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Smoking status and oral health-related quality of life among adults in the United Kingdom

Bakri NN, Tsakos G, Masood M

Br Dent J, 2018 07 27;225(2):153-158.
PMID: 30050198 DOI: 10.1038/sj.bdj.2018.529

Objective: The primary objective of this study was to examine the association between smoking and oral health-related quality of life (OHRQoL) among dentate people aged 16 years and above in England.
Methods: Cross-sectional study, based on the Adult Dental Health Survey (ADHS) 2009. ADHS 2009 involved data collection from 11,380 face-to-face interviews and 6,469 dental examinations from England, Wales and Northern Ireland. This study focuses on the dentate sample from England, consisting of 5,622 individuals who underwent dental examination. OHRQoL was measured by two indices; Oral Health Impact Profile-14 (OHIP-14) and Oral Impacts on Daily Performance (OIDP). Unadjusted and adjusted zero-inflated regression models were used. Adjustment was sequentially done for socio-demographics, clinical oral conditions and self-reported general health.
Results: Prevalence of those who had never smoked, past smokers and current smokers were 45.6%, 35.3% and 19.2% respectively. Current smokers had considerably higher mean OHIP-14 and OIDP scores than non-smokers. There was a statistically significant association between smoking and OHRQoL (both OHIP-14 and OIDP) even in the fully adjusted models. Current smokers were more likely to report worse OHRQoL compared to those who had never smoked in both OHIP-14 and OIDP score. There was no statistically significant difference between past smokers with those who had never smoked in reporting OHIP-14 and OIDP. Among those reporting OHRQoL, there was a stepwise gradient risk of reporting no oral impact, where the probability was higher among those who had never smoked, followed by past smokers and current smokers both in OHIP-14 and OIDP.
Conclusion: Smoking was independently associated with worse OHRQoL, even after adjusting for a range of socio-demographic factors, clinical oral conditions and self-reported general health.
Relationship of periodontal disease and domains of oral health-related quality of life

Masood M, Younis LT, Masood Y, Bakri NN, Christian B

J Clin Periodontol, 2019 02;46(2):170-180.
PMID: 30657192 DOI: 10.1111/jcpe.13072

OBJECTIVES: The aim of this study was to investigate the impact of periodontal disease on the domains of oral health-related quality of life (OHRQoL) of United Kingdom adults.
METHODS: National representative data from the 2009 Adult Dental Health Survey, United Kingdom, were used in this study. Periodontal disease severity was measured using periodontal pocket depth and categorized into three groups: pocket depth up to 3.5, 3.5-5.5 and more than 5.5 mm. OHRQoL was measured using the Oral Health Impact Profile-14 (OHIP-14) scores. Bivariate and multivariable Zero-inflated Poisson regression analysis was used.
RESULTS: A total of 6378 participants was analysed in this study. Periodontal pocketing was significantly associated with higher OHIP-14 scores. Participants with periodontal pocket depths >3.5 mm had a significantly higher prevalence for functional limitation, physical pain and social disability than participants with pocket depths of less than 3.5 mm. Participants with periodontal pocket depth(s) >5.5 mm had significantly higher OFOVO prevalence in all the domains of OHIP-14 except handicap domain than participants with pocket depth(s) <3.5 mm.
PARTICIPANTS:
CONCLUSION: This study showed that for a nationally representative sample of the United Kingdom population, periodontal disease was significantly associated with the domains of OHRQoL.
Fulltext The relationship between oral health and oral health related quality of life among elderly people in United Kingdom

