Oral health and job opportunities

Phatology and Oral medicine

ORIGINAL ARTICLE

Oral health and job opportunities Salute orale e opportunità di lavoro G.H. Marina,b,*, M. Silbermanc, C. Sanguinettid Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET c Universidad Nacional Arturo Jauretche, Argentina d Médicos en Prevención, La Plata, Argentina a

b

Received on 13 May 2015 Accepted on 7 January 2016 *Corresponding author Gustavo H. Marin [email protected]

ABSTRACT

ly modified in order to include missing

OBJECTIVES. Oral diseases are a prob-

teeth). All CVs had similar personal data,

lem for individuals, society and for the

background, and skills. Human resources

public health system. In Latin America,

managers from 300 entities were asked

the high cost of dental treatments leads

to rank candidates from each folder. A

health authorities to divert attention from

multivariate analysis was performed by

oral illnesses and to consider them as

associating all variables.

luxury goods, when compared to other life-threatening diseases. However, dental

RESULTS. Subjects with missing teeth

health far exceeds the healthcare dimen-

ranked in the lowest positions. Although

sion and often involves issues affecting

the capabilities and skills presented in

the social life of individuals, such as the

their CVs were equivalent, candidates

employment world. The aim of the pres-

who did not have a complete dentition,

ent study is to evaluate the relationship

were average rated in 15.5 ± 4.1 position

between job opportunities and dental

in a 20 candidates ranking list. Strong as-

health status.

sociation was observed between rejection of job application and missing teeth

MATERIALS AND METHODS. The authors

(p = 0.003).

conducted a prospective study. Variables

236 | DENTAL CADMOS

| 4/2016

analysed were missing teeth, socioeco-

CONCLUSIONS. The significance of

nomic status and ranking during job se-

teeth health goes well beyond aesthet-

lection process. After stratified two-stage

ics or nourishment function; it plays a

randomized selection of young adults,

strategic role as a key element for labour

volunteers were included in the study.

inclusion. A complete dentition means

Three sets of folders were prepared, each

better opportunities for job applicants.

one made up of the CVs of 20 candidates

Public health policies should aim to cut

(10 CVs of volunteers with complete den-

the vicious circle in which socioeconomic

tition photograph, 5 CVs of candidates

vulnerable communities are imprisoned,

with missing teeth; and 5 CVs of candi-

and to guarantee their access to oral care

dates, whose images had been digital-

and prevention.

© 2016 EDRA SpA. Tutti i diritti riservati

ORIGINAL ARTICLE

bili esaminate sono state: denti man-

la posizione media dei candidati senza

` Oral health ` Oral disease ` Dental treatments ` Job opportunities ` Social life

canti, stato socioeconomico, posizione

dentatura completa si è attestata a 15,5

ottenuta nelle graduatorie durante il

± 4,1 in una graduatoria di 20 candidati.

percorso di selezione lavorativa. Dopo

Una forte correlazione è stata osservata

una selezione casuale stratificata a due

tra il rifiuto all’assunzione e l’edentulia

stadi, alcuni volontari sono stati inclu-

(p = 0,003).

Phatology and Oral medicine

KEY WORDS

si nello studio. Sono stati preparati tre RIASSUNTO

gruppi di cartelle, ognuna composta dai

CONCLUSIONI. La salute dei denti ri-

OBIETTIVI. Le malattie della bocca rap-

CV di 20 candidati (10 CV di candidati

veste un’importanza che va oltre l’esteti-

presentano un problema per le persone,

volontari con dentatura completa e re-

ca e la funzionalità, svolgendo un ruolo

la società e i sistemi sanitari pubblici. In

lativa fotografia, 5 CV con la fotografia

strategico per l’inclusione nel modo del

America Latina l’alto costo dei tratta-

di candidati con denti mancanti e 5 CV

lavoro. Una dentatura completa garan-

menti odontoiatrici distoglie l’attenzione

corrispondenti a candidati per i quali la

tisce migliori opportunità di lavoro per

da tali malattie, che le autorità sanitarie

fotografia era stata modificata digital-

i candidati.

considerano un bene di lusso se compa-

mente per includere i denti mancanti).

Le politiche di sanità pubblica devono mi-

rate con altre malattie potenzialmente

Tutti i CV erano simili per dati persona-

rare a interrompere il circolo vizioso nel

letali. Tuttavia la salute orale va oltre i

li, esperienze e abilità. È stato chiesto ai

quale ricadono le comunità vulnerabili

problemi sanitari, essendo coinvolta in

responsabili delle risorse umane di 300

dal punto di vista socioeconomico, ga-

aspetti relativi alla vita sociale dell’in-

società e istituzioni di classificare i can-

rantendo loro accesso alla prevenzione e

dividuo, quali per esempio quelli legati

didati di ogni cartella. Un’analisi mul-

alla cura dentale.

al mondo del lavoro. Scopo del presente

tivariata è stata realizzata associando

articolo è valutare l’associazione tra le

tutte le variabili.

