Need for addressing oral health disparities in rural Appalachia

Martin, Brian; Wilkerson, Amanda H.; Patterson, Gilbert; Nahar, Vinayak K.; Sharma, Manoj

doi:10.15171/hpp.2017.32

Cited by 6 publications

(5 citation statements)

References 10 publications

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“…The role of environmental risk factors in causing dental caries is very well established, and includes factors such as lack of fluoride, poor oral hygiene habits, and consuming a diet high in sucrose [ 4 , 5 ]. In addition, disparities in terms of income, educational level and access to dental services in areas such as Appalachia in the United States could be associated with an increased risk of oral diseases, especially dental caries [ 6 ]. Moreover, a systematic review study indicated that socioeconomic factors, such as educational level, occupation and income, are highly associated with dental caries among adults [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Genome-Wide Association Study (GWAS) of dental caries in diverse populations

et al. 2021

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Background Dental caries is one of the most common chronic diseases and is influenced by a complex interplay of genetic and environmental factors. Most previous genetic studies of caries have focused on identifying genes that contribute to dental caries in specific ethnic groups, usually of European descent. Methods The aim of this study is to conduct a genome-wide association study (GWAS) to identify associations affecting susceptibility to caries in a large multiethnic population from Argentina, the Philippines, Guatemala, Hungary, and the USA, originally recruited for studies of orofacial clefts (POFC, N = 3686). Ages of the participants ranged from 2 to 12 years for analysis of the primary dentition, and 18–60 years for analysis of the permanent dentition. For each participant, dental caries was assessed by counts of decayed and filled teeth (dft/DFT) and genetic variants (single nucleotide polymorphisms, SNPs) were genotyped or imputed across the entire genome. Caries was analyzed separately for the primary and permanent dentitions, with age, gender, and presence/absence of any type of OFC treated as covariates. Efficient Mixed-Model Association eXpedited (EMMAX) was used to test genetic association, while simultaneously accounting for relatedness and stratification. Results We identified several suggestive loci (5 × 10−8 < P < 5 × 10−6) within or near genes with plausible biological roles for dental caries, including a cluster of taste receptor genes (TAS2R38, TAS2R3, TAS2R4, TASR25) on chromosome 7 for the permanent dentition analysis, and DLX3 and DLX4 on chromosome 17 for the primary dentition analysis. Genome-wide significant results were seen with SNPs in the primary dentition only; however, none of the identified genes near these variants have known roles in cariogenesis. Conclusion The results of this study warrant further investigation and may lead to a better understanding of cariogenesis in diverse populations, and help to improve dental caries prediction, prevention, and/or treatment in future.

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Section: Introductionmentioning

confidence: 99%

Genome-Wide Association Study (GWAS) of dental caries in diverse populations

et al. 2021

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“…The rural populations in India have limited or no access to oral health care facilities (Arokiasamy et al 2006), a similar situation faced by other rural communities (Martin et al 2017). In the past decade, less than 14% of rural Indians diagnosed with common oral diseases received care (Arokiasamy et al 2006).…”

Section: Introductionmentioning

confidence: 99%

Prevalence, Extent, and Severity of Oral Health Impacts Among Adults in Rural Karnataka, India

Bhat

Bhat²,

Brondani

et al. 2020

JDR Clinical & Translational Research

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Introduction: Oral health affects quality of life. Many studies have investigated the factors associated with oral health–related quality of life (OHRQoL). Little is known about OHRQoL of adults living in rural and remote areas of India, where many have lower levels of education and limited availability of oral health care services. Objectives: To determine the prevalence, extent, and severity of OHRQoL impacts associated with psychosocial factors, functional dentition, and patterns of dental visits among rural Indian adults between the ages of 35 and 54 y. Methods: A cross-sectional study was conducted with a multistage stratified sampling strategy targeting 35- to 54-year-olds. Interviews and oral examinations were performed to collect data on sociodemographic variables, Oral Health Impact Profile-14 (OHIP-14), patterns of dental visits, stress, tobacco and alcohol use, and dentition status. Univariate, bivariate, and multivariable analyses were done to determine the factors associated with prevalence, extent, and severity of OHIP-14 using SAS version 9.3. Results: There were 873 participants. Prevalence, extent, and severity of OHIP-14 were 13.4%, 0.5 (0.4-0.7), and 11.8 (11.2-12.5), respectively. The OHIP-14 impacts reported were not severe and mostly affected physical functioning. Levels of education, income, and number of functional teeth (FT) were inversely associated and last dental visit within the previous year was positively associated with prevalence, extent, and severity of OHIP-14. The prevalence of 1 or more oral health impacts was nearly 13% among rural middle-aged adults in India. Conclusions: Low socioeconomic conditions, dental visits, and FT ≤19 were positively associated with prevalence, extent, and severity of oral health impacts. Knowledge Transfer Statement: This article provides data regarding OHRQoL of people in rural areas of a developing country. The study was intended to determine the factors associated with OHRQoL in rural people who are less educated and living in areas with minimal oral health care facilities. The findings of this study could potentially facilitate further research and health promotional activities for rural people of developing countries.

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“…The reasons for differential oncologic outcomes by rural residence are complex, but likely relate to differences in substance use, comorbidities, and most importantly, access to care. Rural communities have higher rates of tobacco and alcohol use, obesity, diet, poor oral health, and lack of physical activity and sun protective behaviors ( 13 , 15 ). Reduced access to dental care represents an opportunity loss for oral cancer screening ( 15 ).…”

Section: Cancer Burden In Rural Regions Of the United Statesmentioning

confidence: 99%

“…Rural communities have higher rates of tobacco and alcohol use, obesity, diet, poor oral health, and lack of physical activity and sun protective behaviors ( 13 , 15 ). Reduced access to dental care represents an opportunity loss for oral cancer screening ( 15 ). Underdeveloped infrastructure and poor health facility access results in lower rates of screening and early detection for breast, colon, and lung cancer ( 16 ).…”

Section: Cancer Burden In Rural Regions Of the United Statesmentioning

confidence: 99%

Human papillomavirus circulating tumor DNA assays as a mechanism for head and neck cancer equity in rural regions of the United States

Windon,

Haring

2024

Front. Oncol.

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The rates of human papillomavirus-positive oropharyngeal cancer (HPV-OPC) are rising worldwide and in the United States, particularly in rural regions including Appalachia. Rural areas face unique health challenges resulting in higher cancer incidence and mortality rates, and this includes HPV-OPC. The recent advent of highly sensitive liquid biopsies for the non-invasive detection of HPV-OPC recurrence (circulating tumor HPV DNA, HPV ctDNA) has been swiftly adopted as part of surveillance paradigms. Though knowledge gaps persist regarding its use and clinical trials are ongoing, the ease of collection and cost-effectiveness of HPV ctDNA make it more accessible for HPV-OPC survivors than usual surveillance methods of frequent exams and imaging. Herein, we discuss how implementing HPV ctDNA assays in rural regions of the United States provide one poignant example of how liquid biopsies can improve cancer care equity.

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Need for addressing oral health disparities in rural Appalachia

Cited by 6 publications

References 10 publications

Genome-Wide Association Study (GWAS) of dental caries in diverse populations

Genome-Wide Association Study (GWAS) of dental caries in diverse populations

Prevalence, Extent, and Severity of Oral Health Impacts Among Adults in Rural Karnataka, India

Human papillomavirus circulating tumor DNA assays as a mechanism for head and neck cancer equity in rural regions of the United States

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