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Does Smoking Hamper Oral Self-Care Among Dental Professionals? JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2015; 12:333-9. [PMID: 26877728 PMCID: PMC4749097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Smoking may impact oral self-care (OSC). This study aimed to analyze the role of smoking in OSC among Iranian dental health professionals. MATERIALS AND METHODS The cross-sectional data were collected at two annual dental meetings and seven randomly selected dental schools in Iran. A total of 1,459 respondents composed of 967 general dental practitioners (GDPs), 229 dental educators (DE), and 263 senior dental students (DS) anonymously completed a self-administered questionnaire inquiring about smoking status and OSC. RESULTS Thirty percent of the male and 12% of the female dental health professionals reported smoking tobacco. There was no difference between their professional status. Women reported better OSC than did men, but only 26% of the women and 17% of the men followed the three most important recommendations for OSC. Smoking was associated with infrequent tooth brushing and flossing, irregular use of fluoride containing toothpaste, consumption of sugary snacks and weak adherence to the recommended OSC guidelines. CONCLUSION Dental health education should place more emphasis on smoking counseling and cessation among dental health professionals.
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Mejàre IA, Klingberg G, Mowafi FK, Stecksén-Blicks C, Twetman SHA, Tranæus SH. A systematic map of systematic reviews in pediatric dentistry--what do we really know? PLoS One 2015; 10:e0117537. [PMID: 25706629 PMCID: PMC4338212 DOI: 10.1371/journal.pone.0117537] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Accepted: 12/26/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To identify, appraise and summarize existing knowledge and knowledge gaps in practice-relevant questions in pediatric dentistry. METHODS A systematic mapping of systematic reviews was undertaken for domains considered important in daily clinical practice. The literature search covered questions in the following domains: behavior management problems/dental anxiety; caries risk assessment and caries detection including radiographic technologies; prevention and non-operative treatment of caries in primary and young permanent teeth; operative treatment of caries in primary and young permanent teeth; prevention and treatment of periodontal disease; management of tooth developmental and mineralization disturbances; prevention and treatment of oral conditions in children with chronic diseases/developmental disturbances/obesity; diagnosis, prevention and treatment of dental erosion and tooth wear; treatment of traumatic injuries in primary and young permanent teeth and cost-effectiveness of these interventions. Abstracts and full text reviews were assessed independently by two reviewers and any differences were solved by consensus. AMSTAR was used to assess the risk of bias of each included systematic review. Reviews judged as having a low or moderate risk of bias were used to formulate existing knowledge and knowledge gaps. RESULTS Out of 81 systematic reviews meeting the inclusion criteria, 38 were judged to have a low or moderate risk of bias. Half of them concerned caries prevention. The quality of evidence was high for a caries-preventive effect of daily use of fluoride toothpaste and moderate for fissure sealing with resin-based materials. For the rest the quality of evidence for the effects of interventions was low or very low. CONCLUSION There is an urgent need for primary clinical research of good quality in most clinically-relevant domains in pediatric dentistry.
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Affiliation(s)
| | - Gunilla Klingberg
- Department of Pediatric Dentistry, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Frida K. Mowafi
- Swedish Council on Health Technology Assessment, Stockholm, Sweden
| | - Christina Stecksén-Blicks
- Department of Odontology, Section for Pediatric Dentistry, Faculty of Medicine, Umeå University, Umeå, Sweden
| | - Svante H. A. Twetman
- Department of Odontology, Section for Cariology, Endodontics, Pediatric Dentistry and Clinical Genetics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sofia H. Tranæus
- Swedish Council on Health Technology Assessment, Stockholm, Sweden
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153
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Huebner CE, Milgrom P. Evaluation of a parent-designed programme to support tooth brushing of infants and young children. Int J Dent Hyg 2015; 13:65-73. [PMID: 25070036 PMCID: PMC4486350 DOI: 10.1111/idh.12100] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study developed and tested an intervention to help parents establish a routine of brushing their young children's teeth twice a day. METHODS Community-based participatory research methods were used to engage parents in the design of the intervention to maximize its relevance and acceptability to others. Input was obtained by interviews and focus groups. The resulting intervention was four 90-min small-group sessions that provided educational information, direct instruction, practice and peer-to-peer problem-solving. A pre- to post-non-randomized design was used to evaluate the intervention's effect to increase or maintain parents' twice daily brushing. RESULTS Intervention participants were 67 primary caregivers of children under six years of age. Of the 67 initial participants, 50 completed a post-intervention questionnaire administered 4 to 8 weeks following the intervention. The proportion of parents who reported brushing their young children's teeth twice a day increased significantly from 59 per cent prior to the intervention to 89 per cent post-intervention (McNemar's X(2) = 10.71, P = 0.002). There were concomitant and statistically significant increases over the study period in parents' confidence for brushing twice a day, attitudes about the importance of brushing and their self-efficacy for tooth brushing. Parents' knowledge of children's oral health, assessed by a 15-item scale developed for this study ('Things to Know About Baby Teeth'), also increased significantly. CONCLUSIONS Twice daily tooth brushing is a low-cost, effective strategy to reduce the risk of childhood caries. As demonstrated here, community-based efforts can help parents achieve this important health behaviour.
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Affiliation(s)
- C E Huebner
- Department of Health Services, University of Washington, Seattle, WA, USA
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154
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Trubey RJ, Moore SC, Chestnutt IG. Children's toothbrushing frequency: the influence of parents' rationale for brushing, habits and family routines. Caries Res 2015; 49:157-64. [PMID: 25634461 DOI: 10.1159/000365152] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 06/09/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To assess the relationship between parental and family factors and children's toothbrushing frequency at different times of day. METHODS A cross-sectional questionnaire survey of predominantly low-socio-economic status parents of children aged 3-6 years (n = 296) in South Wales, UK. Data were collected on the child's weekly toothbrushing frequency (morning and evening), the parents' rationale for brushing their child's teeth in the morning and evening, the strength of a parent's habit for brushing a child's teeth in the morning and evening, and the extent to which the family's daily routines were stable from day to day. Socio-demographic details were also collected. RESULTS Reported weekly brushing frequency was significantly (p < 0.001) higher in the morning (mean ± SD: 6.57 ± 1.37) than the evening (mean ± SD: 5.99 ± 2.15). Parents had significantly (p < 0.001) more interest in the cosmetic benefits of toothbrushing in the morning compared to the evening. Multivariate analysis showed that an increasing focus on the cosmetic benefits of toothbrushing was associated with significantly (p < 0.05) less weekly brushing in the evening. The extent to which brushing a child's teeth was 'habitual' was significantly (p < 0.001) associated with weekly toothbrushing frequency at both times of day. CONCLUSIONS Parents' rationale for brushing their children's teeth can vary at both an individual level and at different times of day. Understanding these variations is important in designing interventions to improve brushing frequency for at-risk children. The results also demonstrate habituation as being an important factor in understanding toothbrushing frequency. Further research is required to understand the mechanisms involved in habit formation and maintenance with children's oral hygiene behaviour.
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Affiliation(s)
- Rob J Trubey
- Violence and Society Research Group, Cardiff University School of Dentistry, Cardiff, UK
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155
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Quach A, Laemmle-Ruff IL, Polizzi T, Paxton GA. Gaps in smiles and services: a cross-sectional study of dental caries in refugee-background children. BMC Oral Health 2015; 15:10. [PMID: 25608733 PMCID: PMC4324800 DOI: 10.1186/1472-6831-15-10] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Accepted: 01/14/2015] [Indexed: 12/04/2022] Open
Abstract
Background Refugees are reported to experience high rates of dental disease, although there are limited data on refugee children. The aim of this study was to report on oral health in refugee-background children in Australia, and to assess their follow-up at dental services. Methods Cross-sectional study of opportunistic oral health screening and subsequent dental service use in refugee-background children attending a refugee health clinic in Victoria, Australia, between November 2006 – November 2010. Results 350 patients (0 – 18 years, mean age 8 years 7 months) had oral health screening; 241 (68.9%) were born overseas, (176 Africa, 65 other countries) and 109 (31.1%) were born in Australia to African-background families. Parents were concerned about oral health in 65/341 (19.1%) children, with specific concern about caries in only 9/341 (2.6%). On assessment, 155/336 (46.1%) had visible caries and 178/345 (51.6%) had caries experience (dmft/DMFT > 0). Where parents were concerned about caries, they were likely to be present (positive predictive value = 100%), however absence of parent concern about caries was not reassuring (negative predictive value = 56.1%). Compared to Australian-born children of African background; African-born children were more likely to be referred for further dental care (adjusted PR 1.33, 95% CI [1.02 – 1.73]), although there was no statistically significant difference in caries prevalence. African-born children were less likely to have caries compared to other overseas-born children (adjusted PR 0.73, 95% CI [0.58 – 0.93]). Overall 187/344 (54.4%) children were referred for further dental care; 91/124 (73.4%) attended any dental appointment. Attendance rates were 90% with a phone reminder system for appointments, attendance reduced when this system lapsed. Conclusions Oral health is an important public health issue in refugee-background children, despite low levels of parent concern and very few parent reported caries. Routine direct oral health assessment is important in refugee-background children and co-ordinated health systems may help improve their attendance at dental services.
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Affiliation(s)
- Alicia Quach
- Department of General Medicine, The Royal Children's Hospital, Melbourne, Australia.
