Yaghma Masood

Impact of malocclusion on oral health related quality of life in young people

BackgroundThe objectives for this study were to assess Oral Health Related Quality of Life (OHRQoL) in young people aged 15–25 who sought orthodontic treatment, and to measure the association between orthodontic treatment need (using the IOTN), sex, age and education level, and oral health related quality of life (OHRQoL).MethodsSurvey of a consecutive series of 323 young adults aged 15 to 25 years, attending orthodontic clinics at the Faculty of Dentistry, Universiti Teknologi MARA. Participants completed the Oral Health Impact Profile-14 (OHIP-14) and had a clinical examination including the Index of Orthodontic Treatment Need- Dental Health Component (IOTN-DHC). Data analyses included descriptive statistics, One-way ANOVA and bivariate and multivariate regression models.ResultsThe mean overall score (± SD) for OHIP-14 in young people aged 15–25 was 22.6 ± 12.5. The psychological discomfort domain was the domain where highest impact was recorded with a mean (± SD) of 4.0 ± 1.9. The regression analyses showed a significant association of IOTN-DHC with overall OHIP-14 score (p < 0.05). Although females reported a slightly higher impact than males, this was not significant in both bivariate and multivariate analyses. Age group had a significant negative association with overall OHIP-14 score (p < 0.05). The 15–18 year old group showed the highest impact on their quality of life due to malocclusion. Participants with a university education report a significantly higher impact on OHRQoL as compared to participants with only secondary education.ConclusionMalocclusion has a significant negative impact on OHRQoL and its domains. This is greatest for the psychological discomfort domain. Younger people and those with a university education report higher levels of impact. There was no reported difference in impact between male and females.

Need of minimal important difference for oral health-related quality of life measures

Demand and use for oral health-related quality of life (OHRQoL) instruments have increased in recent years in both research and clinical settings. These instruments can be used to measure patients health status or detect changes in a patients health status in response to an intervention or changes in disease trajectory. Ensuring universal acceptance of these measures requires easy interpretation of its scores for clinicians, researchers, and patients. The most important way of describing and interpreting this significance of changes in OHRQoL is through the establishment of minimal important difference (MID). The minimally important difference represents the smallest improvement considered worthwhile by a patient. A comprehensive search of published literature identified only 12 published articles on establishment of MID for OHRQoL measures. This scarcity of published studies on MID encourages the need of appropriate interpretation and describing patient satisfaction in reference to that treatment using MID. Anchor- and distribution-based methods are the two general approaches that have been proposed and recommended to interpret differences or changes in OHRQoL. Both of these methods of determining the MID have specific shortcomings; therefore, it is proposed to adopt triangulation approaches in which the methods are combined. The objective of this review is to summarize the need for, importance of, and recommendations for methods of establishing MID for OHRQoL measures.

Impact of national income and inequality on sugar and caries relationship

Objective: The aim of this study was to examine the impact that national income and income inequality in high and low income countries have on the relationship between dental caries and sugar consumption. Methods: An ecological study design was used in this study of 73 countries. The mean decayed, missing, or filled permanent teeth (DMFT) for 12-year-old children were obtained from the WHO Oral Health Country/Area Profile Programme. United Nations Food and Agricultural Organization data were used for per capita sugar consumption. Gross national incomes per capita based on purchasing power parity and the Gini coefficient were obtained from World Bank data. Bivariate and multivariate linear regression analysis was performed to estimate the associations between mean DMFT and per capita sugar consumption in different income and income inequality countries. Results: Bivariate and multivariate regression analysis showed that countries with a high national income and low income inequality have a strong negative association between sugar consumption and caries (B = –2.80, R2 = 0.17), whereas countries with a low income and high income inequality have a strong positive relationship between DMFT and per capita sugar consumption (B = –0.89, R2 = 0.20). Conclusion: The relationship between per capita consumption of sugar and dental caries is modified by the absolute level of income of the country, but not by the level of income inequality within a country.

The Clustering Effects of Surfaces within the Tooth and Teeth within Individuals

The objectives of this study were 1) to provide an estimate of the value of the intraclass correlation coefficient (ICC) for dental caries data at tooth and surface level, 2) to provide an estimate of the design effect (DE) to be used in the determination of sample size estimates for future dental surveys, and 3) to explore the usefulness of multilevel modeling of cross-sectional survey data by comparing the model estimates derived from multilevel and single-level models. Using data from the United Kingdom Adult Dental Health Survey 2009, the ICC and DE were calculated for surfaces within a tooth, teeth within the individual, and surfaces within the individual. Simple and multilevel logistic regression analysis was performed with the outcome variables carious tooth or surface. ICC estimated that 10% of the variance in surface caries is attributable to the individual level and 30% of the variance in surfaces caries is attributable to variation between teeth within individuals. When comparing multilevel with simple logistic models, β values were 4 to 5 times lower and the standard error 2 to 3 times lower in multilevel models. All the fit indices showed multilevel models were a better fit than simple models. The DE was 1.4 for the clustering of carious surfaces within teeth, 6.0 for carious teeth within an individual, and 38.0 for carious surfaces within the individual. The ICC for dental caries data was 0.21 (95% confidence interval [CI], 0.204–0.220) at the tooth level and 0.30 (95% CI, 0.284–0.305) at the surface level. The DE used for sample size calculation for future dental surveys will vary on the level of clustering, which is important in the analysis—the DE is greatest when exploring the clustering of surfaces within individuals. Failure to consider the effect of clustering on the design and analysis of epidemiological trials leads to an overestimation of the impact of interventions and the importance of risk factors in predicting caries outcome.