PAROLE CHIAVE

MATERIALI E METODI. È stato con-

sti. Anche se le competenze e le capaci-

dotto uno studio prospettico. Le varia-

tà riportate nei CV erano equivalenti,

` Salute orale ` Patologia orale ` Trattamenti dentali ` Opportunità di lavoro ` Vita sociale

good for health’s authorities when it is

controls and treatments are also seen in

compared to other life threatening dis-

socially wealthy population [7]. The aim

Oral disease is a problem for individuals,

eases [3].

of this study is to establish the impact of

society and for public health system [1].

Many of the oral diseases are preventable

lack teeth in job’s opportunities.

Dental diseases have been reduced over

with an appropriated dental council and

the last decade in most developed coun-

a change of habits in food and oral hy-

tries, but this decline was not uniform in

giene [4]. However, the delayed reaction

all countries [2].

of public policies towards this issue and

2.1 TYPE OF STUDY

Latin America still has severe health’s

the risk to oral diseases of social exclude

Cross sectional study.

problems that shorten life’s expectations

population, frequently cause the lost of

of some groups of the inhabitants locat-

teeth elements [5].

2.2 PATIENTS SELECTION

ed in these latitudes. It might be for this

Some authors associated the aesthetic

After a free complete health control pro-

reason and also for the high cost of den-

characteristics of individuals and their

vided by the University and the Minister

tal treatments that oral health has not a

economical succeed [6]. It might be then

of Health, 1,840 volunteers from both

priority and is often considered a luxury

a vicious cycle, since access to dental

sexes, aged 18 to 30 years old, were invit-

opportunità di lavoro e lo stato di salute dentale.

RISULTATI. I candidati con denti mancanti sono stati collocati agli ultimi po-

1. INTRODUCTION

2. MATERIALS AND METHODS

DENTAL CADMOS

| 2016;84(4):236-240|

237

Phatology and Oral medicine

ORIGINAL ARTICLE

ed to participate in the selection process.

In addition, 30 Curricula Vitae (CVs)

tionnaire to evaluate the history of his

A stratified double stage randomized

with same contents, knowledge and skills

dental health to be considered as a vol-

sample selection was performed consid-

were built up, and attached to each one of

unteer. Program was accepted by the

ering as major variables denture status

the photographs. Therefore, 30 CVs with

MS-PBA Ethical Committee.

and sex (using SPSS for Windows 14). All

same contents were obtained, only differ-

volunteers were initially divided in two

ing in the presence or absence of teeth in

2.5 STATISTICAL ANALYSIS

groups according to their oral health. The

the applicant’s picture.

The quantitative analysis was made of

first group included those volunteers in

200 small and medium local enterprises,

the information in the program EpiInfo 6

whom at least the loss of 2 or more upper

50 national and international companies,

(CDC/WHO). In the descriptive analysis

front teeth were detected; while the sec-

and 50 government agencies in which

the values of quantitative variables were

ond one had all their teeth.

employees are routinely recruit, were

summarized by mean ± standard devia-

After the conformation of these groups,

asked chose potential employees. Selec-

tion (SD). Qualitative variables were ex-

another selection was performed in-

tion process was given to the head person

pressed by percentage.

side each of them according volunteer’s

in charged of human resources selection

For comparative analysis, the differences

sex. Five females and five males of both

in each institution. These enterprises be-

between averages and percentages were

initials groups were selected. Thus two

longs to services areas with a close con-

performed using t-test for 18 degrees of

groups were finally obtained after selec-

tact to people and they recruit for non

freedom and Chi2 respectively.

tion process: Group 1 integrated by 10

qualified works (cleaning, security, su-

Difference was considered significant

volunteers in whom lack teeth were de-

permarket cashier or chargers, and other

when the p value was < 0.05.

tected and group 2 with 10 volunteers

similar) Job selectors were mainly men

with complete teeth.

(89%), aged between 40 and 54 years

The study was carried out in accordance

old, all of them had a university degree in

with the ethical standards established in

some commercial or administration area.

All 300 human resource head persons

the Declaration of Helsinki.

They were asked to make a ranking from

agreed to answer the request. Only 291

3. RESULTS

1 to 20 of the applicants within 24 hours

selectors arrived to classify the CVs in the

2.3 METHODS

after the folder reception, considering

assigned folders within the next 24 hours

A digital photograph (face and neck) of

the number 1 as the person with the best

of folder delivery. Seven returned their

each volunteer from both groups (1 and

chances to work in their company, while

folders within next 48 hours, and only

2) was obtained during smiling. Group 1

the number 20 would be the last option

2 of them returned them the week after

volunteer’s photographs were copied and

to be taken into account as an employee

receiving it.

doubled in order to have two sets for each

for their institution. The folders present-

The difference in the ranking’s positions

individual of that group. These copies

ed to selector contained 20 CVs that in-

obtained by each one of the groups of

were then digitally modified by adding

cluded 10 complete dentition applicant’s

study is shown in table I.

