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Effectiveness of dental services in facilitating recovery from oral disadvantage

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Abstract

Objective: To determine the effectiveness of dental health care services in facilitating recovery from quality of life decrements in symptom-specific subgroups with the most prevalent chronic infectious diseases (periodontal disease and dental caries), and a ‘stained teeth’ subgroup. Methods: Data were taken from the prospective longitudinal Florida Dental Care Study of 873 individuals 45+ years old. Logistic regression modeling quantified associations between recovery from oral health-related quality of life decrements (‘recovery’) and dental services. Results: Adjusting for age, race, gender, income, approach to dental care, and signs/symptoms, any dental visit (odds ratio, OR: 4.0; 95% confidence interval, CI: 2.3, 6.9), corrective treatment (OR: 3.8; 95% CI: 1.6, 8.7), denture visit (OR:4.8; 95% CI: 1.1, 21.9), or extraction (OR: 6.2; 95% CI: 2.2, 17.4) were positively associated with recovery. Upon conditioning the analyses on specific symptoms, point estimates increased substantially for most service types, and dental cleaning was associated with recovery for the stained teeth subgroup (OR: 10.9; 95% CI: 1.2, 99.4). Conclusion: Dental care was highly effective in treating quality of life decrements. Treatment effectiveness increased substantially when analyses were restricted to symptom-specific subgroups similar to selection criteria of randomized clinical trials (RCTs). Restricted cohort analyses can be applied to many other health outcomes for which RCTs are not feasible or ethical.

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Abbreviations

CI:

confidence interval

OR:

odds ratio

RCT:

randomized, double-blind, placebo-controlled trial

SES:

socioeconomic status

References

  • AB Hill (1965) ArticleTitleThe environment and disease: Association or causation? Proc R Soc Med 58 295–300 Occurrence Handle14283879

    PubMed  Google Scholar 

  • CH Hennekins JE Buring (1987) Epidemiology in Medicine. Little, Brown and Company Boston, MA

    Google Scholar 

  • TJ Kaptchuck (2001) ArticleTitleThe double-blind, randomized, placebo-controlled trial: Gold standard or golden calf? J Clin Epidemiol 54 541–549 Occurrence Handle10.1016/S0895-4356(00)00347-4 Occurrence Handle11377113

    Article  PubMed  Google Scholar 

  • HB Dumbrigue JS Jones JF Esquivel (2001) ArticleTitleControl of bias in randomized controlled trials published in prosthodontic journals. J Prosthet Dent 86 592–596 Occurrence Handle10.1067/mpr.2001.119980 Occurrence Handle11753309

    Article  PubMed  Google Scholar 

  • N Black (1996) ArticleTitleWhy we need observational studies to evaluate the effectiveness of health care. Br Med J 312 1215–1218

    Google Scholar 

  • MM Rovers H Straatman K Ingels GJ Wilt Particlevan der P Broek Particlevan den GA Zielhuis (2001) ArticleTitleGeneralizability of trial results based on randomized versus nonrandomized allocation of OME infants to ventilation tubes or watchful waiting. J Clin Epidemiol 54 789–794 Occurrence Handle10.1016/S0895-4356(01)00340-7 Occurrence Handle11470387

    Article  PubMed  Google Scholar 

  • KF Schultz (1995) ArticleTitleSubverting randomization in controlled trials. JAMA 274 1456–1458 Occurrence Handle10.1001/jama.274.18.1456 Occurrence Handle7474192

    Article  PubMed  Google Scholar 

  • A Padkin K Rowan N Black (2001) ArticleTitleUsing high quality clinical databases to complement the results of randomised controlled trials: The case of recombinant human activated protein C. Br Med J 323 923–926

    Google Scholar 

  • RI Horowitz CM Viscoli JD Clemens RT Sadock (1990) ArticleTitleDeveloping improved observational methods for evaluating therapeutic effectiveness Am J Med 89 630–638 Occurrence Handle10.1016/0002-9343(90)90182-D Occurrence Handle1978566

    Article  PubMed  Google Scholar 

  • OH Klungel BHC Stricker MMB Breteler JC Seidell BM Psaty A Boer Particlede (2001) ArticleTitleIs drug treatment of hypertension in clinical practice as effective as in randomized controlled trials with regard to the reduction of the incidence of stroke? Epidemiology 11 339–344 Occurrence Handle10.1097/00001648-200105000-00014

    Article  Google Scholar 

  • M Aricò MG Valsecchi B Camitta et al. (2000) ArticleTitleOutcome of treatment in children with Philadelphia chromosome-positive acute lymphoblastic leukemia. N Engl J Med 342 998–1006 Occurrence Handle10.1056/NEJM200004063421402 Occurrence Handle10749961

    Article  PubMed  Google Scholar 

  • J Fine J Duff R Chen et al. (2000) ArticleTitleLong-term follow-up of unilateral pallidotomy in advanced Parkinson’s disease. N Engl J Med 342 1708–1714 Occurrence Handle10.1056/NEJM200006083422304 Occurrence Handle10841873