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156
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Rubio FJ, Steel MFJ. Bayesian modelling of skewness and kurtosis with Two-Piece Scale and shape distributions. Electron J Stat 2015. [DOI: 10.1214/15-ejs1060] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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157
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Chong LY, Clarkson JE, Dobbyn-Ross L, Bhakta S. Slow-release fluoride devices for the control of dental decay. Cochrane Database Syst Rev 2014:CD005101. [PMID: 25432017 DOI: 10.1002/14651858.cd005101.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Slow-release fluoride devices have been investigated as a potentially cost-effective method of reducing dental caries in people with high risk of disease. OBJECTIVES To evaluate the effectiveness and safety of different types of slow-release fluoride devices on preventing, arresting, or reversing the progression of carious lesions on all surface types of primary (deciduous) and permanent teeth. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 13 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 7), MEDLINE via Ovid (1946 to 13 August 2014), and EMBASE via Ovid (1980 to 13 August 2014). We searched the US National Institutes of Health Trials Register and the World Health Organization (WHO) International Clinical Trials Registry Platform. We placed no restrictions on the language or date of publication when searching the electronic databases.We first published the review in 2006. The update in 2013 found 302 abstracts, but none of these met the inclusion criteria of the review. SELECTION CRITERIA Parallel randomised controlled trials (RCTs) comparing slow-release fluoride devices with an alternative fluoride treatment, placebo, or no intervention in all age groups. The main outcomes measures sought were changes in numbers of decayed, missing, and filled teeth or surfaces (DMFT/DMFS in permanent teeth or dmft/dmfs in primary teeth), and progression of carious lesions through enamel and into dentine. DATA COLLECTION AND ANALYSIS We conducted data collection and analysis using standard Cochrane review methods. At least two review authors independently performed all the key steps in the review such as screening of abstracts, application of inclusion criteria, data extraction, and risk of bias assessment. We resolved discrepancies through discussions or arbitration by a third or fourth review author. MAIN RESULTS We found no evidence comparing slow-release fluoride devices against other types of fluoride therapy.We found only one double-blind RCT involving 174 children comparing a slow-release fluoride device (glass beads with fluoride were attached to buccal surfaces of right maxillary first permanent molar teeth) against control (glass beads without fluoride were attached to buccal surfaces of right maxillary first permanent molar teeth). This study was assessed to be at high risk of bias. The study recruited children from seven schools in an area of deprivation that had low levels of fluoride in the water. The mean age at the beginning of the study was 8.8 years and at the termination was 10.9 years. DMFT in permanent teeth or dmft in primary teeth was greater than one at the start of the study and greater than one million colony-forming units of Streptococcus mutans per millilitre of saliva.Although 132 children were still included in the trial at the two-year completion point, examination and statistical analysis was performed on only the 63 children (31 in intervention group, 32 in control group) who had retained the beads (retention rate was 47.7% at two years). Among these 63 children, caries increment was reported to be statistically significantly lower in the intervention group than in the control group (DMFT: mean difference -0.72, 95% confidence interval (CI) -1.23 to -0.21; DMFS: mean difference -1.52, 95% CI -2.68 to -0.36 (very low quality evidence)). Although this difference was clinically significant, it only holds true for those children who maintain the fluoride beads; over 50% of children did not retain the beads.Harms were not reported within the trial report. Evidence for other outcomes sought in this review (progression to of caries lesion, dental pain, healthcare utilisation data) were also not reported. AUTHORS' CONCLUSIONS There is insufficeint evidence to determine the caries-inhibiting effect of slow-release fluoride glass beads. The body of evidence available is of very low quality and there is a potential overestimation of benefit to the average child. The applicability of the findings to the wider population is unclear; the study had included children from a deprived area that had low levels of fluoride in drinking water, and were considered at high risk of carries. In addition, the evidence was only obtained from children who still had the bead attached at two years (48% of all available children); children who had lost their slow-release fluoride devices earlier might not have benefited as much from the devices.
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158
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Folayan MO, Adeniyi AA, Chukwumah NM, Onyejaka N, Esan AO, Sofola OO, Orenuga OO. Programme guidelines for promoting good oral health for children in Nigeria: a position paper. BMC Oral Health 2014; 14:128. [PMID: 25331086 PMCID: PMC4216911 DOI: 10.1186/1472-6831-14-128] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 10/10/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The objective of this paper is to draw attention to the oral health needs of children in Nigeria, and promote the use of appropriate interventions for disease prevention in the population. It also evaluates the value of the ongoing twice-daily tooth brushing campaign, which focuses on promoting good periodontal health and its relevance for children in Nigeria. DISCUSSION The main oral health burden for children in Nigeria is untreated dental caries, attributable to low utilization of oral health facilities. While there is a strong association between oral hygiene status and caries occurrence, no research had established an association between frequency of tooth brushing and caries in children in Nigeria. Prevalence of caries and gingivitis is low, despite the fact that a majority of children brush once a day and most of them have fair oral hygiene. Campaigns that promote twice daily brushing to prevent chronic periodontitis in children are not driven by evidences supporting the local epidemic, and therefore cannot be considered as efficient use of the limited resources available. SUMMARY Existing evidences show that the main oral health need of children in Nigeria is the management of untreated caries. Promoting the treatment of caries should be the primary focus of oral health programmes for children in Nigeria, as this would reduce further risks of developing new carious lesions. Public health campaigns should focus efforts at creating demand for oral health care services, for both preventive and curative purposes.
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Affiliation(s)
- Morenike O Folayan
- />Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- />Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
| | - Abiola A Adeniyi
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
- />Department of Preventive Dentistry Lagos State University College of Medicine, Lagos, Nigeria
| | - Nneka M Chukwumah
- />Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
| | - Nneka Onyejaka
- />Department of Child Dental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
| | - Ayodeji O Esan
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
- />Department of Preventive and Community Dentistry, University of Lagos, Lagos, Nigeria
| | - Oyinkan O Sofola
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
- />Department of Preventive and Community Dentistry, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
| | - Omolola O Orenuga
- />Paediatric Dentistry Working Group, Ile-Ife, Nigeria
- />Department of Child Dental Health, University of Lagos, Lagos, Nigeria
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159
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Minihan PM, Morgan JP, Park A, Yantsides KE, Nobles CJ, Finkelman MD, Stark PC, Must A. At-home oral care for adults with developmental disabilities: a survey of caregivers. J Am Dent Assoc 2014; 145:1018-25. [PMID: 25270700 PMCID: PMC4527551 DOI: 10.14219/jada.2014.64] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Little is known about effective at-home oral care methods for people with developmental disabilities (DDs) who are unable to perform personal preventive practices themselves and rely on caregivers for assistance. METHODS A convenience sample of 808 caregivers (84.5 percent paid, 15.5 percent family members) who accompanied adults with DDs (20 years or older) to appointments at a specialized statewide dental care system completed computer-assisted personal interview surveys. The authors used these data to investigate caregivers' at-home oral care experiences and to explore differences between caregivers who were paid and those who were family members. RESULTS Caregivers reported that a high proportion (85 percent) of dentate adults with DDs received assistance with tooth cleaning. They also reported a high prevalence of dental problems, and low adherence to brushing (79 percent) and flossing (22 percent) recommendations. More caregivers reported that they felt confident assisting with brushing than with flossing (85 percent versus 54 percent). Family members and paid caregivers differed with respect to confidence and training. CONCLUSIONS At-home oral care, particularly flossing, presents substantial challenges for adults with DDs. Solutions must be tailored to address the different experiences and distinct needs of the family members and paid caregivers who assist these adults. PRACTICAL IMPLICATIONS Caregivers play an important role in providing at-home oral care, and they must be included in efforts to improve oral health outcomes for people with DDs.
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Affiliation(s)
- Paula M Minihan
- Dr. Minihan is an assistant professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, 136 Harrison Ave., Boston, Mass. 02111, e-mail . Address correspondence to Dr. Minihan
| | - John P Morgan
- Dr. Morgan is an associate professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston
| | - Angel Park
- Ms. Park is a research analyst, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston
| | - Konstantina E Yantsides
- Ms. Yantsides was a research assistant, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, at the time this study was conducted. She now is a senior research coordinator with Tufts University School of Medicine
| | - Carrie J Nobles
- Ms. Nobles was a research assistant, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, at the time this study was conducted. She now is with the University of Massachusetts, Amherst
| | - Matthew D Finkelman
- Dr. Finkelman was an assistant professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston, at the time this study was conducted. He now is with the Clinical and Translational Science Institute at Tufts Medical Center and Tufts University
| | - Paul C Stark
- Dr. Stark is a professor, Department of Public Health and Community Service, Tufts University School of Dental Medicine, Boston
| | - Aviva Must
- Dr. Must is a professor, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston
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160
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Mohebbi SZ, Yazdani R, Sargeran K, Tartar Z, Janeshin A. Midwifery students training in oral care of pregnant patients: an interventional study. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2014; 11:587-95. [PMID: 25628686 PMCID: PMC4290779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 08/04/2014] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Simin Zahra Mohebbi
- Associate Professor, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yazdani
- Associate Professor, Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Katayoun Sargeran
- Assistant Professor, Department of Community Oral Health, School Of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,Corresponding author: K. Sargeran, Department of Community Oral Health, School Of Dentistry, Tehran University of Medical Sciences, Tehran, Iran,
| | - Zeinab Tartar
- Dentist, Tehran University of Medical Sciences, School of Dentistry, Tehran, Iran
| | - Atousa Janeshin
- Dentist, Tehran University of Medical Sciences, School of Dentistry, Tehran, Iran
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161
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Casamassimo PS, Lee JY, Marazita ML, Milgrom P, Chi DL, Divaris K. Improving children's oral health: an interdisciplinary research framework. J Dent Res 2014; 93:938-42. [PMID: 25122218 DOI: 10.1177/0022034514547273] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Despite the concerted efforts of research and professional and advocacy stakeholders, recent evidence suggests that improvements in the oral health of young children in the United States has not followed the prevailing trend of oral health improvement in other age groups. In fact, oral health disparities in the youngest children may be widening, yet efforts to translate advances in science and technology into meaningful improvements in populations' health have had limited success. Nevertheless, the great strides in genomics, biological, behavioral, social, and health services research in the past decade have strengthened the evidence base available to support initiatives and translational efforts. Concerted actions to accelerate this translation and implementation process are warranted; at the same time, policies that can help tackle the upstream determinants of oral health disparities are imperative. This article summarizes the proceedings from the symposium on the interdisciplinary continuum of pediatric oral health that was held during the 43rd annual meeting of the American Association for Dental Research, Charlotte, North Carolina, USA. This report showcases the latest contributions across the interdisciplinary continuum of pediatric oral health research and provides insights into future research priorities and necessary intersectoral synergies. Issues are discussed as related to the overwhelming dominance of social determinants on oral disease and the difficulty of translating science into action.