Masood M, Newton T, Bakri NN, Khalid T, Masood Y

J Dent, 2017 Jan;56:78-83.
PMID: 27825838 DOI: 10.1016/j.jdent.2016.11.002

OBJECTIVES: To identify the determinants of OHRQoL among older people in the United Kingdom.
METHODS: A subset of elderly (≥65year) participants from the UK Adult Dental Health Survey 2009 data was used. OHRQoL was assessed by means of the OHIP-14 additive score. The number of missing teeth; presence of active caries, dental pain, root caries, tooth wear, periodontal pockets>4mm, loss of attachment>9mm; having PUFA>0 (presence of severely decayed teeth with visible pulpal involvement, ulceration caused by dislocated tooth fragments, fistula and abscess); and wearing a denture were used as predictor variables. Age, gender, marital status, education level, occupation and presence of any long standing illness were used as control variables. Multivariate zero-inflated Poisson regression analysis was performed using R-project statistical software.
RESULTS: A total of 1277 elderly participants were included. The weighted mean(SE) OHIP-14 score of these participants was 2.95 (0.17). Having active caries (IRR=1.37, CI=1.25;1.50), PUFA>0 (IRR=1.17, CI=1.05;1.31), dental pain (IRR=1.34, CI=1.20;1.50), and wearing dentures (IRR=1.30, CI=1.17;1.44), were significantly positively associated with OHIP-14 score. Having periodontal pockets>4mm, at least one bleeding site, and anterior tooth wear were not significantly associated with the OHIP-14 score.
CONCLUSION: Whereas previous research has suggested a moderate relationship between oral disease and quality of life in this large scale survey of older adults, the presence of active caries and the presence of one or more of the PUFA indicators are associated with impaired oral health related quality of life in older adults, but not indicators of periodontal status. The implication of this is that whilst focussing on prevention of disease, there is an ongoing need for oral health screening and treatment in this group.
Oral health promotion activities in the workplace: a scoping review

Bakri NN, Smith MB, Broadbent JM, Thomson WM

Health Promot Int, 2023 Jun 01;38(3).
PMID: 35425975 DOI: 10.1093/heapro/daac039

There is limited literature and no reviews on oral health promotion activities in the workplace to guide planning and practice. This review summarizes evidence about oral health promotion activities in the workplace (nature and extent), its impact and the factors that facilitate or act as barriers to implementation. Using the PRISMA-ScR guidelines, scientific articles written in English and published in peer-reviewed journals up to April 2021, from six databases (Medline, PubMed, CINAHL, Scopus, EMBASE and Emcare) were screened and selected. The full texts of 95 articles were then considered; 21 articles met the inclusion criteria of using oral health status or oral health predisposing factors as primary outcome after an intervention in the workplace. Almost all included articles took a quantitative approach (n = 18), two used a qualitative design and another used a mixed-method approach. The most common activities were personalized or group oral health education interventions and oral health screenings conducted by a dental professional. Two studies reported the cost-benefit of workplace oral health promotion (WOHP). The literature indicated that WOHP interventions can be successful in achieving improvements in oral health, measured using a range of clinical (plaque accumulation, gingival inflammation, periodontal inflammation) and self-rated oral health indicators. Based on the limited literature available, WOHP may have benefits for employee oral health and employers, and the support of managers and organizations potentially improves the success of programmes. The workplace would appear to be an ideal setting to promote oral health. However, there is limited information to guide oral health promotion planning and implementation, and policy.
Mapping the Malaysian Smoking Cessation Clinics: A Geographic Information System-Based Study

Md Bohari NF, Sabri NF, Wan Rasdi WND, Mohd Radzi NA, Bakri NN

Asia Pac J Public Health, 2020 12 24;33(2-3):227-233.
PMID: 33356376 DOI: 10.1177/1010539520982718

Although geographic information system-based studies are particularly increasing in other sectors, few have embraced their full potential in health services allocation in Malaysia. This study aimed to produce a visual map on the distribution of smoking cessation clinics (SCCs) in Malaysia and analyze its pattern against the national population of smokers. SCC addresses were obtained from the government website and mapped using geographic information system tools. A total of 199 and 449 private and public SCCs was mapped throughout the country, respectively. The lowest SCC to smoker population ratio was in the state of Negeri Sembilan with 1:3000. The highest SCC to smoker population ratio was in Sabah with 1 SCC for 15 000 smokers. Almost 70% of SCCs were primary health clinics. Smoking cessation clinics were distributed throughout all the states in Malaysia except the state of Sabah.
Workplace oral health promotion activities among community-aged care workers: A qualitative exploration

Bakri NN, Ferguson CA, Majeed S, Thomson WM, Oda K, Bartlett S, et al.

