Community dentistry and oral epidemiology最新文献

{"title":"Trends of Dispensed Opioids Prescribed by Australian Dentists: 2013-2022.","authors":"Leanne Teoh, Marietta Taylor, Erin Kelty, Frank M Sanfilippo, Mathew Lim, Michael McCullough, Christopher Etherton-Beer, Alex Park, David Preen, Amy Page","doi":"10.1111/cdoe.70022","DOIUrl":"https://doi.org/10.1111/cdoe.70022","url":null,"abstract":"<p><strong>Background: </strong>In Australia, the prescribing of opioid medicines by dentists has increased in recent years, despite opioids not being first-line treatment for dental pain. The aim of this longitudinal study was to examine the dispensing of opioids prescribed by dentists in Australia during 2013-2022.</p><p><strong>Method: </strong>A nationally representative 10% sample of patients identified from the Australian Pharmaceutical Benefits Scheme dispensing data from 2013 to 2022 was used. Three outcomes were assessed: (1) incidence of dispensing of all dental prescriptions; (2) incidence of dispensing of opioids prescribed by dentists; (3) average number of tablets/capsules of dental opioid supply. Outcomes pertaining to opioid use were examined overall, and by year, age and sex.</p><p><strong>Results: </strong>From 2013 to 2022, 998 774 dental prescriptions (of any kind) were dispensed to 470 118 patients. The mean annual incidence rate for dispensing any dental medication was 48.4 (95% CI: 48.3-48.5)/1000 person-years. Opioids accounted for 183 303 prescriptions (18.4%), with a mean annual incidence rate of 11.0 (95% CI: 11.0-11.1)/1000 person-years. The majority of patients (99.1%) were dispensed ≤ 4 opioid prescriptions across the 10-year period, with 0.9% of patients (n = 1312) receiving between 5 and 149 dispensed opioids. Over the study period, the average annual incidence of dispensed dental opioids increased by 4.4% (95% CI: 1.0-8.2). A reduction in the mean quantity of opioid pills dispensed was observed over time. Dental opioids were dispensed to 2727 children and adolescents.</p><p><strong>Conclusion: </strong>The incidence of dispensing of dental opioids in Australia increased by an average of 4.4% per year over a decade. While there was a reduction in opioid quantities dispensed, dispensing of opioids for children occurred, and a small number of patients were dispensed excessive quantities of dental opioids. Evidence-based tailored opioid stewardship interventions need to include dentists, and dentists should be provided access to drug monitoring programmes to enable more informed prescribing decisions.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping Dental Care for Children and Adolescents With Rare Diseases: A Brazilian Multicentre Study.","authors":"Heloisa Vieira Prado, Rayssa Maria Soalheiro de Souza, Gabriella Guerra Freire Gabrich Fonseca, Kamila Rodrigues Junqueira Carvalho, Anna Vitória Mendes Viana Silva, Iasmin Fonseca Tolentino Mascarenhas, Beatriz Rezende Bergo, Hanna Larissa Barbosa Soares, Bárbara Mendes de Jesus, Layanne Ribeiro Ferreira E Sobral, Kélisson Duarte Reis, Késia Lara Dos Santos Marques, Fabiana Sodré de Oliveira, Daniella Reis Barbosa Martelli, José Alcides Almeida de Arruda, Benjamin P J Fournier, Denise Vieira Travassos, Soraia Macari, Célia Regina Moreira Lanza, Ana Cristina Borges-Oliveira, Hercílio Martelli-Júnior, Tarcília Aparecida Silva","doi":"10.1111/cdoe.70029","DOIUrl":"https://doi.org/10.1111/cdoe.70029","url":null,"abstract":"<p><strong>Objectives: </strong>To describe the landscape of dental care provided by specialised centres for children and adolescents with rare diseases (RDs) in the state of Minas Gerais, southeastern Brazil.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted involving individuals aged 0-18 years with a confirmed diagnosis of a RD who received care at five specialised dental centres. Data on the diagnosis, age at first dental appointment, frequency of annual visits and travel distance from home to treatment centre were analysed using descriptive and inferential statistics.</p><p><strong>Results: </strong>A total of 1057 individuals with 244 different RDs were identified. Most were boys (54.9%). The average age at the first dental appointment was 8.52 years. Haematological diseases were the most prevalent (38.9%). The average travel distance for treatment was 99.1 km, with individuals from the Jequitinhonha region traveling the farthest (526.3 km). The average number of annual dental visits was 2.4. Patients with craniofacial syndromes accessed care earlier (average: 3.6 years) and had more frequent follow-up appointments (average: 4.8 visits/year). Significant regional disparities were found in age at first appointment (p < 0.001), travel distance (p < 0.001) and frequency of visits (p = 0.002).