the missing teeth by a commercial soft-

CVs, 5 CVs that had lack of teeth and 5

No significant differences were observed

Cs2

CVs randomly chosen from the 10 CVs in

between males and females. Applicants

for Window) forming a new virtual group

which photographs were modified. Fold-

with complete teeth showed no differenc-

named “Group 3”. These modified copies

er classified were analysed according to

es when they were compared with those

were standardized using the image of the

applicant’s position in the ranking, con-

participants in whom dentition images

opposite tooth to the missing one from

sidering variable teeth (complete/lack),

were digitally repaired.

the same person, in this way, 30 images

sex (male/female), and photograph (orig-

Noteworthy, those applicants that had

of volunteers were then obtained (10 vol-

inal/modified by Adobe Photoshop ).

lack of teeth did show significant differ-

ware program (Adobe Photoshop

©

©

unteers with complete denture; 10 with

ences in their ranking position in relation

lack of at least two teeth, and these same

2.4 ETHICAL ASPECTS

to other applicants in the folder; since

10 last volunteers but their teeth digitally

All participants of the study had to sign

they had been always relegated below the

added at their face images).

an informed consent and answer a ques-

half of the list (10th position of the rank-

238 | DENTAL CADMOS

| 4/2016

ORIGINAL ARTICLE

Position given by human resources managers in the list of job’s applicants according to oral health status

Group

be attribute to oral health status.

4.1

+10.1 p = 0.004

+11.4 p = 0.003

vulnerable groups are immersed in vi-

7.1

–4.3 NS

–

–

+6.3 NS

Group 1 (group with missing teeth)

15.5

Group 2 (group with complete dentures)

3.4 4.7

the selection process, so results can only

Difference (with group 2)

SD

Group 3 (teeth digitally added)

initially considered and adjusted during

Difference (with group 3)

Average position

6.9

Legend: SD, Standard Deviation; NS, Not Significant.

Phatology and Oral medicine

Table I

This data also evidences that economical cious circle without exit, since their social condition affects their health, and these problems (like oral health status) exclude them from job opportunities, which finally causes more economical risks for themselves and their families.

ing) and on average in 15.5 ± 4.1 position

However, is necessary to understand that

In the present study makes clear the

in the selection process (table I).

preventive actions towards oral health

significant difference in access to the

Finally, all volunteers were included in

care do not only improves oral cavity con-

employment between those with com-

an official program that provided them of

dition but also avoids systemic problems

plete dentures and those who do not

a personalized treatment and prosthetic

like nutrition status that may influence

possess it.

rehabilitation according to each patient’s

the future of the population affected [8].

Although it is well accepted that oral dis-

needs and problem, until complete teeth

Noteworthy, lack of teeth is associated

ease prevention is a better option than

were restored.

to socio-economic and psychological di-

treated and rehabilitate, the problem

mensions so it could be said that this sta-

once this one already exists, it should be

tus far exceeds the health problem.

considered that at 33.3% of young people

Unfortunately, it exist a large number of

in Argentina has already an incomplete

In countries with a high poverty level,

inhabitants that have already installed

denture.

with a significant maternal and infant

severe dental problems and lack of teeth

Access to oral health care and dental

mortality, and with social exclusion, ef-

[10,11].

treatment should then be considered as

forts and strategies designed to provide

This study was performed in order to

routinely strategy by health authorities in

oral prostheses to those inhabitants with-

determine the impact on the self-confi-

order to reduce social inequalities. Treat-

out a complete dentition, at a first glance

dence and degree of exclusion in terms

ing the absence of teeth, avoids other

might be considered not priority or a lux-

of employment that individuals with ab-

problems that put citizens in conditions of

ury good.

sence of teeth elements might have.

equality against the work market demand.

Adverse health conditions suffered by

Results clearly showed that official mak-

Limitations of the study are the sex of the

communities of many developing coun-

ers responsible for selecting human re-

candidates (mainly women) and the lack

tries usually push local authorities to pri-

sources in some jobs, placed candidates

of homogeneity from job selectors.

oritize attending severe systemic illness

with lack of teeth in worse positions of

that may compromise life, rather than oral

candidates ranking. Since CV personal

illness. This point is related with fact that

data and background of all candidates

government’s political decision makers

were similar it may be inferred that the

often promote options that have impact in

difference lies in the absence of teeth,

the short time period while they remain in

above all upper anterior teeth.

their positions and functions [8].

This study demonstrated that even the

Thus, implementations of government

same person when its image was digitally

policies regarding oral health care are

modified improved their ranking posi-

usually postponed or at least not too

tions compared with the original CV.

well-considered in relation to other

Other variables like sex of the candidate,

health risks [9].

which may bias the data obtained, were

4. DISCUSSION

STUDY FINANCING The authors declare that they have not received funding for the present study. CONFLICT OF INTEREST The authors declare that they have no conflict of interest. REFERENCES 1.

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