title: Knowledge of caries risk factors/indicators among Japanese and Irish adult patients with different socio-economic profiles: a cross-sectional study.
abstract: BACKGROUND
  A previous study has shown deficient knowledge of caries risk factors/indicators in a Japanese adult population regarded to have a high interest in preventive dentistry. No prior research has investigated caries risk knowledge in an Irish adult population. We hypothesise there may be unexpected differences or similarities in knowledge across countries with similar levels of economic development when comparing groups with different socio-economic and cultural profiles. Understanding what influences knowledge is important for the development of effective and efficient caries prevention strategies. The current paper aims to describe the knowledge of caries risk factors/indicators in two groups with different socio-economic profiles from two culturally distinct countries.
  
  
  METHODS
  Cross-sectional surveys of adult dental patients were carried out in Japan and in the Republic of Ireland (RoI) using similar self-administered paper questionnaires. Patients were asked to identify caries risk factors/indicators from eight (Japan) or ten (RoI) listed items. The Japanese study involved 482 patients (aged ≥20 years) from 52 dental members of a nationwide web-based initiative Promoting Scientific Assessment in Prevention of Tooth Decay and Gum Disease (PSAP). The Irish study involved 159 patients (aged 20-69 years) accessing state-provided ('medical card') dental services from eight dental practices in County Cork. The two samples were compared.
  
  
  RESULTS
  A higher proportion of Irish respondents identified 'Not visiting the dentist for check-up and cleaning' (OR 2.655; 99% CI 1.550, 4.547) and 'Not using fluoride' (OR 1.714; 99% CI 1.049, 2.802) than did Japanese respondents. A lower proportion of Irish respondents identified 'A reduced amount of saliva' (OR 0.262; 99% CI 0.159, 0.433) than Japanese respondents. Similarly shown in both studies were a persistent belief that 'Not brushing teeth properly' is a caries risk factor and a lack of knowledge on saliva buffering capacity as a caries risk factor.
  
  
  CONCLUSIONS
  Deficiencies in knowledge which should be addressed: among the Japanese group, of dental check-up/cleaning visits and of fluoride use for caries prevention; among the Irish group, of saliva quantity as a caries risk factor. In addition, in both groups, we need to inform patients of the defensive role of saliva.
authors.affiliation: Oral Health Services Research Centre, University College Cork, Wilton, Cork, Ireland. makikonishi@hotmail.com.
authors.forename: Makiko
authors.identifier: http://orcid.org/0000-0002-6903-6277
authors.initials: M
authors.lastname: Nishi
authors.affiliation: Oral Health Services Research Centre, University College Cork, Wilton, Cork, Ireland.
authors.forename: Máiréad
authors.initials: M
authors.lastname: Harding
authors.affiliation: Oral Health Services Research Centre, University College Cork, Wilton, Cork, Ireland.
authors.forename: Virginia
authors.initials: V
authors.lastname: Kelleher
authors.affiliation: The School of Dentistry, University of Leeds, Leeds, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Whelton
authors.affiliation: Faculty of Dentistry, National University of Singapore, Singapore, Republic of Singapore.
authors.forename: Finbarr
authors.initials: F
authors.lastname: Allen
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Cross-cultural comparison; Dental caries; Fluorides; Ireland; Japan; Knowledge; Risk factors; Saliva; Social determinants of health; Socioeconomic factors