    Article  PubMed  Google Scholar 

  • K Benson AJ Hartz (2000) ArticleTitleA comparison of observational studies and randomized, controlled trials. N Engl J Med 342 1878–1886 Occurrence Handle10.1056/NEJM200006223422506 Occurrence Handle10861324

    Article  PubMed  Google Scholar 

  • J Concato N Shah RI Horwitz (2000) ArticleTitleRandomized, controlled trials, observational studies, and the hierachy of research designs. N Engl J Med 342 1887–1892 Occurrence Handle10.1056/NEJM200006223422507 Occurrence Handle10861325

    Article  PubMed  Google Scholar 

  • N Black (1999) ArticleTitleHigh-quality clinical databases: Breaking down barriers. Lancet 353 1205–1206 Occurrence Handle10.1016/S0140-6736(99)00108-7 Occurrence Handle10217078

    Article  PubMed  Google Scholar 

  • R Horton (2000) ArticleTitleCommon sense and figures: The rhetoric of validity in medicine (Bradford Hill Memorial Lecture 1999). Stat Med 19 3149–3164 Occurrence Handle10.1002/1097-0258(20001215)19:23<3149::AID-SIM617>3.0.CO;2-E Occurrence Handle11113950

    Article  PubMed  Google Scholar 

  • WC Wu SS Rathore Y Wang MJ Radford HM Krumholz (2001) ArticleTitleBlood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 345 1230–1236 Occurrence Handle10.1056/NEJMoa010615 Occurrence Handle11680442

    Article  PubMed  Google Scholar 

  • GH Gilbert RP Duncan AM Kulley RT Coward MW Heft (1997) ArticleTitleEvaluation of bias and logistics in a survey of adults at increased risk for oral health decrements. J Public Health Dent 57 48–58 Occurrence Handle9150063

    PubMed  Google Scholar 

  • GH Gilbert RP Duncan MW Heft TA Dolan WB Vogel (1998) ArticleTitleMultidimensionality of oral health in dentate adults. Med Care 36 988–1001 Occurrence Handle10.1097/00005650-199807000-00006 Occurrence Handle9674617

    Article  PubMed  Google Scholar 

  • GH Gilbert RP Duncan WB Vogel (1998) ArticleTitleDeterminants of dental care use in dentate adults: Six-monthly use during a 24-month period in the Florida Dental Care Study. Soc Sci Med 47 727–737 Occurrence Handle10.1016/S0277-9536(98)00148-8 Occurrence Handle9690820

    Article  PubMed  Google Scholar 

  • KY Liang SL Zeger (1993) ArticleTitleRegression analysis for correlated data. Annu Rev Public Health 14 43–68 Occurrence Handle10.1146/annurev.pu.14.050193.000355 Occurrence Handle8323597

    Article  PubMed  Google Scholar 

  • S Downs N Black (1998) ArticleTitleThe feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Community Health 52 377–384 Occurrence Handle9764259

    PubMed  Google Scholar 

  • U.S. Department of Health and Human Services, National Institute of Dental and Craniofacial Research, National Institutes of Health. 2000. Oral Health in America: A Report of the Surgeon General. Rockville, MD. (http: //www.nidcr.nih.gov/sgr/sgrohweb/welcome.htm).

  • K Levit C Smith C Cowan H Lazenby A Sensenig A Catlin (2003) ArticleTitleTrends in U.S. health care spending, 2001 Health Affairs 22 154–164 Occurrence Handle10.1377/hlthaff.22.1.154

    Article  Google Scholar 

  • The Cochrane Library, Issue 4, 2003. Chichester, UK: John Wiley & Sons, Ltd.

  • V Marinho J Higgins S Logan A Sheiham (2003) ArticleTitleTopical fluoride (toothpastes, mouthrinses, gels, or varnishes) for preventing dental caries in children and adolescents Cochrane Database Syst Rev 4 CD002728

    Google Scholar 

  • MA Awad JP Lund SH Shapiro et al. (2003) ArticleTitleOral health status and treatment satisfaction with mandibular implant overdentures and conventional dentures: A randomized clinical trial in a senior population. Int J Prosthodont 16 390–396 Occurrence Handle12956494

    PubMed  Google Scholar 

  • MA Awad JP Lund E Dufresne JS Feine (2003) ArticleTitleComparing the efficacy of mandibular implant-retained overdentures and conventional dentures among middle-aged edentulous patients: Satisfaction and functional assessment. Int J Prosthodont 16 117–122 Occurrence Handle12737240

    PubMed  Google Scholar 

  • GH Gilbert MW Heft RP Duncan (1993) ArticleTitleOral signs, symptoms, and behaviors in older Floridians. J Public Health Dent 53 151–157 Occurrence Handle8371193