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Affiliation(s)
- P S Casamassimo
- Division of Pediatric Dentistry and Community Oral Health, The Ohio State University College of Dentistry, Columbus, OH, USA Department of Dentistry, Columbus Nationwide Children's Hospital, Columbus, OH, USA
| | - J Y Lee
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
| | - M L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA Clinical and Translational Science Institute, and Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - P Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - D L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - K Divaris
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC, USA
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162
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Broadbent J. Summary of: An analysis of methods of toothbrushing recommended by dental associations, toothpaste and toothbrush companies and in dental texts. Br Dent J 2014; 217:140-1. [PMID: 25104698 DOI: 10.1038/sj.bdj.2014.680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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163
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Folayan MO, Khami MR, Onyejaka N, Popoola BO, Adeyemo YI. Preventive oral health practices of school pupils in Southern Nigeria. BMC Oral Health 2014; 14:83. [PMID: 25001584 PMCID: PMC4105856 DOI: 10.1186/1472-6831-14-83] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2013] [Accepted: 04/07/2014] [Indexed: 11/28/2022] Open
Abstract
Background One of the goals of the World Health Organisation goal is to ensure increased uptake of preventive oral self-care by 2020. This would require the design public health programmes that will ensure children place premium on preventive oral health care uptake. One effort in that direction is the need for countries to define baseline measures on use of preventive oral self-care measures by their population as well as identify factors that impact on its use. This study aims to determine the prevalence and the impact of age and sex on the use of recommended oral self-care measures by pupils in Southern Nigeria. Methods Pupils age 8 to 16 years (N = 2,676) in two urban sites in Southern Nigeria completed a questionnaire about recommended oral self-care (use of fluoridated toothpaste, flossing, regularity of consuming sugary snacks between main meals), time of the last dental check-up and cigarette smoking habit. Chi square was used to test association between age (8-10years, 11–16 years), sex, and use of recommended oral self-care. Logistic regression analysis was used to determine the predictors of use of recommended oral self-care. Results Only 7.8% of the study population practiced the recommended oral self-care. Older adolescents had an 8.0% increased odds (OR: 1.08; CI:0.81–1.43; p = 0.61) and males had a 20.0% decreased odds (OR: 0.80; CI:0.60-1.06; p = 0.12) of practicing recommended oral self-care though observed differences were not statistically significant. Very few respondents (12.7%) had visited the dental clinic for a check-up in the last one year. Majority of the respondents (92.2%) were non-smokers. Conclusions The use of a combination of oral self-care approaches was very low for this study population. Age and sex were predictive factors for the use of components of the oral self-care measures but not significant predictors of use of recommended oral self-care. Future studies would be required to understand ‘why’ and ‘how’ age and sex impacts on the use of caries preventive oral self-care measures to be able to design effective prevention educational programmes for the study population.
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Affiliation(s)
- Morenike O Folayan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
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Vermaire J, Poorterman J, van Herwijnen L, van Loveren C. A Three-Year Randomized Controlled Trial in 6-Year-Old Children on Caries-Preventive Strategies in a General Dental Practice in the Netherlands. Caries Res 2014; 48:524-33. [DOI: 10.1159/000358342] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 12/31/2013] [Indexed: 11/19/2022] Open
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Levin KA, Nicholls N, Macdonald S, Dundas R, Douglas GVA. Geographic and socioeconomic variations in adolescent toothbrushing: a multilevel cross-sectional study of 15 year olds in Scotland. J Public Health (Oxf) 2014; 37:107-15. [PMID: 24917568 DOI: 10.1093/pubmed/fdu034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND This study examined urban-rural and socioeconomic differences in adolescent toothbrushing. METHODS The data were modelled using logistic multilevel modelling and the Markov Chain Monte Carlo method of estimation. Twice-a-day toothbrushing was regressed upon age, family affluence, family structure, school type, area-level deprivation and rurality, for boys and girls separately. RESULTS Boys' toothbrushing was associated with area-level deprivation but not rurality. Variance at the school level remained significant in the final model for boys' toothbrushing. The association between toothbrushing and area-level deprivation was particularly strong for girls, after adjustment for individuals' family affluence and type of school attended. Rurality too was independently significant with lower odds of brushing teeth in accessible rural areas. CONCLUSION The findings are at odds with the results of a previous study which showed lower caries prevalence among children living in rural Scotland. A further study concluded that adolescents have a better diet in rural Scotland. In total, these studies highlight the need for an examination into the relative importance of diet and oral health on caries, as increases are observed in population obesity and consumption of sugars.
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Affiliation(s)
- K A Levin
- NHSGGC, Public Health Directorate, Gartnavel Royal Hospital, 1055 Great Western Road, G12 0HX, UK Ludwig Boltzmann Institute, Untere Donaustraße 47, 3rd Floor, Vienna A-1020, Austria
| | - N Nicholls
- MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow G2 3QB, UK
| | - S Macdonald
- MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow G2 3QB, UK
| | - R Dundas
- MRC/CSO Social and Public Health Sciences Unit, 200 Renfield Street, Glasgow G2 3QB, UK
| | - G V A Douglas
- Leeds Dental Institute, University of Leeds, Leeds LS2 9LU, UK
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Rothen M, Cunha-Cruz J, Zhou L, Mancl L, Jones JS, Berg J. Oral hygiene behaviors and caries experience in Northwest PRECEDENT patients. Community Dent Oral Epidemiol 2014; 42:526-35. [PMID: 24766464 DOI: 10.1111/cdoe.12107] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Accepted: 03/14/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To investigate the association between oral hygiene behaviors (toothbrushing, water rinsing after brushing, interproximal cleaning, and adjunctive use of fluoride products) and recent caries (past 24 months) in a random sample of patients in Northwest PRECEDENT practices. METHODS Practitioner-members of Northwest PRECEDENT, a dental practice-based research network, conducted a longitudinal study on caries risk assessment. At baseline, patients completed a questionnaire on oral self-care, snacking, health, and socio-demographics. A dental examination recorded readily visible heavy plaque and decayed, missing, and filled teeth; chart review captured new caries and treatments in the previous 24 months. Bivariate and multiple generalized estimating equations (GEE) log-linear regression models stratified by age-groups were used to relate oral hygiene behaviors to the primary outcome of mean dental caries in the past 24 months on data from 1400 patients in 63 practices. The primary exposure of interest was fluoride toothbrushing frequency. RESULTS Fluoride toothbrushing once per day or twice or more per day by patients 9-17 was significantly associated with a 50% lower mean caries rate compared with fluoride toothbrushing less than once per day, after adjustment for covariates [rate ratios (RR) = 0.5; 95% confidence intervals (CI) = 0.3-0.8]. After adjustment, for patients 18-64, fluoride toothbrushing two or more times per day was significantly associated with a 40% lower recent mean caries rate (RR = 0.6; 95% CI = 0.4-0.9); in patients 65+, twice a day or more fluoride toothbrushing was not associated with lower caries rates (RR = 1.1; 95% CI = 0.7-1.8). Of the other oral hygiene variables, after adjustment, patients 18-64 who rinsed with water after brushing had a 40% lower mean caries rate compared with no rinsing (RR = 0.6; 95% CI = 0.4-0.9) and the presence of readily visible heavy plaque was significantly associated with an increase in the mean caries rate for patients 18-64 (RR = 1.6; 95% CI = 1.2-2.2) and 65+ (RR = 2.5; 95% CI = 1.8-3.5). CONCLUSIONS In the present study, the frequency of fluoride toothbrushing and the presence of readily visible heavy plaque were the factors most strongly associated with mean caries rate. In young patients with permanent dentition, the daily application of fluoride toothpaste appears more important than emphasis on thorough plaque removal. While for adults, the protective effect of twice daily fluoride toothbrushing disappears with advancing age and the presence of readily visible heavy plaque becomes increasingly associated with caries risk.
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Affiliation(s)
- Marilynn Rothen
- Regional Clinical Dental Research Center, University of Washington, Seattle, WA, USA
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Milsom KM, Rice A, Kearney-Mitchell P, Kellett L. A review of a child population dental preventive programme in Halton and St Helens. Br Dent J 2014; 216:E18. [DOI: 10.1038/sj.bdj.2014.334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Smaïl-Faugeron V, Fron-Chabouis H, Courson F. Methodological quality and implications for practice of systematic Cochrane reviews in pediatric oral health: a critical assessment. BMC Oral Health 2014; 14:35. [PMID: 24716532 PMCID: PMC4108002 DOI: 10.1186/1472-6831-14-35] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 03/31/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND To ensure evidence-based decision-making in pediatric oral health, Cochrane systematic reviews that address topics pertinent to this field are necessary. We aimed to identify all systematic reviews of paediatric dentistry and oral health by the Cochrane Oral Health Group (COHG), summarize their characteristics and assess their methodological quality. Our second objective was to assess implications for practice in the review conclusions and provide an overview of clinical implications about the usefulness of paediatric oral health interventions in practice. METHODS We conducted a methodological survey including all paediatric dentistry reviews from the COHG. We extracted data on characteristics of included reviews, then assessed the methodological quality using a validated 11-item quality assessment tool (AMSTAR). Finally, we coded each review to indicate whether its authors concluded that an intervention should be implemented in practice, was not supported or was refuted by the evidence, or should be used only in research (inconclusive evidence). RESULTS We selected 37 reviews; most concerned the prevention of caries. The methodological quality was high, except for the assessment of reporting bias. In 7 reviews (19%), the research showed that benefits outweighed harms; in 1, the experimental intervention was found ineffective; and in 29 (78%), evidence was insufficient to assess benefits and harms. In the 7 reviews, topical fluoride treatments (with toothpaste, gel or varnish) were found effective for permanent and deciduous teeth in children and adolescents, and sealants for occlusal tooth surfaces of permanent molars. CONCLUSIONS Cochrane reviews of paediatric dentistry were of high quality. They provided strong evidence that topical fluoride treatments and sealants are effective for children and adolescents and thus should be implemented in practice. However, a substantial number of reviews yielded inconclusive evidence.
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Affiliation(s)
- Violaine Smaïl-Faugeron
- Institut National de la Santé et de la Recherche Médicale, UMR S 872, Equipe 22, Centre de Recherche des Cordeliers, Paris, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Bretonneau, Service d’Odontologie, Paris, France
- Université Paris Descartes - Sorbonne Paris Cité, Faculté de Chirurgie Dentaire, Unité de Recherches Biomatériaux Innovants et Interface EA4462, 1 rue Maurice Arnoux, 92120 Montrouge, France
| | - Hélène Fron-Chabouis
- Université Paris Descartes - Sorbonne Paris Cité, Faculté de Chirurgie Dentaire, Unité de Recherches Biomatériaux Innovants et Interface EA4462, 1 rue Maurice Arnoux, 92120 Montrouge, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Charles Foix, Service d’Odontologie, Ivry-sur-Seine, France
| | - Frédéric Courson
- Assistance Publique-Hôpitaux de Paris, Hôpital Bretonneau, Service d’Odontologie, Paris, France
- Université Paris Descartes - Sorbonne Paris Cité, Faculté de Chirurgie Dentaire, Unité de Recherches Biomatériaux Innovants et Interface EA4462, 1 rue Maurice Arnoux, 92120 Montrouge, France
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Gibbs L, Waters E, de Silva A, Riggs E, Moore L, Armit C, Johnson B, Morris M, Calache H, Gussy M, Young D, Tadic M, Christian B, Gondal I, Watt R, Pradel V, Truong M, Gold L. An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds: a protocol paper for Teeth Tales. BMJ Open 2014; 4:e004260. [PMID: 24622949 PMCID: PMC3963385 DOI: 10.1136/bmjopen-2013-004260] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006-2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia. METHODS AND ANALYSIS This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1-4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe). ETHICS AND DISSEMINATION Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences. TRIAL REGISTRATION NUMBER Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).
