Background-Older adults are susceptible to reduced saliva production related to certain medications, radiation and chronic conditions. Many of these people have many physical and oral health problems and limited access to dental care. The use of effective screening tools for xerostomia and hyposalivation would be helpful in identifying those at risk. The authors conducted a study to investigate the association between three measures of oral dryness: hyposalivation (low unstimulated salivary flow), self-reported xerostomia and clinically assessed dry mouth.

Objective The purpose of this study was to examine the association between participants 1) who reported having had clinical diagnoses of depression and anxiety with 6+ teeth removed and 2) who reported having had clinical diagnoses of depression and anxiety with edentulism. Methods The Behavioral Risk Factor Surveillance System (BRFSS) Survey 2010 was used for the study. Analyses involved using SAS 9.3 to determine variable frequencies, Rao–Scott chi-square bivariate analyses, and Proc Surveylogistic for the logistic regressions on complex survey designs. Participants eligibility included being 18 years or older and having complete data on depression, anxiety, and number of teeth removed. Results There were 76 292 eligible participants; 13.4% reported an anxiety diagnosis, 16.7% reported a depression diagnosis, and 8.6% reported comorbid depression and anxiety. The adjusted logistic regression models were significant for anxiety and depression alone and in combination for 6+ teeth removed (AOR: anxiety 1.23; 95% CI: 1.10, 1.38; P = 0.0773; AOR: depression 1.23; 95% CI: 1.10, 1.37; P = 0.0275; P < 0.0001; and AOR: comorbid depression and anxiety 1.30; 95% CI: 1.14, 1.49; P = 0.0001). However, the adjusted models with edentulism as the outcome failed to reach significance. Conclusions Comorbid depression and anxiety are associated independently with 6+ teeth removed compared with 0–5 teeth removed in a national study conducted in United States. Comorbid depression and anxiety were not shown to be associated with edentulism as compared with any teeth present.

ObjectivesThe aim of the study was to evaluate the prevalence of and factors associated with abnormal thyroid function in older men with or at risk for HIV infection. MethodsA cross-sectional analysis of 636 men !49 years old was carried out using data obtained from interviews, from measurements of body mass index (BMI), HIV-1 serology and viral load, CD4 cell count, hepatitis C virus (HCV) assays, thyroid-stimulating hormone (TSH) and free thyroid hormone levels. ResultsParticipants were 54% black, 57% overweight/obese, 57% HIV seropositive, and 72% HCV seropositive; 38% reported recent cocaine or heroin use. Decreased TSH was found in 56 men (8.8%) and raised TSH in 23 men (3.6%). Only three men had abnormal free thyroxine levels. ConclusionsAbnormal TSH levels were noted in 12.4% of older men with or at risk for HIV infection, but nearly all reflected subclinical hyperthyroidism or subclinical hypothyroidism.Keywords: endocrine, epidemiology, thyroid function tests, thyroid hormones, thyroid-stimulating hormone IntroductionSince highly active antiretroviral therapy (HAART) became available, HIV-related mortality in treated individuals has been decreasing [1]. The proportion of older people living with HIV and AIDS has been increasing and persons aged 50 years and older now represent more than 24% of people living with HIV/AIDS in the USA [2].The prevalence of thyroid dysfunction in the adult general population in the USA is high. Some 0.3% experience hypothyroidism, 4.3% subclinical hypothyroidism, 0.5% hyperthyroidism, and 0.7% subclinical hyperthyroidism [3,4]. Thyroid dysfunction may contribute to morbidity from osteoporosis, hyperlipidaemia, cardiovascular disease and neuropsychiatric illness, all of which have been associated with HIV infection or its treatment [5][6][7]. With aging, the prevalence of thyroid dysfunction increases [4,8].Early in the AIDS epidemic, evaluation of thyroid function was performed predominantly on hospitalized patients, who were generally young and acutely ill. Several studies found lower free thyroxine (FT 4 ) levels and higher thyroid binding globulin levels, associated with lower CD4 lymphocyte counts or advanced HIV infection [9][10][11][12]. More recently, cross-sectional studies among HIV-infected patients showed an increased prevalence of subclinical hypothyroidism, ranging from 3.5 to 12.2% [13][14][15]. Hypothyroidism has been reported to be more prevalent in HIV-infected men than women, different from the gender distribution in the general population, and thyroid dysfunction has been associated with receipt of stavudine, lamivudine and HAART, and low CD4 cell count [13][14][15][16][17] DOI: 10.1111/j.1468-1293.2008.00601.x HIV Medicine (2008 Methods Study participantsThe Cohort of HIV and At Risk Aging Men's Prospective Study (CHAMPS) recruited 643 men within 1 year of their 50th birthday or older, with or at risk for HIV infection from injecting drug use, unprotected sex with men, having five or more sexual partners within the last 5 years, exchange of sex for m...