Role of miRNA in head and neck squamous cell carcinoma

Head and neck squamous cell carcinoma (HNSCC) is the sixth most common malignancy worldwide. Evidence suggests that miRNAs play an important role in progression, recurrence, metastasis and postoperative survival of HNSCC. Studies have investigated the utility of miRNAs as diagnostic/prognostic tools and as potential therapeutic targets and biomarkers that may improve the management and outcomes of HNSCC. The aim of this article is to review the current literature on aberrant expression profiles of miRNAs in biopsy samples of HNSCC and their role in cancer development, metastasis, prognosis and survival of these patients. This review gives an overview that miRNAs deregulation play major role in the development of HNSCC. They offer the potential to be used as biomarkers or novel therapeutic targets. Future research is required to test their use in both of these fields.

Development of a conceptual model of oral health for malocclusion patients

OBJECTIVES To provide an empirical test of the applicability of Lockers conceptual model of oral health for malocclusion patients, and to suggest alternative models of the effect of malocclusion on well-being. MATERIALS AND METHODS Data from a survey of 323 adolescents attending for orthodontic treatment were analyzed to develop a new oral health model for malocclusion patients. Oral health-related quality of life (OHRQoL) was measured using the 14-item Oral Health Impact Profile; malocclusion was measured using the Dental Health Component (DHC) of the Index of Orthodontic Treatment Need (IOTN). Using structural equation modeling, the relationship between conceptual domains in Lockers model was explored and three models of their interrelationship tested for goodness of fit. RESULTS Fit indexes for Lockers model indicated that it did not fit the data well. Therefore, a modified model was developed to incorporate additional paths between other levels to better fit the data. The best fit was provided by a model in which the direct effects of malocclusion on pain, discomfort, and handicapping-and the direct effect of pain on disability-were removed. A direct effect of functional limitation on disability was allowed. The modified Oral Health Impact Profile model proved to be a good fit to the data (root mean square error of approximation  =  0.069). CONCLUSION The pathways identified in Lockers (1988) conceptual model of oral health may not be appropriate for describing the relationships between OHRQoL constructs in individuals with malocclusion. An alternative model is proposed.

Dentists should be at the forefront in the fight against sugar

Sugar is the new tobacco. All eff orts should be made to reduce sugar consumption. Education and governmental regulations alone cannot reduce consumption. A multisectorial approach is required using all possible routes: whole population, highrisk group, and targeted population approaches. Decreases in tobacco consumption have arguably flowed from the introduction of legislation (a whole population approach) and smoking cessation in clinics (a targeted population approach). We should consider the use of similar approaches to combat the threat posed by sugar. Whole population approaches to control sugar consumption such as legislation and partnership with manufacturers have been attempted; however, few eff orts have been made for a targeted population approach —eg, sugar cessation programmes at the individual level similar to smoking cessation. Evidence supports the eff ectiveness of tobacco cessation services delivered via dental health-care practitioners. Tobacco cessation services delivered in public dental clinics have the potential to improve the health and wellbeing of millions of people globally. Dentists are well positioned to play an important part in reducing sugar consumption just as they do for smoking cessation. Dental caries is one of the earliest consequences of sugar consumption. Dentists have a strategic position to identify risk early in life and take preventive measure. Early detection of high sugar consumption in children is very important; children are the main targets of marketing campaigns for sweet products. Added sugar has found its way into almost all food, and the use of sugar as a means to calm, entertain, or reward children has become normalised, whereas sugar should be an occasional treat. At the individual level, reducing sugar consumption can be particularly challenging. Estimation of individuals sugar intake can be difficult: food products labelling is often unclear. Effectiveness, cost-effectiveness, and feasibility of sugar cessation programmes in dental clinics need to be established, and more reasearch is needed. According to the Healthy lives, healthy people report from the Department of Health, if sugar consumption could be reduced by 30% within the next 5 years, the obesity epidemic could be stopped and the benefi ts for individuals and countries could be enormous. According to the Tackling obesities: future choices project report, the obesity epidemic costs the UK £5 billion a year, potentially rising to £50 billion by 2050. Therefore, it is crucial to use dentists’ strategic position to help controlling sugar consumption as a targeted population approach from early childhood to later in life.

Within-Family Discussion on Harmful Effects of Smoking and Intention to Initiate Smoking Among European Adolescents.

Objective:The main objective of this study was to determine the impact of discussion within family about the harmful effects of smoking on intention to initiate smoking in the long term among nonsmoking adolescents. Methods:Data from Global Youth Tobacco Survey for 25 European countries were used. The outcomes of interest were, therefore, the intention to initiate smoking 1 and 5 years after the survey. Discussion within family about harmful effect of smoking was the main predictor with age, sex, and smoking status of parents, friends, and classmates as covariates. The association between predictors and outcomes was assessed through multiple regression analysis. Results:A total of 118,703 nonsmoking adolescents were included. Within-family discussion significantly reduced the odds of intention to initiate smoking 1 and 5 years later. Intention to initiate smoking also was significantly associated with the smoking status of friends, classmates, and parents, except for fathers smoking status, which was not associated with intention to initiate 1 year later. Conclusions:This study demonstrated that within-family discussion about the harmful effects of smoking may contribute to reduce the intention to start smoking among adolescents in the long term. Such a discussion was associated with reduced intention to smoke even when adjusting for parent/friend and classmate smoking.

Vending machine threat.

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