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Affiliation(s)
- Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Elizabeth Waters
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Andrea de Silva
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Elisha Riggs
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
- Healthy Mothers Healthy Families Research Group, Murdoch Children's Research Institute, Parkville, Victoria, Australia
| | - Laurence Moore
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, Scotland
| | - Christine Armit
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - Britt Johnson
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Michal Morris
- Centre for Culture, Ethnicity and Health, Richmond, Victoria, Australia
| | - Hanny Calache
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Mark Gussy
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Dana Young
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Maryanne Tadic
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - Bradley Christian
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Iqbal Gondal
- Faculty of Information Technology, Monash University and Pakistan Australia Association Melbourne, Caulfield, Victoria, Australia
| | - Richard Watt
- Epidemiology and Public Health, University College London, London, UK
| | - Veronika Pradel
- Merri Community Health Services, Brunswick, Victoria, Australia
| | - Mandy Truong
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Lisa Gold
- Deakin Health Economics, Deakin University, Burwood, Victoria, Australia
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Limited evidence available for the impact of school-based behavioural interventions on oral health. Evid Based Dent 2014; 14:42-3. [PMID: 23792395 DOI: 10.1038/sj.ebd.6400929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
DATA SOURCES The Cochrane Oral Health Group's Trials Register, and Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, PsycINFO, Current Controlled Trials, ClinicalTrials.gov, Web of Science and Dissertations and Theses via Proquest databases were searched. A number of relevant journals, (Acta Odontologica Scandinavica, ASDC Journal of Dentistry for Children, British Dental Journal, Caries Research, Community Dental Health, Community Dentistry and Oral Epidemiology, Journal of the American Dental Association, Journal of Dental Research, Journal of Public Health Dentistry, Swedish Dental Journal, International Journal of Paediatric Dentistry) not already searched as part of the Cochrane Journal Handsearching Programme were handsearched. There were no restrictions regarding language or date of publication. STUDY SELECTION Randomised controlled trials (RCTs) where randomisation occured at the level of the group (cluster by school and/or class) or individual children were included. Included studies had to include behavioural interventions addressing both toothbrushing and consumption of cariogenic foods or drinks and have a primary school as a focus for delivery of the intervention. DATA EXTRACTION AND SYNTHESIS Two pairs of review authors independently extracted data related to methods, participants, intervention design including behaviour change techniques (BCTs) utilised, outcome measures and risk of bias. A qualitative synthesis was conducted. RESULTS Four studies involving a total of 2302 children were included. One study was at unclear risk of bias and three were at high risk of bias. The studies were heterogeneous in both intervention and outcome measures and also suffered from poor reporting. Only one included study reported caries development as an outcome. This small study at unclear risk of bias showed a prevented fraction of 0.65 (95% confidence interval (CI) 0.12 to 1.18) in the intervention group. However, as this is based on a single study, this finding should be interpreted with caution. All three studies that reported plaque outcomes found statistically significant reduction in plaque in the intervention groups, but due to differences in plaque reporting between studies these could not be combined. Two of these studies included an active home component where parents were given tasks relating to the school oral health programme (games and homework), to complete with their children. Secondary outcome measures from one study reported that the intervention had a positive impact upon children's oral health knowledge. CONCLUSIONS Currently, there is insufficient evidence for the efficacy of primary school-based behavioural interventions for reducing caries. There is limited evidence for the effectiveness of these interventions on plaque outcomes and on children's oral health knowledge acquisition. None of the included interventions were reported as being based on or derived from behavioural theory. There is a need for further high quality research to utilise theory in the design and evaluation of interventions for changing oral health related behaviours in children and their parents.
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Sun FC, Engelman EE, McGuire JA, Kosmoski G, Carratello L, Ricci-Nittel D, Zhang JZ, Schemehorn BR, Gambogi RJ. Impact of an anticaries mouthrinse on in vitro remineralization and microbial control. Int J Dent 2014; 2014:982071. [PMID: 24648842 PMCID: PMC3933167 DOI: 10.1155/2014/982071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Revised: 09/09/2013] [Accepted: 09/15/2013] [Indexed: 11/20/2022] Open
Abstract
Objective. The objective of this research was to evaluate the caries control potential of a new fluoride mouthrinse that also contained antimicrobial agents and a biofilm disrupting agent using different in vitro models. Methods. Four in vitro studies were conducted to assess the performance of this three pronged approach to caries control: (1) traditional enamel fluoride uptake, (2) surface microhardness study using pH cycling model and subsequent fluoride uptake, (3) a salivary biofilm flow-through study to determine the anti-microbial activity, and (4) a single species biofilm model measuring effect on biofilm matrix disruption. Results. The data showed that a LISTERINE rinse with fluoride, essential oils and xylitol was superior in promoting enamel fluoride uptake and in enhancing antimicrobial activity over traditional commercially available fluoridated products. An increase of the surface microhardness was observed when the LISTERINE rinse was used in combination with fluoridated toothpaste versus the fluoridated toothpaste alone. Finally, it was demonstrated that xylitol solutions disrupted and reduced the biovolume of biofilm matrix of mature Streptococcus mutans. Conclusion. These in vitro studies demonstrated that a fluoride mouthrinse with antimicrobial agent and biofilm matrix disrupting agent provided multifaceted and enhanced anti-caries efficacy by promoting remineralization, reducing acidogenic bacteria and disrupting biofilm matrix.
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Affiliation(s)
- Frank C. Sun
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
| | - E. Eric Engelman
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
| | - James A. McGuire
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
| | - Gabrielle Kosmoski
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
| | - Lauren Carratello
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
| | | | - Jane Z. Zhang
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
| | - Bruce R. Schemehorn
- Dental Product Testing, Therametric Technologies, Inc., 9880 Douglas Floyd Parkway, Noblesville, IN, USA
| | - Robert J. Gambogi
- Johnson & Johnson Consumer & Personal Product Worldwide, Skillman, NJ, USA
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Wigen TI, Wang NJ. Tooth brushing frequency and use of fluoride lozenges in children from 1.5 to 5 years of age: a longitudinal study. Community Dent Oral Epidemiol 2014; 42:395-403. [PMID: 24428413 DOI: 10.1111/cdoe.12094] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Accepted: 12/15/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The purpose of the analyses was to study development, stability and changes in oral health behaviour - tooth brushing frequency, use of fluoride lozenges and fluoridated toothpaste in children from 1.5 to 5 years of age - and to study associations between oral health behaviour and family characteristics. METHODS This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and data from the Public Dental Services. A total of 771 children were followed from 1.5 to 5 years of age. Questionnaires regarding oral health behaviour in children were completed by the parents three times during preschool age. RESULTS More than half of the children (52%) had their teeth brushed twice daily at 1.5 years of age, increasing to 61% at 3 years and 76% at 5 years of age. At 1.5 years of age, 37% of the children used fluoride lozenges daily, increasing to 74% at 3 years and 75% at 5 years of age. The majority of the children who had started brushing twice daily and used fluoride lozenges daily at 1.5 years of age continued these behaviours until the age of 5 years. At 1.5 years of age, children who brushed twice daily were more likely to use fluoride lozenges daily than children who brushed less frequently (P = 0.03). Multiple logistic regression showed that the probability of a child having its teeth brushed twice daily continuously during preschool age was higher when both parents were of western origin [odds ratios (OR) 4.0, confidence intervals (CI) 1.3-11.9] than when one or both parents were of non-western origin. Children with one older sibling brushed more frequently (OR 1.4, CI 1.0-1.9) and used fluoride lozenges more often (OR 1.6, CI 1.1-2.2) during preschool age than children without older siblings. CONCLUSIONS Oral health behaviour established in early life was stable during preschool age. The results indicate that tooth brushing frequency and use of fluoride lozenges were not in accordance with the present recommendations based on the scientific literature. The teeth of Norwegian preschoolers were brushed less frequently than recommended, and more children than recommended were using fluoride lozenges.
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Affiliation(s)
- Tove I Wigen
- Department of Paediatric Dentistry and Behavioural Science, Institute of Clinical Dentistry, University of Oslo, Oslo, Norway
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Chi DL, Tut O, Milgrom P. Cluster-randomized xylitol toothpaste trial for early childhood caries prevention. JOURNAL OF DENTISTRY FOR CHILDREN (CHICAGO, ILL.) 2014; 81:27-32. [PMID: 24709430 PMCID: PMC4000539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The purpose of this study was to assess the efficacy of supervised tooth-brushing with xylitol toothpaste to prevent early childhood caries (ECC) and reduce mutans streptococci. METHODS In this cluster-randomized efficacy trial, 196 four- to five-year-old children in four Head Start classrooms in the Marshall Islands were randomly assigned to supervised toothbrushing with 1,400 ppm/31 percent fluoride xylitol or 1,450 ppm fluoride sorbitol toothpaste. We hypothesized that there would be no difference in efficacy between the two types of toothpaste. The primary outcome was the surface-level primary molar caries increment (d(2-3)mfs) after six months. A single examiner was blinded to classroom assignments. Two classrooms were assigned to the fluoride-xylitol group (85 children), and two classrooms were assigned to the fluoride-sorbitol group (83 children). The child-level analyses accounted for clustering. RESULTS There was no difference between the two groups in baseline or end-of-trial mean d(2-3)mfs. The mean d(2-3)mfs increment was greater in the fluoride-xylitol group compared to the fluoride-sorbitol group (2.5 and 1.4 d(2-3)mfs, respectively), but the difference was not significant (95% confidence interval: -0.17, 2.37; P=.07). No adverse effects were reported. CONCLUSION After six months, brushing with a low-strength xylitol/fluoride tooth-paste is no more efficacious in reducing ECC than a fluoride-only toothpaste in a high caries-risk child population.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA.
