Publications by authors named "Youngha Song"

8 Publications

  • Page 1 of 1

Community Water Fluoridation: Caveats to Implement Justice in Public Oral Health.

Int J Environ Res Public Health 2021 03 1;18(5). Epub 2021 Mar 1.

Department of Dental Education, College of Dentistry, Yonsei University, Seoul 03722, Korea.

Community water fluoridation (CWF), a long-established public health intervention, has been studied for scientific evidence from both of yea and nay standpoints. To justify CWF with scientific evidence inevitably leads to ethical justification, which raises the question of whether oral health is of individual concern or social responsibility. As dental caries is a public health problem, public health ethics should be applied to the topic instead of generic clinical ethics. From both pro- and anti-fluoridationists' perspectives, CWF is a public health policy requiring a significant level of intervention. Thus, there needs to take further considerations for justifying CWF beyond the simple aspect of utility. For further ethical considerations on CWF, three caveats were suggested: procedural justice, social contexts, and maintenance of trust. The process to justify CWF should also be justified, not simply by majority rule but participatory decision-making with transparency and pluralistic democracy. Social contexts are to be part of the process of resolving conflicting values in public health interventions. Public trust in the dental profession and the oral healthcare system should be maintained over the considerations. This article suggests accountability for reasonableness as a framework to consider infringement by CWF for public justification of its implementation.
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http://dx.doi.org/10.3390/ijerph18052372DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967766PMC
March 2021

Association of periodontitis with oral malodor in Korean adults.

PLoS One 2021 4;16(3):e0247947. Epub 2021 Mar 4.

Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea.

This study aimed to evaluate the association of periodontitis with the organoleptic score (OLS)-defined oral malodor after validating OLS with odoriferous sulfur compounds in mouth air among Korean adults. A total of 330 adults aged 47-86 years were recruited from the Yangpyeong health cohort, South Korea, in 2015. Oral malodor was assessed using a 6-point OLS by a trained dentist and validated with the concentrations of hydrogen sulfide (HS) and methyl mercaptan (MM) using a gas chromatographer. Periodontitis was measured by assessing the radiographic alveolar bone loss on digital orthopantomography. Statistical analyses including descriptive statistics, partial correlation, ANOVA, and multivariable logistic regression with putative confounders were applied. OLS was significantly correlated with the concentrations of HS and MM (partial r = 0.401 and 0.392, respectively; both p<0.001) after controlling for confounders. Individuals with periodontitis had 1.8 times the risk of OLS-defined oral malodor in multivariable models (adjusted odds ratio = 1.77 in the model with the number of teeth and 1.82 in the model with denture wearing; p = 0.047 and 0.035, respectively). Periodontitis was associated with OLS-defined oral malodor among Korean adults independent of known confounders. Periodontal conditions should be considered for clinical practice and research of oral malodor.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0247947PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932065PMC
March 2021

Are trust and satisfaction similar in dental care settings?

Community Dent Oral Epidemiol 2020 12 26;48(6):480-486. Epub 2020 Jun 26.

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.

Objectives: Trust and satisfaction in dental care settings are salient constructs to operationalize the concept of dentist-patient relationships (DPR). This study aimed to compare the similarity of both constructs with regard to factor structure and revise the scales for better psychometric properties.

Methods: Data analysed in the study were collected in self-complete questionnaires from a random sample of 4011 adults living in South Australia. Trust and satisfaction were assessed using the Dentist Trust Scale and the Dental Care Satisfaction scale. Items in the scales were initially examined with a split-half sample in exploratory factor analysis and cluster analysis. Factor structures of different model designs were tested on the other half sample in confirmatory factor analysis. The final model was cross-validated on the first half sample for structural invariance.

Results: Exploratory factor analysis revealed a three-factor structure consisting of 'trust', 'satisfaction' and 'distrust/dissatisfaction' (60.2% of the variance explained; Cronbach's α = 0.94, 0.81, 0.73, respectively). Cluster analysis supported the factor solution with the same three major clusters except for a single-item independent branch of the 'cost' domain from the satisfaction scale. The final model was designed with two correlated but distinct factors, 'trust' and 'satisfaction', with the modification of one inter-item covariance and deleting the least associated item (GFI = 0.96, CFI = 0.98, RMSEA = 0.06). The stability of the final model was achieved through cross-validation (P = .143, ∆CFI < 0.001).

