High prevalence of toothache among Great East Japan Earthquake survivors living in temporary housing

Abstract

Objectives The Great East Japan Earthquake and subsequent tsunami cause large‐scale destruction in the north‐eastern coastal areas in Japan, and forced many survivors to relocate to prefabricated temporary housing, a typical emergency accommodation. Based on the hypothesis that higher toothache prevalence among the disaster survivors is associated with postdisaster distress, we determined the impact of temporary residential environment as potential stressor on the subjective toothache prevalence. Methods A repeated cross‐sectional health survey based on self‐reported questionnaire was conducted in 2776 disaster survivors, of whom 1446 participants underwent dental examination by dentists. Housing type was categorized into three groups including the same housing as before the earthquake, temporary housing and rented/new housing. The association of housing type with subjective toothache prevalence was examined using multivariate logistic regression analysis in all subjects and subgroup analysis in dental examination applicants. Stratified analysis by survey wave was applied with inclusion of covariates such as the socio‐demographic factors, and presence of insomnia and psychological distress. In subgroup analysis, presence of dental caries and gum problems in dental examination were included as factors of direct exposure to subjective toothache. Results In the first survey wave, the participants living in the temporary housing had significantly higher odds ratio (OR) for toothache prevalence compared to the participants living in the same housing (OR: 3.76, 95% confidence interval [CI]: 1.85‐7.65, P < 0.001); whereas in all other survey waves, there was no significant difference. Subgroup analysis of dental examination applicants confirmed the presence of significant association of subjective toothache prevalence in the temporary housing group alone (OR: 3.27, 95% CI: 1.38‐7.76, P = 0.004), but not in the rented/new housing group (OR: 1.50, 95% CI: 0.57‐3.91, P = 0.411), even after adjusting for covariates related to oral findings. Conclusion Temporary housing may be a factor to increase the risk of subjective toothache among disaster survivors only at postdisaster acute phase.

Dental Pain and Worsened Socioeconomic Conditions Due to the COVID-19 Pandemic

“…Although few studies are directly comparable to ours, the findings are supported by a previous study conducted following another crisis, the devastating 2011 earthquake in Japan, showing that survivors who had lost their properties were more likely to report dental pain (Tsuchiya et al 2019).…”

“…Dental pain was assessed by the following single question: “Have you had dental pain within the last month?” and the respondents chose their answer (yes or no). A similar question has been used in previous studies (Kuhnen et al 2009; Tsuchiya et al 2019).…”

“…and the respondents chose their answer (yes or no). A similar question has been used in previous studies (Kuhnen et al 2009;Tsuchiya et al 2019).…”

“…Dental pain is a significant health problem that reduces quality of life and well-being (Santos et al 2019). Lower socioeconomic conditions, stressful circumstances, less dental care utilization, and unfavorable oral health–related behaviors have been reported as risk factors for dental pain (Kuhnen et al 2009; Medina-Solís et al 2017; Tsuchiya et al 2019). Under the COVID-19 pandemic, higher anxiety and depression are reported among those who lost their income (Hertz-Palmor et al 2020) and those who had insecure jobs (Ganson et al 2021).…”

Socioeconomic gradients in toothache experience among Australian adults: A time trend analysis from 1994 to 2013

“….” Dentate adults who responded “very often,” “often” or “sometimes” were classified as experiencing toothache. Several studies worldwide used the same or very similar question , allowing international comparison. This question was asked of dentate people and those who had lost all their natural teeth less than one year before the survey.…”