| | - Ohnmar Tut
- Griffith Health Institute, Griffith University, Gold Coast, Australia
| | - Peter Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, Wash., USA
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Poklepovic T, Worthington HV, Johnson TM, Sambunjak D, Imai P, Clarkson JE, Tugwell P. Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev 2013:CD009857. [PMID: 24353078 DOI: 10.1002/14651858.cd009857.pub2] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Effective oral hygiene is a crucial factor in maintaining good oral health, which is associated with overall health and health-related quality of life. Dental floss has been used for many years in conjunction with toothbrushing for removing dental plaque in between teeth, however, interdental brushes have been developed which many people find easier to use than floss, providing there is sufficient space between the teeth. OBJECTIVES To evaluate the effects of interdental brushing in addition to toothbrushing, as compared with toothbrushing alone or toothbrushing and flossing for the prevention and control of periodontal diseases, dental plaque and dental caries. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 7 March 2013), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 2), MEDLINE via OVID (1946 to 7 March 2013), EMBASE via OVID (1980 to 7 March 2013), CINAHL via EBSCO (1980 to 7 March 2013), LILACS via BIREME (1982 to 7 March 2013), ZETOC Conference Proceedings (1980 to 7 March 2013) and Web of Science Conference Proceedings (1990 to 7 March 2013). We searched the US National Institutes of Health Trials Register (http://clinicaltrials.gov) and the metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/) for ongoing trials to 7 March 2013. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomised controlled trials (including split-mouth design, cross-over and cluster-randomised trials) of dentate adult patients. The interventions were a combination of toothbrushing and any interdental brushing procedure compared with toothbrushing only or toothbrushing and flossing. DATA COLLECTION AND ANALYSIS At least two review authors assessed each of the included studies to confirm eligibility, assessed risk of bias and extracted data using a piloted data extraction form. We calculated standardised mean difference (SMD) and 95% confidence interval (CI) for continuous outcomes where different scales were used to assess an outcome. We attempted to extract data on adverse effects of interventions. Where data were missing or unclear we attempted to contact study authors to obtain further information. MAIN RESULTS There were seven studies (total 354 participants analysed) included in this review. We assessed one study as being low, three studies as being high and three studies as being at unclear risk of bias. Studies only reported the clinical outcome gingivitis and plaque data, with no studies providing data on many of the outcomes: periodontitis, caries, halitosis and quality of life. Three studies reported that no adverse events were observed or reported during the study. Two other studies provided some data on adverse events but we were unable to pool the data due to lack of detail. Two studies did not report whether adverse events occurred. Interdental brushing in addition to toothbrushing, as compared with toothbrushing alone Only one high risk of bias study (62 participants in analysis) looked at this comparison and there was very low-quality evidence for a reduction in gingivitis (0 to 4 scale, mean in control): mean difference (MD) 0.53 (95% CI 0.23 to 0.83) and plaque (0 to 5 scale): MD 0.95 (95% CI 0.56 to 1.34) at one month, favouring of use of interdental brushes. This represents a 34% reduction in gingivitis and a 32% reduction in plaque. Interdental brushing in addition to toothbrushing, as compared with toothbrushing and flossing Seven studies provided data showing a reduction in gingivitis in favour of interdental brushing at one month: SMD -0.53 (95% CI -0.81 to -0.24, seven studies, 326 participants, low-quality evidence). This translates to a 52% reduction in gingivitis (Eastman Bleeding Index). Although a high effect size in the same direction was observed at three months (SMD -1.98, 95% CI -5.42 to 1.47, two studies, 107 participants, very low quality), the confidence interval was wide and did not exclude the possibility of no difference. There was insufficient evidence to claim a benefit for either interdental brushing or flossing for reducing plaque (SMD at one month 0.10, 95% CI -0.13 to 0.33, seven studies, 326 participants, low-quality evidence) and insufficient evidence at three months (SMD -2.14, 95% CI -5.25 to 0.97, two studies, 107 participants very low-quality evidence). AUTHORS' CONCLUSIONS Only one study looked at whether toothbrushing with interdental brushing was better than toothbrushing alone, and there was very low-quality evidence for a reduction in gingivitis and plaque at one month. There is also low-quality evidence from seven studies that interdental brushing reduces gingivitis when compared with flossing, but these results were only found at one month. There was insufficient evidence to determine whether interdental brushing reduced or increased levels of plaque when compared to flossing.
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Affiliation(s)
- Tina Poklepovic
- Department of Research in Biomedicine and Health, School of Medicine, University of Split, Soltanska 2, Split, Croatia, 21 000
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Benson PE, Parkin N, Dyer F, Millett DT, Furness S, Germain P. Fluorides for the prevention of early tooth decay (demineralised white lesions) during fixed brace treatment. Cochrane Database Syst Rev 2013:CD003809. [PMID: 24338792 DOI: 10.1002/14651858.cd003809.pub3] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Demineralised white lesions (DWLs) can appear on teeth during fixed brace treatment because of early decay around the brackets that attach the braces to the teeth. Fluoride is effective in reducing decay in susceptible individuals in the general population. Individuals receiving orthodontic treatment may be prescribed various forms of fluoride treatment. This review compares the effects of various forms of fluoride used during orthodontic treatment on the development of DWLs. This is an update of a Cochrane review first published in 2004. OBJECTIVES The primary objective of this review was to evaluate the effects of fluoride in reducing the incidence of DWLs on the teeth during orthodontic treatment.The secondary objectives were to examine the effectiveness of different modes of fluoride delivery in reducing the incidence of DWLs, as well as the size of lesions. Participant-assessed outcomes, such as perception of DWLs, and oral health-related quality of life data were to be included, as would reports of adverse effects. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 31 January 2013); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12); MEDLINE via OVID (1946 to 31 January 2013); and EMBASE via OVID (1980 to 31 January 2013). SELECTION CRITERIA We included trials if they met the following criteria: (1) parallel-group randomised clinical trials comparing the use of a fluoride-containing product versus placebo, no treatment or a different type of fluoride treatment, in which (2) the outcome of enamel demineralisation was assessed at the start and at the end of orthodontic treatment. DATA COLLECTION AND ANALYSIS At least two review authors independently, in duplicate, conducted risk of bias assessments and extracted data. Authors of trials were contacted to obtain missing data or to ask for clarification of aspects of trial methodology. The Cochrane Collaboration's statistical guidelines were followed. MAIN RESULTS For the 2013 update of this review, three changes were made to the protocol regarding inclusion criteria. Fourteen studies included in the previous version of the review were excluded from this update for the following reasons: five previously included studies were quasi-randomised, a further five were split-mouth studies, three measured outcomes on extracted teeth only and in one, the same fluoride intervention was used in each intervention group of the study.Three studies and 458 participants were included in this updated review. One study was assessed at low risk of bias for all domains, in one study the risk of bias was unclear and in the remaining study, the risk of bias was high.One placebo-controlled study of fluoride varnish applied every six weeks (253 participants, low risk of bias), provided moderate-quality evidence of an almost 70% reduction in DWLs (risk ratio (RR) 0.31, 95% confidence interval (CI) 0.21 to 0.44, P value < 0.001). This finding is considered to provide moderate-quality evidence for this intervention because it has not yet been replicated by further studies in orthodontic participants.One study compared two different formulations of fluoride toothpaste and mouthrinse prescribed for participants undergoing orthodontic treatment (97 participants, unclear risk of bias) and found no difference between an amine fluoride and stannous fluoride toothpaste/mouthrinse combination and a sodium fluoride toothpaste/mouthrinse combination for the outcomes of white spot index, visible plaque index and gingival bleeding index.One small study (37 participants) compared the use of an intraoral fluoride-releasing glass bead device attached to the brace versus a daily fluoride mouthrinse. The study was assessed at high risk of bias because a substantial number of participants were lost to follow-up, and compliance with use of the mouthrinse was not measured.Neither secondary outcomes of this review nor adverse effects of interventions were reported in any of the included studies. AUTHORS' CONCLUSIONS This review found some moderate evidence that fluoride varnish applied every six weeks at the time of orthodontic review during treatment is effective, but this finding is based on a single study. Further adequately powered, double-blind, randomised controlled trials are required to determine the best means of preventing DWLs in patients undergoing orthodontic treatment and the most accurate means of assessing compliance with treatment and possible adverse effects. Future studies should follow up participants beyond the end of orthodontic treatment to determine the effect of DWLs on participant satisfaction with treatment.
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Affiliation(s)
- Philip E Benson
- Academic Unit of Oral Health and Development, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK, S10 2TA
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Outcome of a Community-Based Oral Health Promotion Project on Primary Schoolchildren's Oral Hygiene Habits. Int J Dent 2013; 2013:485741. [PMID: 24319461 PMCID: PMC3844209 DOI: 10.1155/2013/485741] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Revised: 08/23/2013] [Accepted: 09/16/2013] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the effect of a school-based intervention project conducted in a mid-sized Finnish city, Laukaa on schoolchildren's oral health behavior. Material and Methods. In the intervention, all children received dental education and some of the 7–12-year-old schoolchildren received individual tooth brushing instructions by a dental nurse in 2009-2010. Parents were present at the instruction sessions. In 2009 and 2010, all the children answered a questionnaire or an oral hygienist on their oral health behavior without identification. Results. Tooth brushing frequency increased significantly among the schoolchildren between the years 2009 (61.2%) and 2010 (65%) (P < 0.05); more so among younger children (7–10-year-olds) compared to the older ones (11-12-year-olds). The 2010 results showed a slight trend of decreasing tooth brushing frequency by age both among girls and boys. Younger children got significantly more often parental help or reminding. The girls brushed their teeth significantly more frequently (71.9%) than boys (57.0%). Conclusions. Our findings indicate that oral health intervention can be beneficial on health behavior especially for children at low grades. All children, 11 to 12 years of age, especially boys, need continuous health promotion.
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177
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Churchley D, Schemehorn BR. In vitro assessment of a toothpaste range specifically designed for children. Int Dent J 2013; 63 Suppl 2:57-63. [DOI: 10.1111/idj.12083] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
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Raj S, Goel S, Sharma VL, Goel NK. Short-term impact of oral hygiene training package to Anganwadi workers on improving oral hygiene of preschool children in North Indian City. BMC Oral Health 2013; 13:67. [PMID: 24279468 PMCID: PMC4222748 DOI: 10.1186/1472-6831-13-67] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Accepted: 11/19/2013] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Globally, dental caries is categorized in the list of public health problems in preschool children. In India, lack of availability and affordability of oral health enhances the cost of treatment and care. Empowering community workers like Anganwadi workers (AWWs) in oral health, and providing basic oral health awareness to the mothers through them can be feasible model. So, the present study was conducted to evaluate the short-term impact of Oral Hygiene Training Package (OHTP) to AWWs on improving oral hygiene of preschool children. METHODS This before and after comparison field trial was done in Anganwadi centres (AWCs) of Chandigarh city, India. 534 children aged 36-72 months attending 21 AWCs were examined before and after imparting trainings to AWWs. OHTP was administered to AWWs, which consisted of power-point presentation and demonstrated the skills like proper brushing technique, plaque disclosure, flossing technique, gum massaging etc. The AWWs later imparted training to mothers in their respective AWCs. Post intervention data was collected after three months.Outcome measures were improvement in oral health status (plaque, debris, gingival health), oral habits (brushing, rinsing) and decrease in caries activity (Snyder test). RESULTS Prevalence of dental caries was found to be 48.3%. Only 4.1% of the population reported brushing twice which increased significantly to 9.9% post-intervention (p = 0.000). There was a significant decrease in debris (78.3% to 54.1%), and stage-1 plaque (75.5 to 66.5%) in the oral cavity. Caries activity by Snyder's test decreased from 48.2% to 31.2% (p = 0.01) post-intervention. CONCLUSIONS Controlled trials of using AWWs to improve oral hygiene appear to be justified. TRIAL REGISTRATION CTRI/2012/07/002786.
