Physicians' knowledge of and adherence to improving oral health

Dental knowledge of educators and healthcare providers working with children with autism spectrum disorders

OBJECTIVES

To evaluate dental knowledge and attitudes toward oral health care among healthcare providers and educators working with children with autism spectrum disorders (ASD) in central Saudi Arabia.  

METHODS

 There were 305 questionnaires distributed to 7 special-needs centers between September and November 2014. A total of 217 questionnaires were collected with a response rate of 71.1%. The study took place in the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. 

RESULTS

Approximately 50.2% of the participants did not offer any toothbrushing advice, and 73.3% never recommended dental checkup visits to parents, and 75.6% never performed dental examinations to children under their care. Ten percent thought that children should have their first dental visit after 6 years of age. Almost all participants agreed that children should practice oral hygiene, and 60.4% think they should brush twice per day. In general, the participants choose toothbrushes and toothpaste as the main tools to perform oral hygiene. There were 35% of participants who believed that parents should be responsible for the children's oral hygiene, and a few participants mentioned teachers and therapists to be responsible. Most of the participants (71.4%) did not receive any dental information from dental professional resources, only 14.3% of participants believed bacteria to be the cause of dental cavities.  

CONCLUSION

There is a clear lack of dental knowledge and attitudes, and its practical application among the participating group of healthcare providers working with children with ASD in Riyadh.

Effects of a Comprehensive Oral Health Curriculum on Knowledge, Behavior, and Attitude of Physician Assistant Students

PURPOSE

Oral health assessment by the medical provider needs to be thorough and accurate. Many schools for medical providers are providing an increasing amount of oral health education to students during the didactic year. A dedicated and comprehensive oral health curriculum was developed for a physician assistant (PA) program in Virginia for the purpose of evaluating the effectiveness of the curriculum for changing students' attitudes, behavior, and knowledge.

METHODS

First- and fourth-semester PA students attended about 18 hours of lectures, laboratories, and clinical experiences dedicated to oral health. The change in student attitude, behavior, and knowledge of oral health and assessment was assessed using a validated precurricular and postcurricular survey.

RESULTS

The responses to the precurricular and postcurricular surveys were compared using paired t-tests. The analysis revealed an overall significant increase (P < .001) in attitude and knowledge of oral health after the curriculum intervention. The only significant change noted in student behavior was an increase in flossing frequency.

CONCLUSION

The oral health curriculum was successful in changing the attitude and knowledge of all students, regardless of their level of education in PA school. Therefore, an oral health curriculum conceivably could be added to a medical education program at any time that the course load allows for additional hours.

Current training provision and training needs in oral health for UK general practice trainees: survey of General Practitioner Training Programme Directors

BACKGROUND

In the UK the incidence of oral cancers has risen by a third in the last decade, and there have been minimal improvements in survival rates. Moreover, a significant proportion of the population no longer access dental health services regularly, instead presenting their oral health concerns to their General Medical Practitioner. Therefore, General Practitioners (GP) have an important role in the diagnosis of oral health pathologies and the earlier detection of oral cancers. This study aims to understand the current provision of training in oral health and cancer for GP trainees and to identify how unmet training needs could be met.

METHODS

A cross-sectional survey of GP Training Programme Directors using an online questionnaire asking about current oral health education training (hospital placements and structured teaching), the competencies covered with trainees and ways to improve oral health training. Quantitative data were analysed using descriptive statistics and content analysis was undertaken of free text responses.

RESULTS

We obtained responses from 132 GP Training Programme Directors (GPTPDs), from 13 of the 16 UK medical deaneries surveyed. The majority of respondents (71.2%) indicated that their programmes did not provide any structured oral health training to GP trainees and that ≤ 10% of their trainees were undertaking hospital posts relevant to oral health. GPTPDs were of the view that the quality of oral health training was poor, relative to the specified competencies, and that teaching on clinical presentations of 'normal' oral anatomy was particularly poor. It was envisaged that oral health training could be improved by access to specialist tutors, e-learning programmes and problem-based-learning sessions. Respondents highlighted the need for training sessions to be relevant to GPs. Barriers to improving training in oral health were time constraints, competing priorities and reluctance to taking on the workload of dentists.

CONCLUSIONS

This UK-wide survey has identified important gaps in the training of GP trainees in relation to oral health care and cancer detection. Addressing these knowledge and skill gaps, particularly in the identification of oral cancers, will help to improve oral health and, more importantly, the timely diagnosis of oral cancer.

Association between periodontal diseases and systemic illnesses: A survey among internal medicine residents in Nigeria

OBJECTIVE

To assess internal medicine residents' knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients' periodontal health.

METHODS

A cross-sectional survey using a self-administered questionnaire was conducted among internal medicine residents attending the Faculty of Internal Medicine 2014 Update Course organized by the National Postgraduate Medical College of Nigeria. Participants came from all over the country. Data on respondents' demographic characteristics, periodontal disease knowledge, knowledge of associations between periodontal disease and systemic illnesses, and attitudes toward patients' periodontal health were collected. Data were analyzed using Epi INFO software. The Pearson chi square test was used to measure significant association between categorical variables such as the knowledge of periodontal disease and gender, age group and designation of the participants (p ⩽ 0.05).

