with regard to affluent young people. This study aimed to investigate whether young people from affluent backgrounds met public health recommendations for physical activity.METHODS:Diary accounts of lifestyle activity were collected from 219 students ages 9 to 15 years attending a fee-paying school in England.RESULTS:Pupils spent an average of 121 minutes per day participating in physical activities of at least moderate intensity, considerably more than public health recommendations of 60 minutes per day. However, almost a quarter of these young people engaged in less than 60 minutes of physical activity per day of at least moderate intensity.CONCLUSIONS:The picture to emerge was one of a balance between sedentary pursuits such as television and homework and physical activities such as sport and active play