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Affiliation(s)
- Sonika Raj
- Centre for Public Health, Panjab University, Sector 14, Chandigarh 160014, India
| | - Sonu Goel
- School of Public Health, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India
| | - Vijay Lakshmi Sharma
- Centre for Public Health, Panjab University, Sector 14, Chandigarh 160014, India
| | - Naveen Krishan Goel
- Department of Community Medicine, Government Medical College and Hospital, Sector 32, Chandigarh 160035, India
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Kraivaphan P, Amornchat C, Triratana T, Mateo LR, Ellwood R, Cummins D, DeVizio W, Zhang YP. Two-year caries clinical study of the efficacy of novel dentifrices containing 1.5% arginine, an insoluble calcium compound and 1,450 ppm fluoride. Caries Res 2013; 47:582-90. [PMID: 23988908 DOI: 10.1159/000353183] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Accepted: 05/22/2013] [Indexed: 11/19/2022] Open
Abstract
A 2-year double-blind randomized three-treatment controlled parallel-group clinical study compared the anti-caries efficacy of two dentifrices containing 1.5% arginine, an insoluble calcium compound (di-calcium phosphate or calcium carbonate) and 1,450 ppm fluoride (F), as sodium monofluorophosphate, to a control dentifrice containing 1,450 ppm F, as sodium fluoride, in a silica base. The 6,000 participants were from Bangkok, Thailand and aged 6-12 years initially. They were instructed to brush twice daily, in the morning and evening, with their randomly assigned dentifrice. Three trained and calibrated dentists examined the children at baseline and after 1 and 2 years using the National Institute of Dental Research Diagnostic Procedures and Criteria. The number of decayed, missing and filled teeth (DMFT) and surfaces (DMFS) for the three study groups were very similar at baseline, with no statistically significant differences among groups. After 1 year, there were no statistically significant differences in caries increments among the three groups. After 2 years, the two groups using the dentifrices containing 1.5% arginine, an insoluble calcium compound and 1,450 ppm F had statistically significantly (p < 0.02) lower DMFT increments (21.0 and 17.7% reductions, respectively) and DMFS increments (16.5 and 16.5%) compared to the control dentifrice. The differences between the two groups using the new dentifrices were not statistically significant. The results of this pivotal clinical study support the conclusion that dentifrices containing 1.5% arginine, an insoluble calcium compound and 1,450 ppm F provide significantly greater protection against caries lesion cavitation, in a low to moderate caries risk population, than dentifrices containing 1,450 ppm F alone.
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Affiliation(s)
- P Kraivaphan
- Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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180
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Bonnot J, Pillon F. Revue des prescriptions odontologiques à l’officine. ACTUALITES PHARMACEUTIQUES 2013. [DOI: 10.1016/j.actpha.2013.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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181
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Weber-Gasparoni K, Warren JJ, Reeve J, Drake DR, Kramer KWO, Marshall TA, Dawson DV. An effective psychoeducational intervention for early childhood caries prevention: part II. Pediatr Dent 2013; 35:247-251. [PMID: 23756309 PMCID: PMC4870833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The purpose was to compare whether mothers exposed to an autonomy-supportive psychoeducational videotaped message, informed by self-determination theory (SDT), demonstrated greater changes in behavior concerning their children's oral health than mothers exposed to a neutral message delivered by brochure. METHODS Data were collected at baseline, one- and six-month follow-ups from 415 12- to 49-month-old WIC-enrolled children and their mothers: 283 in the video intervention group and 132 in the brochure control group. Mothers completed questionnaires regarding their child's dietary/oral hygiene habits. Chi-square, Wilcoxon Signed Rank, Mann-Whitney, and McNemar tests were used to analyze data (P<0.05). RESULTS Significantly more positive changes were observed for dietary/oral hygiene behaviors among the intervention group mothers at one- and six-month follow-ups than for the controls. Significantly fewer mothers in the intervention group shared dining ware with their child at both one- (P=0.0046) and six-month follow-ups (P<0.0001); this practice was decreased only at six-months for the control group mothers (P=0.05). Restricting consideration only to mothers who were not checking for white spot lesions at baseline, a significantly greater proportion of mothers in the intervention group performed this behavior at six-months (P=0.0044). CONCLUSIONS Data provided evidence of the effectiveness of the SDT videotaped oral health message relative to a neutral brochure.
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Affiliation(s)
- Karin Weber-Gasparoni
- Department of Pediatric Dentistry, College of Dentistry, the University of Iowa, Iowa City, Iowa, USA.
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182
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Global oral public health--the current situation and recent developments. J Public Health Policy 2013; 33:382-6. [PMID: 22895505 DOI: 10.1057/jphp.2012.22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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183
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Modesto A, Klein O, Tenuta LMA, Gerlach RF, Vieira AR. Summary of the IADR Cariology Research, Craniofacial Biology, and Mineralized Tissue Groups Symposium, Iguaçu Falls, Brazil, June 2012: Gene-environment Interactions and Epigenetics in Oral Diseases: Enamel Formation and its Clinical Impact on Tooth Defects, Caries, and Erosion. DENTISTRY 3000 2013; 1:http://dentistry3000.pitt.edu/ojs/index.php/dentistry3000/article/view/16/17. [PMID: 25392764 PMCID: PMC4225817 DOI: 10.5195/d3000.2013.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Characteristics of enamel may influence or modulate individual susceptibility to caries and erosion. These characteristics are defined during development, which is under strict genetic control, but can easily be modified in many ways by environmental factors. In the symposium, translational aspects of embryology, biochemistry, and genetics of amelogenesis were presented. The symposium provided unique insight into how basic sciences integrate with clinically relevant problems. The need for improved understanding of risks at the individual level, taking into consideration both environmental exposures and genetic background, was presented. The symposium was divided into four stepwise and interconnected topics as follows: 1) The Many Faces of Enamel Development; 2) Enamel Pathogenesis: Biochemistry Lessons; 3) Environmental Factors on Enamel Formation; and, 4) Genetic Variation in Enamel Formation Genes.
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Affiliation(s)
- Adriana Modesto
- University of Pittsburgh, School of Dental Medicine, Pittsburgh, PA, USA
| | - Ophir Klein
- University of California, School of Dentistry, San Francisco, CA, USA
| | - Livia M A Tenuta
- University of Campinas, Piracicaba Dental School, Piracicaba, SP, Brazil
| | | | - Alexandre R Vieira
- University of Pittsburgh, School of Dental Medicine, Pittsburgh, PA, USA
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Zamataro CB, Tenuta LMA, Cury JA. Low-fluoride dentifrice and the effect of post-brushing rinsing on fluoride availability in saliva. Eur Arch Paediatr Dent 2012; 9:90-3. [DOI: 10.1007/bf03262616] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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185
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Caries prevention with fluoride toothpaste in children: an update. Eur Arch Paediatr Dent 2012; 10:162-7. [DOI: 10.1007/bf03262678] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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186
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Itthagarun A, Thaveesangpanich P, King NM, Tay FR, Wefel JS. Effects of different amounts of a low fluoride toothpaste on primary enamel lesion progression: a preliminary study using in vitro pH-cycling system. Eur Arch Paediatr Dent 2012; 8:69-73. [PMID: 17394894 DOI: 10.1007/bf03262573] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIMS To evaluate and compare the efficacy of pea and half-pea portions of child formula fluoride (500 ppm) toothpaste on artificially created enamel lesions in primary teeth. METHODS Sound primary incisors were painted with nail varnish, leaving a 1 mm wide window and then placed in a demineralising solution for 96 h to produce artificial carious lesions 60-100 microm deep. The teeth were longitudinally sectioned (100 microm thick) and divided into 3 groups. Group A: treated with a pea-sized portion of a non-fluoride containing toothpaste (1:3, toothpaste: deionized water), while Groups B and C were treated with half-pea-sized and pea-sized portions of a 500 ppm fluoride containing toothpaste, respectively. The pH-cycling model was utilized for 7 days. RESULTS Groups A and B lesions increased in depth by 60% while those in Group C increased by 19%. The mineral content of the surface zone decreased significantly in Groups A and B but not in Group C. CONCLUSION Reduction of the amount of fluoride toothpaste to less than a pea-size in order to minimize the risk of fluorosis should be undertaken with caution because it may compromise the cariostatic effects of the toothpaste.
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Affiliation(s)
- A Itthagarun
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR.
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187
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Watt RG, Carter N, Gregory S, Cockcroft B, Makhani S, Dyer T, Davies G, Richards D, Thomas D, Milsom K. General and vague. Br Dent J 2012; 213:540-1; author reply 541. [DOI: 10.1038/sj.bdj.2012.1093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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188
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Monse B, Heinrich-Weltzien R, Mulder J, Holmgren C, van Palenstein Helderman WH. Caries preventive efficacy of silver diammine fluoride (SDF) and ART sealants in a school-based daily fluoride toothbrushing program in the Philippines. BMC Oral Health 2012; 12:52. [PMID: 23171244 PMCID: PMC3549940 DOI: 10.1186/1472-6831-12-52] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2011] [Accepted: 10/31/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to caries.The objective of the study was to assess and compare the effect of a single application of 38% SDF with ART sealants and no treatment in preventing dentinal (D3) caries lesions on occlusal surfaces of permanent first molars of school children who participated in a daily school-based toothbrushing program with fluoride toothpaste. METHODS The prospective community clinical trial in the Philippines was conducted over a period of 18 months and included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based fluoride toothpaste brushing program. Children were randomly assigned for SDF application or ART sealant treatment. Children from two of the eight schools did not receive SDF or ART sealant treatment and served as controls. SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars. Surfaces that were originally defined as sound at baseline but which changed to dentinal (D3) caries lesions were defined as surfaces with new caries (caries increment). Non-compliance to the daily toothbrushing program in three schools offered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste brushing and in non-toothbrushing children. RESULTS In the brushing group, caries increment in the SDF treatment group was comparable with the non-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a statistically significant lower hazard ratio of 0.12 (0.02-0.61). In the non-brushing group, caries increment in the SDF treatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only statistically significant for the sealant group (HR 0.33; 0.20-0.54). Caries increment was lower in toothbrushing children than in non-toothbrushing children. Hazard ratios reached statistical significance for the non-treated children (HR 0.43; 0.21-0.87) and the sealant-treated children (HR 0.15; 0.03-0.072). CONCLUSIONS A one-time application of 38% SDF on the occlusal surfaces of permanent first molars of six- to eight-year-old children is not an effective method to prevent dentinal (D3) caries lesions. ART sealants significantly reduced the onset of caries over a period of 18 months. TRIAL REGISTRATION NUMBER German Clinical Trial Register DRKS00003427.