    PubMed  Google Scholar 

  • GH Gilbert RP Duncan MW Heft TA Dolan WB Vogel (1997) ArticleTitleOral disadvantage among dentate adults. Community Dent Oral Epidemiol 25 301–313 Occurrence Handle9332808

    PubMed  Google Scholar 

  • N Kressin A Spiro R Bosse R Garcia L Kazis (1996) ArticleTitleAssessing oral health-related quality of life: Findings from the normative aging study. Med Care 34 416–427 Occurrence Handle10.1097/00005650-199605000-00004 Occurrence Handle8614164

    Article  PubMed  Google Scholar 

  • D Locker Y Miller (1994) ArticleTitleEvaluation of subjective oral health status indicators. J Public Health Dent 54 167–176 Occurrence Handle7932353

    PubMed  Google Scholar 

  • A Leao A Sheiham (1995) ArticleTitleRelation between clinical dental status and subjective impacts on daily living. J Dent Res 74 1408–1413 Occurrence Handle7560392

    PubMed  Google Scholar 

  • J Fiske S Gelbier RM Watson (1990) ArticleTitleThe benefit of dental care to an elderly population assessed using a sociodental measure of oral handicap. Br Dent J 168 153–156 Occurrence Handle2310635

    PubMed  Google Scholar 

  • B Bergendal (1989) ArticleTitleThe relative importance of tooth loss and denture wearing in Swedish adults. Community Dent Health 6 103–111 Occurrence Handle2667700

    PubMed  Google Scholar 

  • J Fiske DM Davis C Frances S Gelbier (1998) ArticleTitleThe emotional effects of tooth loss in edentulous people Br Dent J 184 90–93 Occurrence Handle10.1038/sj.bdj.4809551 Occurrence Handle9489217

    Article  PubMed  Google Scholar 

  • C McGrath R Bedi (1998) ArticleTitleA study of the impact of oral health on the quality of life of older people in the UK–findings from a national survey. Gerodontology 15 93–98 Occurrence Handle10.1111/j.1741-2358.1998.00093.x Occurrence Handle10530183

    Article  PubMed  Google Scholar 

  • RE Matthias KA Atchison SO Schweitzer JE Lubben A Mayer-Oakes F Jong ParticleDe (1993) ArticleTitleComparisons between dentist ratings and self-ratings of dental appearance in an elderly population. Spec Care Dentist 13 53–60 Occurrence Handle8272984

    PubMed  Google Scholar 

  • RP Strauss RJ Hunt (1993) ArticleTitleUnderstanding the value of teeth to older adults: Influences on the quality of life. J Am Dent Assoc 124 105–110

    Google Scholar 

  • CW Peek GH Gilbert RP Duncan MW Heft JC Henretta (1999) ArticleTitlePatterns of change in self-reported oral health among dentate adults. Med Care 37 1237–1248 Occurrence Handle10.1097/00005650-199912000-00007 Occurrence Handle10599605

    Article  PubMed  Google Scholar 

  • GD Slade (1998) ArticleTitleAssessing change in quality of life using the Oral Health Impact Profile. Community Dent Oral Epidemiol 26 52–61 Occurrence Handle9511843

    PubMed  Google Scholar 

  • LS Chavers GH Gilbert BJ Shelton (2003) ArticleTitleTwo-year incidence of oral disadvantage, a measure of oral health-related quality of life. Community Dentistry and Oral Epidemiol 31 21–29 Occurrence Handle10.1034/j.1600-0528.2003.00031.x

    Article  Google Scholar 

  • LS Chavers GH Gilbert BJ Shelton (2002) ArticleTitleRacial and socioeconomic disparities in oral disadvantage, a measure of oral health-related quality of life: 24-month incidence. J Public Health Dent 62 140–147 Occurrence Handle12180041

    PubMed  Google Scholar 

  • D Locker (2001) ArticleTitleDoes dental care improve the oral health of older adults? Community Dent Health 18 7–15 Occurrence Handle11421409

    PubMed  Google Scholar 

  • Bloom B, Gift HC, Jack SS. Dental services and oral health. Vital Health Stat 10 1992; (183): 1–95.

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Authors and Affiliations

  1. Department of Diagnostic Sciences, University of Alabama at Birmingham, Birmingham, Alabama

    Monica A. Fisher & Gregg H. Gilbert

  2. Departments of Internal Medicine and Biostatistics, University of Kentucky, Lexington, Kentucky

    Brent J. Shelton

Authors
  1. Monica A. Fisher
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  2. Gregg H. Gilbert
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  3. Brent J. Shelton
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Correspondence to Monica A. Fisher.

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Fisher, M.A., Gilbert, G.H. & Shelton, B.J. Effectiveness of dental services in facilitating recovery from oral disadvantage. Qual Life Res 14, 197–206 (2005). https://doi.org/10.1007/s11136-004-3929-2

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