Breastfeeding provides health benefits to infants and mothers, yet many women decide against breastfeeding. This study examined differences in the prevalence of breastfeeding among national, urban, rural, and Appalachian regions of the USA.Methods: Secondary data analysis of the US 2007 National Survey of Children's Health (n=27 388) data were completed for prevalence, insurance coverage, and medical home (a source of comprehensive primary care) determinations according to rural or urban location. Results:The weighted US and Appalachian prevalences of breastfeeding were 0.755 (CI 0.743-0.767) and 0.683 (CI 0.672-0.694). National and Appalachian urban prevalences were 0.770 (CI 0.757-0.784) and 0.715 (CI 0.702-0.728). Rural areas had a significantly lower prevalence of breastfeeding of 0.687 (CI 0.661-0.713). Appalachia was significantly lower than the national rural level at 0.576 (CI 0.554-0.598). Women with Medicaid/State Children's Health Insurance Program (SCHIP) had an odds ratio of 1.79 of not breastfeeding compared with privately insured women. Nationally, 26.6% (CI 24.5-28.7) of children of women who did not breastfeed did not have a medical home.Conclusions: Anticipatory guidance about breastfeeding with culturally sensitive awareness programs and interventions directed at rural populations, especially in high risk geographic areas such as Appalachia, may be needed. Healthcare professionals have a unique opportunity to provide anticipatory guidance to pregnant women by discussing the benefits of breastfeeding during visits. High school health educational programs should address the benefits of breastfeeding with rural females.

Objective Many people have dental arches with unrestored edentulous areas posterior to natural teeth. One dental pattern is the shortened dental arch (SDA) Due to the lack of teeth, individuals with a SDA may eat a restricted diet including soft, highly processed foods. Such diets may increase the risk of overweight or obesity. We examined the SDA and body mass index (BMI) to determine if there was an association in adults aged 45–65 years. Methods The data for this study were U.S. National Health and Nutrition Examination Survey (NHANES) 2005–2008 merged files. There were 5,773 eligible participants. The data were examined for frequencies, and with Chi square and logistic regression. Results There were 69.3% of participants with a shortened mandibular arch who had a BMI ≥ 25 as compared with 71.8% of participants who had a complete mandibular dental arch who had a BMI ≥ 25; (p = .7246). There were 70.6% of participants with a shortened maxillary arch who had a BMI ≥ 25 as compared with 71.9% of participants who had a complete maxillary dental arch who had a BMI ≥ 25 (p= .8859). The adjusted odds ratio for shortened mandibular dental arch was 0.70 (95% CI: 0.46, 1.08) on BMI ≥ 25. The adjusted odds ratio for shortened maxillary dental arch was 1.06 (0.63, 1.78). Conclusions The research hypothesis that SDA was related to higher BMI, and the corollary that restored or complete dentition had better odds of a lower BMI were not supported.

With a diverse population of dentists, dental hygienists, and dental assistants, there is a wide range of sizes and shapes of individuals. Ergonomic considerations have resulted in the design of many adjustable delivery systems, chairs, and pieces of equipment. Companies have marketed instrumentation specifically for people with small hands, yet little research has been done regarding the advertising claims. The objective of this study was to compare the perceptions of dental and dental hygiene students after they used a conventional syringe and a petite syringe that has been marketed as advantageous for individuals with smaller hands. The two syringes were compared for aspiration, injection, and sense of control. A total of 181 students were invited to serve as subjects in the study, and ninety participated. The study involved two phases. During phase I, students used conventional and petite syringes to give a simulated inferior alveolar nerve block injection. In phase II, students gave a simulated palatal injection using both sizes of syringes. After performing the simulations, the students responded to a questionnaire. The students reported that the petite syringe gave them control, and 62.2 percent of them preferred it to the conventional syringe. There were differences in preferences between female and male students and also differences in preferences based on students' glove sizes. The female students preferred the petite syringe when aspiration was required. Overall, the students who wore small and extra small gloves had a preference for the petite syringe and felt it provided a sense of control, a key component when learning to provide injections.

The recruitment of community-dwelling older adults, particularly those with cognitive impairment and those residing in rural areas, has been consistently challenging for researchers, especially in the dental field. This study reports on recruitment experiences from an ongoing study investigating the association between oral health and cognitive status in later life. Multiple recruitment strategies, including educational presentations and traveling to participants’ homes, were used to enroll rural elderly participants with various levels of cognitive function. In general, multi-pronged, proactive recruitment strategies were more effective than traditional, passive methods in reaching participants with varying degrees of cognitive impairment. The outcome of this study suggests that successful recruitment of such populations involves gaining the support of staff at relevant community organizations, informing community members (including older adults and their family members) of the project and the importance of oral health, and making data collection sites accessible for older adults.

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