RESULTS

Of 150 questionnaires distributed, 123 were returned (82% response rate); 109 questionnaires were completed properly and included in the analysis. The most common source of residents' information on oral health was television (59.4%). Only 11.2% of respondents were aware that gingival bleeding was the earliest sign of periodontal disease. Respondents correctly identified periodontal disease as a risk factor for coronary heart disease (45.9%), stroke (43.5%), hospital-acquired pneumonia (53.2%), diabetes mellitus (13.8%), and preterm birth (11%). Increased age (p = 0.032) and male gender (p = 0.022) were associated significantly with knowledge of periodontal disease as a risk factor for stroke. Higher designation (p = 0.002) and longer duration in residency training (p = 0.004) were associated significantly with knowledge of periodontal disease as risk factor for peripheral arterial disease. The majority (90.9%) of respondents had positive attitudes toward the referral of their patients for regular periodontal care.

CONCLUSIONS

Knowledge of periodontal disease as a risk factor for systemic illnesses among medical residents in Nigeria is inadequate. These relationships should be emphasized in continuing medical education courses.

Knowledge and Attitude of Medical Nurses toward Oral Health and Oral Health Care of Pregnant Women

BACKGROUND

This study assessed the knowledge and attitudes of medical nurses regarding oral health and oral health care of pregnant women.

METHODS

This cross sectional study of 133 nurses in the district of Tumpat, Kelantan (Malaysia) used self-administered questionnaires.

RESULTS

Most nurses knew that dental plaque is associated with periodontal disease (97.7%). However, most nurses erroneously believed that tooth decay (86.5%) and excessive sugar consumption (87.2%) led to periodontal disease. About half of the nurses knew about the relationship between periodontal disease of pregnant women and low birth weight (43.6%) and preterm birth (48.9%). Many nurses had the misconception that the developing foetus draws calcium from the mothers' teeth (78.2%). Most nurses had good attitudes toward improving their oral health knowledge (97.0%) and agreed they should help to deliver oral health education to pregnant women (94.0%). Age, length of service as a nurse, and length of service in antenatal care had no effect on the scores for the nurses' knowledge and attitude regarding oral health and oral health care of pregnant women.

CONCLUSION

Medical nurses had limited knowledge about oral health of pregnant women and had some misunderstandings about oral health, although they had good attitudes. Age, length of service as a nurse, and length service in antenatal care had no effect on the knowledge and attitude scores of the nurses.

Midwifery students training in oral care of pregnant patients: an interventional study

OBJECTIVE

Midwives may play an important role in oral health promotion of pregnant women, whom they are in close contact with. Our aim was to evaluate an educational intervention on the oral health attitude and practices among the junior midwifery students of Tehran University of Medical Sciences in 2010.

MATERIALS AND METHODS

The junior midwifery students were divided into intervention (n=29) and control (n=33) groups. The intervention group was first educated about general oral health, oral hygiene practices during pregnancy, and tooth brushing and flossing on models. Subsequently, the students performed role playing to ensure they understood the aforementioned lessons correctly. Before and three months after the training course the students filled out a validated self-administered questionnaire and a simplified plaque index was recorded. Statistical analysis was done by Mann-Whitney test and linear regression models.

RESULTS

Before the intervention, the mean scores of attitude in general oral health for the intervention and control groups were 5.8 and 5.4, respectively, which improved to 8.9 and 5.4 after the intervention (P<0.001). The mean score of oral health attitude in pregnancy was 20.4 in the intervention group and increased to 30.9 (P<0.001). The intervention group demonstrated much better oral health practices in pregnancy and lower plaque index score after the intervention.

CONCLUSION

The promising finding about attitude and practice improvement in midwifery students after participating in a short course on oral health promotion in pregnancy shows the necessity to enrich their training program by including this subject.

Primary care nurses' awareness of and willingness to perform children's oral health care

BACKGROUND

The majority of young children receive no early dental examination while attending primary health care for routine check-ups. Our aim was to study primary care nurses' knowledge of oral health care (OHC) and their attitudes toward delivering OHC, as well as to assess their willingness to obtain OHC information.

METHODS

We conducted a cross-sectional survey of all primary-care nurses working in the public health centres of Tehran city. An anonymous self-administered questionnaire queried their knowledge in paediatric-, general and medicine-related areas of dentistry, providing knowledge scores for three domains. The nurses' attitudes toward OHC and their willingness to obtain OHC information underwent evaluation with statements utilizing a five-point Likert scale. Altogether 680 nurses took part in the survey. The Chi-square test, t-test, one-way ANOVA and logistic regression model served for statistical analyses.

RESULT

The mean score for the paediatric dentistry domain (3.6, SD: 1.5) was lower than for the medical (4.4, SD: 2.3) and dental domains (5.8, SD: 1.5). Obtaining higher scores in the paediatric (OR = 1.2) and dental (OR = 1.3) domains, and a greater willingness to receive OHC information (OR = 5.3), were associated with a positive attitude toward OHC. Nurses with a lower education (OR = 1.9) and better oral health behaviour (OR = 1.1) as well as those working in a non-affluent region (OR = 1.6) had a more positive attitude toward OHC.

CONCLUSION

Primary care nurses' low level of knowledge in OHC and their positive attitude and willingness to obtain more information point to the need for appropriate OHC training and encouragement for the nurses to promote oral health and prevent dental diseases.