</p><p><strong>Conclusions: </strong>Children and adolescents with RDs had delayed initiation of dental care, low follow-up rates and substantial travel burdens. The concentration of specialised centres in the state capital underscores the need for policy reforms to improve equitable access, particularly for patients in remote areas.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Barriers and Potential Strategies for People Who Use Drugs in Accessing Oral Healthcare: A Qualitative Study of Service Providers.","authors":"Tejashree Kangutkar, Mark Gussy, Ronald Knevel, Hanny Calache","doi":"10.1111/cdoe.70028","DOIUrl":"https://doi.org/10.1111/cdoe.70028","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Access to appropriate oral healthcare is vital for overall health and well-being. However, people who use drugs (PWUD) often face significant barriers in accessing oral healthcare services. This qualitative study focused on exploring the perspectives of public oral health service providers and harm reduction workers to understand the barriers that they perceived were experienced by PWUD in accessing oral healthcare and identified potential strategies to address these barriers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Thirty-five participants (20 public oral health service providers and 15 harm reduction workers) were recruited from both metropolitan and regional areas of Victoria, Australia, through purposive sampling and a snowballing technique. Individual online semi-structured interviews were conducted, and data were analysed using a hybrid approach to thematic analysis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Service providers felt that continuous drug use impacted PWUD's ability to perceive dental pain, which delayed identification of oral health symptoms at the individual level. Major life crises meant that PWUD had limited awareness about the oral health consequences of their drug use, which further hindered their access to care. Service providers described how negative experiences and perceived judgements by PWUD about the visual effects of drugs created barriers to accessing dental care. Triggers of memories of traumatic abuse associated with the dental environments were also identified as a distressing factor for PWUD. Perceived service-level barriers included the lack of explicit recognition of PWUD as eligible for priority access in public dental clinics, financial impediments and coercive tactics from some oral health service providers. Service providers with experience of working in rural areas shared how the lack of anonymity and the risk of being identified as a drug user was an additional challenge for PWUD in accessing oral health services in rural areas. The participants proposed several potential strategies including drop-in oral health sessions at harm reduction facilities involving case managers to address appointment issues and training oral health service providers in trauma-informed care. They emphasised the need for interprofessional collaboration between oral health and harm reduction sectors. One key recommendation proposed by the participants was to establish oral health integrated harm reduction programmes that require careful consideration of feasibility, acceptability, resource allocation and potential implications on service quality.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study highlighted previously unrecognised perceived barriers by service providers working with PWUD that could impact the implementation of any interventions that aim to improve access to dental services by PWUD. By addressing the individual and service level barriers comprehensively, healthcare systems can better address the oral h","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Periodontal Therapy on Tooth Loss: A Register-Based Longitudinal Study in Denmark.","authors":"Eero Raittio, Vibeke Baelum","doi":"10.1111/cdoe.70026","DOIUrl":"https://doi.org/10.1111/cdoe.70026","url":null,"abstract":"<p><strong>Objectives: </strong>While regular periodontal care is advocated to reduce tooth loss considerably among periodontitis patients, evidence from observational studies is often limited to small single-center studies. This study aims to quantify the effect of periodontal care on tooth extractions among 40-year-old new periodontitis patients over 20 years.</p><p><strong>Methods: </strong>A nationwide register-based cohort study was conducted, encompassing 40-year-old individuals with incident periodontitis in 2001, tracked through Danish registers until the end of 2021. Receiving any periodontal care was determined annually, and the number of tooth extractions served as the annually varying outcome. G-estimation of structural nested mean models adjusted for time-varying confounding and loss to follow-up was employed to estimate the average treatment effect of periodontal therapy on subsequent tooth extractions.