BackgroundOral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services.MethodsWe used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators.ResultsThe study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and <20 teeth (Indian adjusted OR 0.31, 95 % CI 0.16-0.59; Pakistani/Bangladeshi adjusted OR 0.22, 95 % CI 0.08-0.57). They attended the dentist less frequently and were more likely to add sugar to hot drinks, but were significantly less likely to consume sweets and cakes. Adjustment for these attenuated the differences but they remained significant. Black participants had reduced risk of all outcomes but after adjustment for lifestyle the difference in fillings was attenuated, and extractions and tooth loss became non-significant.ConclusionsContrary to most health inequalities, oral health was better among non-White groups, in spite of lower use of dental services. The differences could be partially explained by reported differences in dietary sugar.

Objective:To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience among prisoners. Method:A cross-sectional survey was conducted on a convenience sample of 300 prisoners across three prison establishments in Scotland. Depression and dental anxiety were measured using the Centre for Epidemiological Studies Depression Scale and the Modified Dental Anxiety Scale, respectively. Drug use was assessed using three yes (scoring 1)/ no (scoring 0) questions: 'ever taken (illegal) drugs', 'injecting drugs' and 'ever participated in a rehabilitation programme'. Participants had an oral examination to determine dental caries experience (missing [MT] and untreated decay [D 3cv T]) in all four quadrants. Latent variable path analysis was conducted to test the mediation model. Results:A total of 342 prisoners participated, of which 298 yielded a complete data set. Depression was associated with missing teeth and untreated decay (D 3 T) through an indirect pathway (Total standardized indirect effects = 0.11, P < .01) via drug use and dental anxiety (X 2 [71] = 89.8, P = .07; Root Mean Square Error of Approximation: 0.03; Comparative Fit Index: 0.994 and Tucker-Lewis index: 0.992). Twenty-two percent of the variance in untreated decay and missing teeth was explained by both drug use and dental anxiety; however, the strongest predictor was drug use (total standardized direct effects = 0.45, P < .001). Conclusion:A relatively simple model to assist understanding dental decay experience of people in prison has been proposed. The data collected were consistent with our specified model. Drug use acted as the primary mediator and dental anxiety as a secondary mediator between depression and dental decay experience. Given the comorbidity between mental health and drug use and dental decay experience, an integrated or shared approach is proposed. We recommend that future research should concentrate on building a firmer picture by replicating and extending the framework presented. K E Y W O R D Sdental anxiety, dental decay experience, depression, drug use, prison | 249 ARORA et Al.

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Proboscis lateralis is a rare craniofacial anomaly characterized by a trunk-like process attached to the medial portion of the orbital roof on the affected side. We report a case, which, though resembling proboscis lateralis in some ways, has certain unique features. This case had an appendage arising from the right malar region with a central tract lined by stratified squamous epithelium. It had erectile properties and was communicating with an enlarged ipsilateral maxillary sinus. Because of these characteristic features it appears to be a new, as yet unreported, facial anomaly.

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