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Affiliation(s)
- Bella Monse
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, GIZ Office Manila, PDCP Bank Centre, V,A, Rufino cor, L,P, Leviste Str, Makati City, Metro Manila, Philippines.
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Blinkhorn F, Brown N, Freeman R, Humphris G, Martin A, Blinkhorn A. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries. BMC Public Health 2012; 12:681. [PMID: 22909327 PMCID: PMC3520707 DOI: 10.1186/1471-2458-12-681] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Accepted: 08/14/2012] [Indexed: 11/22/2022] Open
Abstract
Background Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. Methods/Design This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. Discussion The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. Trial registration ACTRN12612000712808
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Affiliation(s)
- Fiona Blinkhorn
- School of Health Sciences, University of Newcastle, Ourimbah, New South Wales 2258, Australia
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Evans D. Some evidence that one-to-one dietary interventions in the dental setting can change behaviour. Evid Based Dent 2012; 13:42. [PMID: 22722410 DOI: 10.1038/sj.ebd.6400855] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
DATA SOURCES The Cochrane Oral Health Group Trials Register CENTRAL, Medline, Embase, PsycINFO, CINAHL, Web of Science conference proceedings (IADR and ORCA), reference lists and Dissertations Abstracts were searched. STUDY SELECTION Randomised controlled trials assessing the effectiveness of 1:1 dietary interventions in a dental care setting were included. This could be brief advice, skills training, self help materials, counselling or lifestyle strategies delivered by any member of the dental team. DATA EXTRACTION AND SYNTHESIS Two reviewers independently screened and abstracted data with disagreements resolved by discussion and a third review author. The Cochrane risk of bias assessment tool was used. RESULTS Five studies were included; two were at high risk of bias, three were at unclear risk of bias. Two were multi-intervention studies where the dietary intervention was one component of a wider programme of prevention, but where data on dietary behaviour change were reported. One of the single intervention studies concerned caries prevention. The others concerned general health outcomes. No studies were aimed at preventing tooth erosion. Four out of five studies found a significant change in dietary behaviour in at least one of the primary outcomes. CONCLUSIONS There is some evidence that one-to-one dietary interventions in the dental setting can change behaviour, although the evidence is greater for interventions aiming to change fruit/vegetable and alcohol consumption than for those aiming to change dietary sugar consumption. There is a need for more studies, particularly in the dental practice setting, as well as greater methodological rigour in the design, statistical analysis and reporting of such studies.
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Affiliation(s)
- Dafydd Evans
- Dental School, University of Dundee, Dundee, Scotland, UK
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191
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Vibhute A, Vandana KL. The effectiveness of manual versus powered toothbrushes for plaque removal and gingival health: A meta-analysis. J Indian Soc Periodontol 2012; 16:156-60. [PMID: 23055578 PMCID: PMC3459492 DOI: 10.4103/0972-124x.99255] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2009] [Accepted: 11/28/2011] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The aim of this systematic review and associated meta-analysis was to compare manual and powered brushes in relation to the removal of plaque and gingival health. Stain removal, adverse effects and microbiological evaluation cost were also considered. MATERIALS AND METHODS To be included in the review, a trial had to be a randomized-controlled trial (RCT) comparing manual and powered brushes. Trials confined to comparing different types of powered or different types of manual brushes were excluded. Split mouth designs were eligible. Trials with subjects of specific age group (18-25 years) were included. The primary outcomes were plaque and gingival health with data defined as short-term (0-28 days) duration were analyzed. Powered brushes were categorized into three groups depending on mode of action. Numerical data extracted were checked by a fourth reviewer for accuracy. RESULTS Three trials with full articles were identified. These include trials published between 2002 and 2005. The trials involved 56 subjects at baseline, without loss of subject for follow up. Powered brushes reduced plaque and gingivitis at least as effectively as manual brushing. Ionic brushes statistically significantly reduced plaque and gingivitis. CONCLUSION In general there was no evidence of a statistically significant difference between powered and manual brushes. However, ionic brushes significantly reduce plaque and gingivitis in both the short-term evaluations. The clinical significance of this reduction is not known. Observation of methodological guidelines and greater standardization of design would benefit both future trials and meta-analyses.
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Affiliation(s)
- Akshay Vibhute
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
| | - K. L. Vandana
- Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India
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Catteau C, Trentesaux T, Delfosse C, Rousset MM. [Consumption of fruit juices and fruit drinks: impact on the health of children and teenagers, the dentist's point of view]. Arch Pediatr 2011; 19:118-24. [PMID: 22206891 DOI: 10.1016/j.arcped.2011.11.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 08/25/2011] [Accepted: 11/23/2011] [Indexed: 10/14/2022]
Abstract
OBJECTIVES The French dietary guidelines published in 2001 recommend daily consumption of 5 portions of fruit or vegetable. Despite this advice, the consumption of fruit in France, especially in the north of France, is low, whereas sale of 100% fruit juices, fruit drinks, and fruit-flavored beverages is increasing. The impact of contemporary changes in beverage patterns on dental caries has received less attention than the impact on childhood obesity. Nevertheless, the cariogenic potential of soft drinks is known. Drinking fruit juices, fruit drinks, or fruit-flavored beverages over a long period of time and continuous sipping could therefore be harmful for the teeth. The aim of this study was to examine the sugar content of such beverages. METHODOLOGY Four different major supermarkets were visited to select a representative sample of beverages for sale. Fruit juices, nectars, fruit drinks (water and fruit juices) and fruit-flavored waters were included. Lemonades, teas, and drinks containing artificial sweetener were not included. The data were collected in April 2010 by reading nutrition labels. The variables studied were the sugar content (g/100mL), the presence of added sugar, and the percentage of fruit juices. A descriptive analysis of the variables studied was conducted. The mean sugar content of the French population's favorite juices (orange, grapefruit, pineapple, apple, and grape) was compared to the sugar content of a corresponding 100-g portion of fresh fruit. The data were processed using Microsoft Excel. RESULTS Hundred and eighty-seven different beverages were analyzed: 89 fruit juices, 26 nectars, 51 fruit drinks (sparkling or flat), and 21 fruit-flavored waters. Unlike fruit-flavored waters, nectars and fruit drinks contained fruit juices. Nectars and fruit drinks contained an average of 44.5% (± 10.7%) and 10.5% (± 3.8%) fruit juice, respectively. The sugar content varied from 0 g/100mL to 17.5 g/100mL. The average sugar content was 2.4 (± 2.1) g/100mL, 8.8 (± 2.3) g/100mL, 10.7 (± 1.9) g/100mL, and 10.8 (± 1) g/100mL for fruit-flavored waters, fruit drinks, fruit juices, and nectars, respectively. High sugar content was reported for grape juice, with an average of 15.6 (± 1.9) g/100mL. Nectars, fruit drinks, and 71.4% of fruit-flavored waters contained added sugar. CONCLUSION These beverages are rich in sugar and labels should better inform consumers on the sugar content. Dental caries is a chronic disease of childhood, which has common risk factors with obesity. General practitioners, dieticians, and dentists must work together to provide preventive guidance: fruit juice intake has to be limited and other beverages restricted to occasional use; fruit juice may contribute to only one portion of the recommended five a day.
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Affiliation(s)
- C Catteau
- Département santé publique, faculté de chirurgie dentaire, université Lille-2, place de Verdun, 59000 Lille, France.
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Tubert‐Jeannin S, Auclair C, Amsallem E, Tramini P, Gerbaud L, Ruffieux C, Schulte AG, Koch MJ, Rège‐Walther M, Ismail A. Fluoride supplements (tablets, drops, lozenges or chewing gums) for preventing dental caries in children. Cochrane Database Syst Rev 2011; 2011:CD007592. [PMID: 22161414 PMCID: PMC6876544 DOI: 10.1002/14651858.cd007592.pub2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Dietary fluoride supplements were first introduced to provide systemic fluoride in areas where water fluoridation is not available. Since 1990, the use of fluoride supplements in caries prevention has been re-evaluated in several countries. OBJECTIVES To evaluate the efficacy of fluoride supplements for preventing dental caries in children. SEARCH METHODS We searched the Cochrane Oral Health Group's Trials Register (to 12 October 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3), MEDLINE via OVID (1950 to 12 October 2011), EMBASE via OVID (1980 to 12 October 2011), WHOLIS/PAHO/MEDCARIB/LILACS/BBO via BIREME (1982 to 12 October 2011), and Current Controlled Trials (to 12 October 2011). We handsearched reference lists of articles and contacted selected authors. SELECTION CRITERIA We included randomised or quasi-randomised controlled trials comparing, with minimum follow-up of 2 years, fluoride supplements (tablets, drops, lozenges) with no fluoride supplement or with other preventive measures such as topical fluorides in children less than 16 years of age at the start. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces (DMFS). DATA COLLECTION AND ANALYSIS Two review authors, independently and in duplicate, assessed the eligibility of studies for inclusion, and carried out risk of bias assessment and data extraction. In the event of disagreement, we sought consensus and consulted a third review author. We contacted trial authors for missing information. We used the prevented fraction (PF) as a metric for evaluating the efficacy of the intervention. The PF is defined as the mean caries increment in controls minus mean caries increment in the treated group divided by mean caries increment in controls. We conducted random-effects meta-analyses when data could be pooled. We assessed heterogeneity in the results of the studies by examining forest plots and by using formal tests for homogeneity. We recorded adverse effects (fluorosis) when the studies provided relevant data. MAIN RESULTS We included 11 studies in the review involving 7196 children.In permanent teeth, when fluoride supplements were compared with no fluoride supplement (three studies), the use of fluoride supplements was associated with a 24% (95% confidence interval (CI) 16 to 33%) reduction in decayed, missing and filled surfaces (D(M)FS). The effect of fluoride supplements was unclear on deciduous or primary teeth. In one study, no caries-inhibiting effect was observed on deciduous teeth while in another study, the use of fluoride supplements was associated with a substantial reduction in caries increment.When fluoride supplements were compared with topical fluorides or with other preventive measures, there was no differential effect on permanent or deciduous teeth.The review found limited information on the adverse effects associated with the use of fluoride supplements. AUTHORS' CONCLUSIONS This review suggests that the use of fluoride supplements is associated with a reduction in caries increment when compared with no fluoride supplement in permanent teeth. The effect of fluoride supplements was unclear on deciduous teeth. When compared with the administration of topical fluorides, no differential effect was observed. We rated 10 trials as being at unclear risk of bias and one at high risk of bias, and therefore the trials provide weak evidence about the efficacy of fluoride supplements.