</p><p><strong>Results: </strong>The study included 1251 40-year-olds with incident periodontitis in 2001. The average follow-up from 2002 onwards was 19.1 years and amounted to 23,878 person-years. On average, participants received periodontal care in 12.1 years (SD 6.3) and lost an average of 2.3 teeth (SD 3.5). G-estimation showed that receiving periodontal therapy in a given year compared to not receiving any periodontal therapy reduced the number of teeth extracted in the following year by 0.04 (95% CI: 0.02; 0.06). Receiving periodontal therapy for 5 years in a row compared to not receiving any periodontal therapy was associated with an average of 0.08 (95% CI: 0.04; 0.13) fewer extracted teeth, while on average 0.62 teeth were lost in a 5-year period (0.12 per year).</p><p><strong>Conclusions: </strong>Periodontal therapy resulted in a modest reduction in tooth extractions among 40-year-olds with incident periodontitis over 20 years. The effectiveness of periodontal therapy against tooth loss seems to be considerably smaller than indicated by earlier clinical studies.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145174148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Outcomes and Their Sociodemographic and Service Utilisation Determinants in a Rural Population.","authors":"Mariana Silveira Echeverria, Rafaela do Carmo Borges, Sarah Arangurem Karam, Gabrielle Haubert, Mariana Gonzalez Cademartori, Bernardo Antonio Agostini, Flávio Fernando Demarco","doi":"10.1111/cdoe.70024","DOIUrl":"https://doi.org/10.1111/cdoe.70024","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of the study was to evaluate the number of remaining teeth, use of dental prosthesis, and self-perception of oral health according to sociodemographic variables and use of dental services in a rural population of the Municipality of Pelotas, RS, through a cross-sectional population-based study.</p><p><strong>Methods: </strong>A cross-sectional study was conducted in the rural area of Pelotas, Brazil, aiming to assess the oral health status of adults aged 18 or older. Data collection occurred through a systematic sampling process in two stages, with sociodemographic factors and oral health outcomes analysed. The number of remaining teeth, use of dental prosthesis, self-perception of oral health and dental visit patterns were among the variables examined. Prevalence ratios were estimated using Poisson regression and odds ratios were estimated using ordinal logistic regression.</p><p><strong>Results: </strong>Out of 1519 adults surveyed, the majority were male, aged 40-59, and had incomplete elementary education. Elderly women and people in the richest income quintile exhibited lower rates of remaining teeth and higher use of prosthesis, while people with higher education and use of dental services in the last year had more teeth. Worse self-perception of oral health was more prevalent in men, at age 40-59 and who had used dental services for curative reasons.</p><p><strong>Conclusions: </strong>The study highlights the need for targeted interventions to address oral health disparities in rural areas, emphasising the importance of preventive measures and equitable access to dental services. Strategies focusing on increasing access and reducing financial barriers can contribute to improving oral health outcomes among rural populations.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dental Shame: A Call for Understanding and Addressing the Role of Shame in Oral Health.","authors":"Louise Folker, Luna Dolezal, Astrid Pernille Jespersen, Martha Paisi, Lyndsey Withers, Christina Worle, Esben Boeskov Øzhayat","doi":"10.1111/cdoe.70019","DOIUrl":"https://doi.org/10.1111/cdoe.70019","url":null,"abstract":"<p><p>This commentary highlights dental shame as a pervasive but underexplored phenomenon with significant implications for oral health and systemic inequities. It proposes dental shame as a critical lens for understanding and addressing the complex interplay between personal, social, economic, cultural and systemic factors contributing to oral health challenges. Drawing on interdisciplinary expertise, the authors collectively propose that dental shame is both a consequence and determinant of oral health issues, leading to a self-reinforcing dynamic of avoidance, withdrawal and exacerbated inequities. They identify five key aspects of oral health where dental shame warrants deeper investigation: clinical encounters, care and social services, daily oral health behaviours, systemic inequities and psychological trauma. On this basis, the authors call for more research on dental shame and advocate for shame-sensitive practices in dentistry and other health care and social settings. This approach includes fostering shame competence in practitioners, addressing systemic barriers and designing empathetic, inclusive care environments. Ultimately, the authors state that understanding and addressing dental shame can transform oral health promotion, reduce inequities and improve overall health outcomes.