Community Dent Oral Epidemiol, 2023 Nov 10.
PMID: 37950336 DOI: 10.1111/cdoe.12924

BACKGROUND: The workplace is an ideal-and priority-setting for health promotion activities. Developing and implementing workplace health promotion interventions, including oral health promotion activities, can help create health-supporting workplace environments.
OBJECTIVE: To pilot workplace oral health promotion activities among staff working in the aged care sector, report their impact and explore participants' views on the factors that contribute to participation and effectiveness.
METHODS: This study comprised three phases: (i) the development and face validation of the resources, (ii) a 3-h educational session and (iii) five interview sessions with participants 4-6 weeks following the education session. The recorded interviews were transcribed verbatim and analysed thematically.
RESULTS: Eleven community-aged care workforce were invited to five feedback sessions. Ten participants were female and ranged in age from 18 to 64. All participants gave favourable comments about the content and delivery of the training session and accompanying resources. The participants felt that the benefits of WOHP include improved staff knowledge, awareness and oral care routine, the ability to share (and put into practice) the gained knowledge and information with their dependants, a lower risk of having poor oral health that adversely affects their well-being and work tasks, and potentially beneficial impacts on the organization's staff roster. Their attendance in the WOHP was facilitated by being paid to attend and scheduling the sessions during work time. Future WOHP suggestions include the possibility of a one-stop dental check-up at the workplace or staff dental care discounts from local dental practitioners and combining oral health with other health promotion activities.
CONCLUSIONS: Planning and implementing WOHP was deemed acceptable and feasible in this study context and successfully achieved short-term impacts among community-aged care workers. Appropriate times and locations, organizational arrangements and a variety of delivery options contributed to successful programme planning and implementation.
Virtual counselling of tobacco cessation during the COVID-19 pandemic: A qualitative study on the experiences and perceptions of Malaysian dental undergraduates and their patients

Roslan N, Yusof N, Md Bohari NF, Md Sabri BA, Mohd Radzi NA, Bakri NN, et al.

Eur J Dent Educ, 2024 Feb;28(1):28-40.
PMID: 37132218 DOI: 10.1111/eje.12912

INTRODUCTION: When dental institutions had to close down during the Movement Control Order (MCO) implementation due to the COVID-19 pandemic, dental students were faced with delays in completing their tobacco cessation schedule. An alternative was to allow students to conduct virtual counselling (VC) for smoking cessation for their patients to address their clinical requirements. This study aimed to explore Malaysian dental undergraduates' and patients' experiences undergoing smoking cessation counselling through virtual platforms.
MATERIALS AND METHODS: The study consisted of qualitative, semi-structured Focus Group Discussions (for students, n = 23) and in-depth interviews (for patients, n = 9); to phenomenologically describe the perceptions of participants involved in the VC. Each session was recorded with the participants' permission. The recorded session was transcribed verbatim and thematically analysed using the qualitative data analysis software, NVivo™.
RESULTS: The major themes that emerged were: (1) General opinions and experiences, (2) Content of VCs, (3) Remote access to counselling, (4) Patient-clinician relationships, (5) Technical issues, (6) Changes after VCs, and (7) Future application. Most students and patients were quite comfortable with VC as it is convenient, allowing students to be creative and avoid the hassle of transport and traffic. However, some of the students felt that it lacked the personal touch and guidance from lecturers who would normally be present during physical class.
CONCLUSION: Virtual counselling enables remote access to counselling, but it is also subjected to some limitations, especially regarding lack of clinical assessments, human touch and internet issues. Though participants were optimistic about adapting it in the future, multiple factors must be considered. Ultimately, the behavioural change will depend on the patient's motivation in making a difference.