A multilevel analysis of the importance of oral health instructions for preventing tooth loss: The 8020 Promotion Foundation Study of Japanese Dental Patients

Abstract

Background: Many studies have reported risk factors for tooth loss. Oral health instruction is considered effective at improving oral health behavior and oral health. However, few studies have examined the relationship of dental clinic factors, such as the number of dental hygienists and implementation of oral health instructions, with tooth loss. Here, we conducted a multilevel analysis to clarify the dental clinic risk factors associated with tooth loss.Methods: Baseline surveys were conducted at 1,216 dental clinics in 46 prefectures in Japan, and 12,399 dental patients aged 20 years and over underwent oral examinations and completed a questionnaire. The dental clinics also completed a questionnaire at baseline. A 3-year follow-up survey included 2,488 patients in 585 dental clinics. Multilevel multivariate logistic regression analysis was used to examine the risk of tooth loss at the patient and clinic levels.Results: Of the patient variables, older age, higher mean probing pocket depth, current or past smoking, and bleeding during tooth brushing were associated with higher risks of tooth loss. Individuals with many teeth who visited dental clinics for maintenance were at significantly lower risk of tooth loss. Of the clinic variables, patients attending dental clinics with four or more dental hygienists had a significantly lower risk of tooth loss (OR 0.67, 95% CI 0.50–1.00). Patients attending dental clinics that provide oral health instructions for 20 min or more had a significantly lower risk of tooth loss (OR 0.69, 95% CI 0.50–0.96).Conclusions: In addition to individual risk factors for tooth loss, dental clinic factors such as length of oral health instruction and number of dental hygienists are associated with tooth loss. In dental clinics, ensuring sufficient time for dental hygienists to provide oral health instructions can help prevent tooth loss in dental patients.

Caries prevalence, oral health practices/behaviours and dental anxiety levels amongst dental hygiene students: A cross‐sectional study

“…Reportedly, patients who regularly visit the dentist for maintenance have a significantly lower risk of tooth loss and tend to maintain daily oral hygiene habits. Nevertheless, it is important to provide sufficient time for oral health instructions and implementation of preventive measures for patients undergoing dental check‐ups 30 . Lecturers should revise the undergraduate dental hygiene curriculum to explain the significance of regular dental visits and develop students’ self‐attitudes and responsibilities.…”

“…In previous studies, these rates were 20% and 15% in Turkish, 26 27.55% and 18.75% Chinese, 9 20.63% and 23.80% Indian, 28 and 45.2% and 33.3% Lithuanian dental students, respectively 29 . Thus, patients consider oral health instructions provided by their dental hygienists as important, dental hygienists’ maintenance of proper self‐oral hygiene behaviours/practices is imperative 30 . Nevertheless, there appears to be a discrepancy between what healthcare providers know regarding the importance of daily plaque control and their own behaviors 10,11 .…”

“…In conclusion, oral hygiene practices amongst dental hygiene students should be developed and strongly emphasized in their undergraduate curriculum, starting from the first year onwards, to improve oral health and relevant systemic health. 30 As shown in Table 1, the students' bleeding during tooth brushing rate was 13.93%. This rate was 3.6% and 47% in Lithuanian 29 and Chinese students, 9 respectively.…”

Japan’s Dental Care under Universal Health Coverage and Challenges from Population Ageing: An Analysis on Health Insurance Claims Data and Dental Hygiene Survey

“…The improvement is more prominent in the older age groups. Japan Dental Association launched the "80-20 campaign" in 1989, which means "maintaining at least 20 teeth at the age of 80" [ 3 ].…”

“…A study analyzing the data on dental clinics and patients behavior demonstrated the importance of dental hygienists in influencing the patients' behavior [ 5 ] and tooth loss [ 6 ]. Home visits by dental hygienists are also covered by health insurance.…”