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'How Good to Finally Have Options!' A Qualitative Reflexive Thematic Analysis Exploring Parents' Perceptions of Non-Invasive and Minimally Invasive Caries Management Strategies.","authors":"Una Stamere, Inese Stars, Nicola Innes, Natalija Protasa, Sergio E Uribe, Rodrigo Mariño, Ilze Maldupa","doi":"10.1111/cdoe.70025","DOIUrl":"https://doi.org/10.1111/cdoe.70025","url":null,"abstract":"<p><strong>Objectives: </strong>Caries prevalence remains high in Latvia, with limited adoption of minimally invasive dentistry (MID). While provider barriers are known, parental perspectives are underexplored. This study examined Latvian parents' views on MID to identify key barriers and facilitators to its acceptance.</p><p><strong>Methods: </strong>An inductive qualitative approach was applied to explore parents' perceptions of non-invasive and minimally invasive caries management strategies. Data were collected using semi-structured interviews, conducted with parents (n = 19) whose children had experience of either minimally invasive or traditional caries management. All interviews were recorded, transcribed verbatim and analysed with reflexive thematic analysis.</p><p><strong>Results: </strong>Four main themes were generated: (1) 'avoiding unnecesary discomfort and distress' described parents' views and experiences of non-invasive and minimally invasive caries management strategies as physically and psychologically less traumatic for their child and themselves; (2) 'prioritising treatment qualities', explored parents' expectations and priorities regarding the qualities offered by different dental treatment options; (3) 'the power of information', illustrated that parents' awareness of non-invasive and minimally invasive caries management strategies contributed to a better understanding of treatments and promoted choice, but required access to that information; and (4) 'choices of suitable options', described parents' reflections on having a variety of options for dental treatment, rather than a single option offered.</p><p><strong>Conclusions: </strong>Parents value effective communication, clear information and access to treatment options when considering minimally invasive caries management. Their views highlight the need for a shift towards patient-centred care models that prioritise comfort, informed decision-making and choice in paediatric dentistry.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145112190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Framework for Equitable and Effective Oral Health Research in Africa.","authors":"Maha El Tantawi, Morenike Oluwatoyin Folayan, Ahmed Bhayat","doi":"10.1111/cdoe.70018","DOIUrl":"10.1111/cdoe.70018","url":null,"abstract":"<p><strong>Background: </strong>The current heightened attention to oral health underscores the need to address populations who have been historically marginalised in mainstream policy and research endeavours. African countries lack sufficient data on oral health problems and potential solutions to inform decision-making.</p><p><strong>Aim: </strong>This commentary addresses the shortcomings of oral health research in Africa and proposes a framework to foster fair and efficient research in this area.</p><p><strong>Materials and methods: </strong>We present an assessment of the current state of oral health research in Africa and outline key components of the framework.</p><p><strong>Results: </strong>The framework includes: enhancing the capacities of African researchers, cultivating leadership, prioritising locally pertinent research, establishing equitable partnerships with international researchers, and translating research findings into actionable policies and practices.</p><p><strong>Conclusion: </strong>These pillars offer a roadmap for steering oral health research in Africa toward impactful outcomes that improve the oral health of African populations.