title: Is the value of oral health related to culture and environment, or function and aesthetics?
abstract: OBJECTIVE
  To examine the disutility of tooth loss. It compared how people value their teeth in two countries which are culturally similar in order to explore the effect of culture on self-perceptions of oral health.
  
  
  METHODS
  Cross sectional study.
  
  
  METHODS
  Participants were recruited from subjects attending two hospitals in Turkey and in Iran.
  
  
  METHODS
  Nineteen descriptions of mouths with varying degrees and types of tooth loss were presented to the participants. They were shown mouth models of partially edentate dentitions and the teeth missing were explained in relation to the participants own mouth. The participants were specifically asked to consider the role their teeth played in function (chewing), communication (speech) and aesthetics (looks) along with "all the other things that make your mouth important".
  
  
  METHODS
  The participants were asked to indicate on a visual analogue scale how they would value the health of their mouth if they lost the tooth/teeth described and the resultant space was left unrestored.
  
  
  RESULTS
  Overall 152 subjects participated, 78 in Turkey and 74 in Iran with 83 being female and 69 male. Their mean age was 29.5 years (SD 9.3), 62.5% had experienced tooth loss and 37.5% had complete (or completely restored) dentitions. Although there were no differences between the two countries in the degree of utility people attached to anterior teeth, Turkish participants attached significantly more disutility than Iranians to the loss of premolar and molar teeth (p < 0.003).
  
  
  CONCLUSIONS
  Country of origin had an influence on the value placed on certain parts of the dentition and this effect is independent of the number of missing teeth, gender and age. This implies that attitudes to oral health are influenced by prevalent cultural attitudes more than by function.
authors.forename: M Z
authors.initials: MZ
authors.lastname: Nassani
authors.forename: E J
authors.initials: EJ
authors.lastname: Kay
authors.forename: T I
authors.initials: TI
authors.lastname: Al-Nahhal
authors.forename: R
authors.initials: R
authors.lastname: Okşayan
authors.forename: A
authors.initials: A
authors.lastname: Usumez
authors.forename: T M
authors.initials: TM
authors.lastname: Mohammadi
mesh_terms: D000328:Adult; D000367:Age Factors; D001294:Attitude to Health; D001641:Bicuspid / Q000473:pathology; D003430:Cross-Sectional Studies; D003469:Culture; D003481:Cuspid / Q000473:pathology; D004955:Esthetics, Dental; D005260:Female; D006801:Humans; D007180:Incisor / Q000473:pathology; D007492:Iran; D007576:Jaw, Edentulous, Partially / Q000208:ethnology / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008334:Mandible; D008409:Mastication / Q000502:physiology; D008437:Maxilla; D008963:Molar / Q000473:pathology; D009909:Oral Health; D012649:Self Concept; D012737:Sex Factors; D012931:Social Environment; D013060:Speech / Q000502:physiology; D016388:Tooth Loss / Q000208:ethnology / Q000523:psychology* / Q000534:rehabilitation; D014421:Turkey; D064232:Visual Analog Scale