Conclusions: Trust and satisfaction in dental care settings are unidimensionally different yet highly correlated factors concurrently. Demonstrating the discriminant and complementary functions of both constructs can justify the rationale to apply them together in further studies for DPR.
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http://dx.doi.org/10.1111/cdoe.12559DOI Listing
December 2020

Dentist-patient relationships and oral health impact in Australian adults.

Community Dent Oral Epidemiol 2020 08 13;48(4):309-316. Epub 2020 Apr 13.

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.

Objectives: Dentist-patient relationships (DPRs) are a key component in clinical encounters with potential benefits for oral health outcomes. This study aimed to investigate whether better DPR variables are associated with higher oral health-related quality of life (OHRQoL).

Methods: A total of 12 245 adults aged 18 years or over were randomly sampled from South Australia in 2015-2016. Data were collected from self-complete questionnaires and analysed as a cross-sectional design. The outcome variable was the Oral Health Impact Profile (OHIP-14). Explanatory DPR variables included trust in dentists, satisfaction with dental care, and dental fear. Covariates comprising oral health behaviours, dental services, demographics, and socioeconomic status were included as potential confounding variables. Bivariate correlation analyses and multivariable linear regression were performed for the associations among explanatory, outcome variables and other covariates.

Results: Response data were analysed from 4220 participants (response rate = 41.9%). Unadjusted mean total scores of DPR variables and OHIP-14 were associated with most of the study participants' characteristics (P < .05). Bivariate correlations among DPR variables and OHIP-14 showed a diverse range of coefficients (|r| or |ρ|=0.22-0.67). Multivariable regression analyses in both individual/clustered block entry and full model indicated that higher satisfaction and less dental fear (B = -0.039 and 0.316, respectively in the full model) were associated with lower OHIP-14 after adjusting for possible confounders (P < .01).

Conclusions: This study found that favourable DPR variables, mainly greater satisfaction and less dental fear are positively associated with better OHRQoL. Further studies are warranted to investigate the causality and mediation/moderation of DPR variables on oral health outcomes.
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http://dx.doi.org/10.1111/cdoe.12534DOI Listing
August 2020

Trust in dentist-patient relationships: mapping the relevant concepts.

Eur J Oral Sci 2020 04 10;128(2):110-119. Epub 2020 Mar 10.

Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia.

Trust has a central role in healthcare encounters. This review explored concepts relevant to trust in dentist-patient relationships. The findings were demonstrated by drawing visual system maps for better understanding of the inherent complexity. A pragmatic approach was employed to search for evidence. The approach was initiated with a systematised searching protocol and followed by an iterative process of drawing maps and complementing references. The analysis-synthesis process found relevant key concepts and sub-concepts presented within three frameworks: the continuum of studying trust (utilisation, measurement, and establishment); beneficiaries of trust utilisation (patients, dentists, and oral health system); and a transformational model of trust development (identification-based, knowledge-based, and deterrence/calculus-based trust). Trust in dentist-patient relationships needs to be assessed in a multidisciplinary approach for interconnectedness among relevant concepts. The findings are represented in patient-centred care and quality of care with common underlying values. Despite the centrality of trust in medical/dental contexts, empirical evidence is insufficient beyond normative suggestions from previous studies. Based on the implications of thematic analysis and interpretation of the system maps, this paper can serve as a guide and source of information for further research of trust in dentist-patient relationships.
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http://dx.doi.org/10.1111/eos.12686DOI Listing
April 2020

Human Milk Oligosaccharide 2'-Fucosyllactose Reduces Neurodegeneration in Stroke Brain.

Transl Stroke Res 2020 10 2;11(5):1001-1011. Epub 2020 Jan 2.

Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli, Taiwan.