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Facilitators and Challenges as Perceived by Dental Service Providers in the Provision of Oral Healthcare for Culturally and Linguistically Diverse Populations.","authors":"Sudheer Babu Balla, Nikolaos Angelakopoulos, Jyothi Tadakamadla, Santosh Kumar Tadakamadla","doi":"10.1111/cdoe.70021","DOIUrl":"10.1111/cdoe.70021","url":null,"abstract":"<p><strong>Objectives: </strong>Vulnerable groups, particularly those from Culturally and Linguistically Diverse (CALD) backgrounds, face heightened risks of poor oral health. There is a notable gap in systematically analysing the facilitators and challenges dental service providers face in meeting the needs of patients from CALD backgrounds. This study, therefore, sought to systematically review existing literature to address this gap and provide insights into the factors that influence dental service provision for CALD communities.</p><p><strong>Methods: </strong>A comprehensive search of six electronic databases was conducted to identify facilitators and challenges in oral healthcare provision. Database searches covered January 1985 to May 2025 (last updated 31 May 2025). A meta-integration approach was employed to synthesise qualitative and quantitative findings. The quality of evidence was assessed using the Mixed Method Appraisal Tool (MMAT). Data organisation followed Ferlie and Shortell's healthcare model, with key themes identified via thematic analysis.</p><p><strong>Results: </strong>Thirteen papers were included in this review, comprising three quantitative and 10 qualitative studies, sourced from diverse countries, including the United Kingdom, Australia, New Zealand, Japan, Sweden, Netherlands, Finland, Germany, the United States and Canada. Article quality varied from moderate to high. Although individual-level factors such as cultural beliefs and language barriers, impacted dental service provision and rigid organisational structures also served as a significant challenge. Structural/system-level challenges included policy implementation gaps, insufficient cross-cultural training for dental providers and affordability issues.</p><p><strong>Conclusion: </strong>The evidence from dental service providers in diverse settings suggests they encounter several challenges when providing dental care to CALD communities. In summary, delivering culturally sensitive oral healthcare is inherently complex. Policymakers must acknowledge that addressing the needs of CALD patients necessitates establishing supportive environments and strengthening institutional capabilities.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strong Heart, Strong Smile: Tooth Loss and Incidence of CVD in American Indian Populations.","authors":"Lindsey Montileaux Mabbutt, Paul Jensen, Amanda Fretts, Lyle Best, Joana Cunha-Cruz","doi":"10.1111/cdoe.70020","DOIUrl":"https://doi.org/10.1111/cdoe.70020","url":null,"abstract":"<p><strong>Objectives: </strong>Tooth loss and cardiovascular disease (CVD) share risk factors and complex pathways in disease progression and co-morbidities. To date, little research on the relationship between tooth loss and CVD has been conducted in American Indian populations. This study investigated the prevalence of edentulism among American Indian adults and its association with the incidence of CVD.</p><p><strong>Methods: </strong>The ongoing longitudinal Strong Heart Study (SHS) is being conducted in rural American Indian communities in North Dakota, South Dakota and Oklahoma since 1989. This cohort study included SHS participants who had available tooth loss data during the 1997-1999 wave, which serves as the baseline for this analysis. Data analysis was performed in August 2023. Anthropometric, health and behaviour data were obtained from physical exams and interviews. Participants who reported no natural teeth were considered edentulous. CVD events were obtained from continuous mortality and morbidity surveillance through 2019. Crude and adjusted Cox proportional hazards regression models were fit to examine the association of edentulism with CVD events.</p><p><strong>Results: </strong>Of 1982 participants, 29% (n = 584) were edentulous at baseline, and 41% (n = 822) developed CVD during up to 22 years follow-up. When adjusting for site, age, sex, education, smoking, diabetes, BMI and hypertension, the hazard ratio for developing CVD was 1.36 (95% CI: 1.15, 1.60) for the participants who were edentulous when compared to those reporting natural teeth present.</p><p><strong>Conclusions: </strong>The findings confirm the high burden of oral diseases and CVD among this sample of American Indians and suggest a significant positive association between edentulism and incidence of CVD that was partially explained by shared risk factors. The study highlights the need for interventions that address risk factors for non-communicable diseases to improve both oral health and cardiovascular health of American Indians.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}