Int Poster J Dent Oral Med 2008, Vol 10 No 01, Poster 392
Dental practice during a world cruise: characterisation of oral health at sea
Dr. Bernhard A.J. Sobotta, PD Dr. med. dent. habil. MPH PhD Mike T. John
Department of Prosthodontics and Materials Science, University of Leipzig
PD Dr. med. dent. habil. MPH Ina Nitschke
Clinic for Geriatric and Special Care Dentistry, University of Zurich
3 - 6 June 2007
9th International Symposium on Maritime Health
More than 100 million passengers, mostly from industrialised nations, have
taken a cruise since 1980 on a growing fleet of cruise ships with ever
increasing numbers of crew, the majority of whom come from developing
Little is known about oral health of these two distinctly different
populations of passengers and crew of cruise ships at sea.
Material and Methods
In a retrospective, descriptive epidemiologic study design the routine
documentation of all dental treatment provided during two months at sea in
2006 was analysed after the voyage. Subjects were n = 57 passengers (3.5 %
of 1619) with a mean age of 71 (± 9.8) years and n = 56 crew (5.6 % of 999)
with a mean age of 37 (± 12.0) years. Age, gender, nationality, number of
natural teeth and implants were extracted. The prosthetic status was
described by recording the number of teeth replaced by fixed prosthesis and
number of teeth replaced by removable prosthesis. Oral health-related
quality of life (OHRQoL) was measured using the 14-item Oral Health Impact
Profile (OHIP-14) and characterised by the OHIP sum score.
Women attended for treatment more often than men. Passengers had a mean
number of 20 natural teeth plus substantial fixed and removable
prosthodontics. Crew had a mean of 26 teeth. British crew and Australian
passengers attended the dental service above average. Crew tended to have a
higher average OHIP-14 sum score than passengers indicating an increased
rate of perceived problems. Emergency patients from both crew and passengers
have a higher sum score than patients attending for routine treatment.
|Figure 1 Patients prosthetic status (%) and mean number of teeth
||Figure 2 Crew nationality (%) n= 999
|Table 1 Mean OHIP summary scores (x) by diagnosis and number of appointments (n)
|Figure 3 Patients' age distribution (%) of crew and passengers
||The vessel in Hong Kong
Differences seen between the two groups are not exclusively attributable
to the age factor but represent differing backgrounds in home countries.
Socioeconomic factors serve to explain the high standard of prosthetic care
in passengers. Crew in general present with less sophisticated prosthetic
devices. This is in line with their different socioeconomic status and
origin from developing countries. The level of dental fees aboard in
comparison to treatment costs in home countries may explain some of the
differences in attendance. British officers would find subsidised crew
treatment rates low in comparison to private rates at home. Filipino cabin
stewards in turn would still receive basic treatment in their home country
(extractions) substantially cheaper than on board. Passengers have enjoyed
high standards of prosthetic care in the past and will expect a similarly
high standard from ship based facilities. The ease of access to quality
dental care may explain the relatively low level of perceived problems as
characterised by oral health-related quality of life scores. The dental
officer aboard has to be prepared to care for very varied diagnostic and
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This Poster was submitted by Dr. Bernhard A.J. Sobotta.
Dr. Bernhard A.J. Sobotta
Department of Prosthodontics and Materials Science
University of Leipzig
Nürnberger Str. 57