2'-Fucosyllactose (2'-FL) is a major oligosaccharide in human milk and is present at trace levels in cow milk. 2'-FL reduces inflammation in the gastrointestinal tract. Its action in the central nervous system has not been well characterized. The purpose of this study is to determine 2'-FL-mediated neural protection and repair in culture and stroke brain. In rat primary cortical neuronal cultures, 2'-FL significantly antagonized N-methyl-D-aspartate (NMDA) or glutamate-mediated changes in ATP production, MAP2 immunoreactivity, and TUNEL. The influx of Ca (Cai) was examined in primary cortical neurons expressing GCaMP5, an endogenous calcium probe. NMDA increased Cai; 2'-FL significantly attenuated this reaction. In a rat middle cerebral artery occlusion model of stroke, we found that intracerebroventricular pretreatment or oral posttreatment with 2'-FL significantly reduced brain infarction, mitigated microglial activation, improved locomotor activity, and upregulated brain-derived neurotrophic factor (BDNF) expression. Post-stroke delivery of 2'-FL increased bromodeoxyuridine (BrdU) labeling in the perilesioned area. These BrdU cells co-expressed NeuN, or nestin, or GFAP. Using subventricular Matrigel cultures, we demonstrated that 2'-FL increased cell migration from subventricular zone explant. This response was reduced by anti-BDNF blocking antibody. In conclusion, our data suggest that 2'-FL has neuroprotective action through inhibition of Cai, inflammation, and apoptosis. Posttreatment with 2'-FL facilitates neural repair in stroke brain.
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http://dx.doi.org/10.1007/s12975-019-00774-zDOI Listing
October 2020

Degrees of xerostomia? A Rasch analysis of the Xerostomia Inventory.

Community Dent Oral Epidemiol 2020 02 12;48(1):63-71. Epub 2019 Nov 12.

Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.

Objective(s): The global demographic changes resulting in an ageing population require attention on xerostomia, as its prevalence appears to increase with age. The Xerostomia Inventory (XI) is a 11-item instrument developed to evaluate the symptoms and behavioural components of xerostomia, while a shortened 5-item version named Summated Xerostomia Inventory (SXI) was later proposed. The aim of the present study was to evaluate the construct validity of the XI and whether the SXI can provide a shortened version. Since previous studies focused only on dimensionality and reliability, we employed modern psychometric methodology to investigate properties such as differential item functioning (DIF) and targeting.

Study Design: The XI was applied to 164 middle-aged to older adults who participated in a randomized controlled trial to investigate the effects of alcohol-containing mouth rinse in Singapore. The psychometric properties of the XI were investigated with the Rasch model (Partial Credit Model). Overall model fit was evaluated with a summary chi-square statistic. Item fit was evaluated with the Fit Residual, and values between -2.5 and 2.5 are considered acceptable. DIF by sex was evaluated through a two-way ANOVA of the residuals.

Results: After collapsing the categories of "Hardly ever" and "Fairly often", the test of global fit (χ (30) = 34.32, P = .27) indicated overall fit to the Rasch model. Since Fit Residuals were between -2 and 2, the fit of individual items was also adequate. No DIF was found between men and women, and targeting was adequate (μ = -0.56).

Conclusion: The current study expanded the evidence on the XI and SXI validity and provides new implications for practice: a 3-point categorization ("Never," "Occasionally" and "Very often") should be preferred rather than the original 5-point categorization; the XI and SXI scores can be compared between men and women and will reflect true differences in xerostomia rather than measurement bias.
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http://dx.doi.org/10.1111/cdoe.12504DOI Listing
February 2020

Examinations for overseas-trained dentists in Australia and the UK: formative and summative feedback.

Authors:
Youngha Song

Br Dent J 2019 Jun;226(11):833-836

Australian Research Centre for Population Oral Health, University of Adelaide, South Australia, Australia.

Examinations for overseas-trained dentists are enforced to qualify for registration to perform dental practices in some countries. Feedback on the examinations in Australia and the UK is presented as formative and summative evaluations from a participant and practitioner's perspective. The formats of both examinations are analysed with the foci of the composition, implementation and standard-setting/standardisation in practical tests. The structures of the examinations are formulated in a different manner, resulting in different pass rates. Some administrative errors and loopholes are identified in the implementation. The issue of reliability is raised for the acceptability of the practical examination. Among components of the examinations, establishing the relationship and communicating with patients is more valued to practitioners trained overseas, along with medical emergency protocols for patients' safety. To better evaluate the competency of overseas-trained dentists in Australia and the UK, three suggestions are proposed. Firstly, the examination governing body should ask for and refer to feedback from actively practising dentists passing through the qualification process. Next, the examinations should redirect the target of competency from dental manikin-based dexterity to a more comprehensive evaluation. Finally, the equivalent level of qualifying competency for the examinations described in official publications may need to be revisited.
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http://dx.doi.org/10.1038/s41415-019-0371-yDOI Listing
June 2019