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Affiliation(s)
- Stéphanie Tubert‐Jeannin
- Faculty of Dentistry, CHU of Clermont‐Ferrand, University of AuvergneDental Public Health11 Boulevard Charles de GaulleClermont‐FerrandFrance63000
| | - Candy Auclair
- Hotel Dieu ‐ CHU of Clermont‐Ferrand, University of AuvergnePublic HealthBd Leon MalfreyClermont‐FerrandFrance63003
| | - Emmanuel Amsallem
- CETAFQuality ‐ Evaluation ‐ Etudes67‐69 Avenue de Rochetaillée ‐ BP 167Saint‐Etienne Cedex 02France42012
| | - Paul Tramini
- Faculty of DentistryPublic Health545 Avenue du Professeur Jean Louis VialaMontpellierFrance34193 Cedex 5
| | - Laurent Gerbaud
- Hotel Dieu ‐ CHU of Clermont‐Ferrand, University of AuvergnePublic HealthBd Leon MalfreyClermont‐FerrandFrance63003
| | - Christiane Ruffieux
- Institute of Social and Preventive MedicineHealth Care Evaluation Unit & Clinical Epidemiology CentreCentre Hospitalier Vaudois and University of LausanneBugnon 17LausanneSwitzerlandCh‐1005
| | - Andreas G Schulte
- Witten/Herdecke UniversityAlfred‐Herrhausen‐Straße 50WittenGermany58448
| | - Martin J Koch
- Heidelberg University Dental SchoolDepartment of Conservative DentistryUniverität Heidelberg Im Neuenheimer Feld 400HeidelbergGermany69120
| | - Myriam Rège‐Walther
- University of LausanneCenter for Primary Care and Public HealthBiopôle 2Route de la Corniche 10LausanneSwitzerland1010
| | - Amid Ismail
- Kornberg School of Dental Medicine, Temple University3223 North Broad StreetPhiladelphiaPennsylvaniaUSAPA 19140 5007
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195
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Sambunjak D, Nickerson JW, Poklepovic T, Johnson TM, Imai P, Tugwell P, Worthington HV. Flossing for the management of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev 2011:CD008829. [PMID: 22161438 DOI: 10.1002/14651858.cd008829.pub2] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Good oral hygiene is thought to be important for oral health. This review is to determine the effectiveness of flossing in addition to toothbrushing for preventing gum disease and dental caries in adults. OBJECTIVES To assess the effects of flossing in addition to toothbrushing, as compared with toothbrushing alone, in the management of periodontal diseases and dental caries in adults. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 17 October 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4), MEDLINE via OVID (1950 to 17 October 2011), EMBASE via OVID (1980 to 17 October 2011), CINAHL via EBSCO (1980 to 17 October 2011), LILACS via BIREME (1982 to 17 October 2011), ZETOC Conference Proceedings (1980 to 17 October 2011), Web of Science Conference Proceedings (1990 to 17 October 2011), Clinicaltrials.gov (to 17 October 2011) and the metaRegister of Controlled Clinical Trials (to 17 October 2011). We imposed no restrictions regarding language or date of publication. We contacted manufacturers of dental floss to identify trials. SELECTION CRITERIA We included randomised controlled trials conducted comparing toothbrushing and flossing with only toothbrushing, in adults. DATA COLLECTION AND ANALYSIS Two review authors independently assessed risk of bias for the included studies and extracted data. We contacted trial authors for further details where these were unclear. The effect measure for each meta-analysis was the standardised mean difference (SMD) with 95% confidence intervals (CI) using random-effects models. We examined potential sources of heterogeneity, along with sensitivity analyses omitting trials at high risk of bias. MAIN RESULTS Twelve trials were included in this review, with a total of 582 participants in flossing plus toothbrushing (intervention) groups and 501 participants in toothbrushing (control) groups. All included trials reported the outcomes of plaque and gingivitis. Seven of the included trials were assessed as at unclear risk of bias and five were at high risk of bias.Flossing plus toothbrushing showed a statistically significant benefit compared to toothbrushing in reducing gingivitis at the three time points studied, the SMD being -0.36 (95% CI -0.66 to -0.05) at 1 month, SMD -0.41 (95% CI -0.68 to -0.14) at 3 months and SMD -0.72 (95% CI -1.09 to -0.35) at 6 months. The 1-month estimate translates to a 0.13 point reduction on a 0 to 3 point scale for Loe-Silness gingivitis index, and the 3 and 6 month results translate to 0.20 and 0.09 reductions on the same scale.Overall there is weak, very unreliable evidence which suggests that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 or 3 months.None of the included trials reported data for the outcomes of caries, calculus, clinical attachment loss, or quality of life. There was some inconsistent reporting of adverse effects. AUTHORS' CONCLUSIONS There is some evidence from twelve studies that flossing in addition to toothbrushing reduces gingivitis compared to toothbrushing alone. There is weak, very unreliable evidence from 10 studies that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 and 3 months. No studies reported the effectiveness of flossing plus toothbrushing for preventing dental caries.
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Affiliation(s)
- Dario Sambunjak
- Department of Research in Biomedicine and Health, University of Split School of Medicine, Soltanska 2, Split, Croatia, 21 000
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Kommentar. Monatsschr Kinderheilkd 2011. [DOI: 10.1007/s00112-011-2471-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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197
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Tickle M, Milsom KM, Donaldson M, Killough S, O'Neill C, Crealey G, Sutton M, Noble S, Greer M, Worthington HV. Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services. BMC Oral Health 2011; 11:27. [PMID: 21985746 PMCID: PMC3196725 DOI: 10.1186/1472-6831-11-27] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2011] [Accepted: 10/10/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries is a persistent public health problem with little change in the prevalence in young children over the last 20 years. Once a child contracts the disease it has a significant impact on their quality of life. There is good evidence from Cochrane reviews including trials that fluoride varnish and regular use of fluoride toothpaste can prevent caries. The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children. METHODS/DESIGN A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit). 1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental questionnaires. DISCUSSION This is a pragmatic trial conducted in general dental practice. It tests a composite caries prevention intervention, which represents an evidence based approach advocated by current guidance from the English Department of Health which is feasible to deliver to all low risk (caries free) children in general dental practice. The trial will provide valuable information to policy makers and clinicians on the costs and effects of caries prevention delivered to young children in general dental practice. TRIAL REGISTRATION EudraCT No: 2009 - 010725 - 39 ISRCTN: ISRCTN36180119 Ethics Reference No: 09/H1008/93:
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Affiliation(s)
- Martin Tickle
- School of Dentistry, the University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Keith M Milsom
- School of Dentistry, the University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Michael Donaldson
- Health and Social Care Board, County Hall. 182 Galgorm Road, Ballymena, County Antrim, Northern Ireland, BT42 1QB, UK
| | - Seamus Killough
- British Dental Association, 2 Woodstock Link, Belfast, County Antrim, Northern Ireland, BT6 8DD, UK
| | - Ciaran O'Neill
- Department of Economics, National University of Ireland, University Road Galway, County Galway, Ireland
| | - Grainne Crealey
- Northern Ireland Clinical Research Support Centre, Education and Research Centre, Royal Group of Hospitals Trust, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK
| | - Matthew Sutton
- School of Community Based Medicine, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK
| | - Solveig Noble
- Northern Health and Social Care Trust, Greenmount Avenue, Ballymena, County Antrim, Northern Ireland, BT43 6DA, UK
| | - Margaret Greer
- Northern Ireland Clinical Research Support Centre, Education and Research Centre, Royal Group of Hospitals Trust, Grosvenor Road, Belfast, Northern Ireland, BT12 6BA, UK
- Northern Health and Social Care Trust, Greenmount Avenue, Ballymena, County Antrim, Northern Ireland, BT43 6DA, UK
| | - Helen V Worthington
- School of Dentistry, the University of Manchester, Oxford Road, Manchester, M13 9PL, UK
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Milgrom P, Weinstein P, Huebner C, Graves J, Tut O. Empowering Head Start to improve access to good oral health for children from low income families. Matern Child Health J 2011; 15:876-82. [PMID: 18246416 PMCID: PMC2914140 DOI: 10.1007/s10995-008-0316-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 01/22/2008] [Indexed: 11/26/2022]
Abstract
Surveys over 20 years have documented worsening in the dental health of preschoolers. Healthy People 2010 Midcourse Review reports the country moving away from oral health goals for young children; the slip is 57%. Exacerbating this is the inability of Medicaid to provide for those in need. Most children receive examinations only: few receive comprehensive care. We urge Head Start grantees to adopt a new approach to oral health goals and in this paper offer: (1) a review of the problem and premises preventing a solution; (2) a proposal that Head Start adopt a public health perspective; and (3) specific roles staff and dental personnel can take to mount aggressive strategies to arrest tooth decay at the grantee site.
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Affiliation(s)
- Peter Milgrom
- University of Washington, Box 357475, Seattle, WA 98195-7475; telephone 206 685 4183; fax 206 685 4258; email
| | - Philip Weinstein
- University of Washington, Box 357475, Seattle, WA 98195-7475; telephone 206 5432034; fax 206 685 4258; email
| | - Colleen Huebner
- University of Washington, Box 357230, Seattle, WA 98195-7230; telephone 206 685-9852; fax 206 616-8370; email
| | - Janessa Graves
- University of Washington, Box 357475, Seattle, WA 98195-7475; telephone 206 6161339; fax 206 685 4258; email
| | - Ohnmar Tut
- University of Washington, Box 357475, Seattle, WA 98195-7475; telephone 206 685 4183; fax 206 685 4258; email
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Newby CS, Rowland JL, Lynch RJM, Bradshaw DJ, Whitworth D, Bosma ML. Benefits of a silica-based fluoride toothpaste containing o-cymen-5-ol, zinc chloride and sodium fluoride. Int Dent J 2011; 61 Suppl 3:74-80. [PMID: 21762159 PMCID: PMC9374939 DOI: 10.1111/j.1875-595x.2011.00053.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/17/2023] Open
Abstract
Fluoride toothpastes in conjunction with tooth brushing are used to clean teeth, control plaque build-up and for anti-caries benefits. Toothpastes are designed with attractive flavours and appearances to encourage regular prolonged use to maximise these benefits. The incorporation of additional ingredients into toothpaste is a convenient way to provide supplementary protection that fits into people's everyday oral care routine. Such ingredients should not compromise the primary health benefits of toothpaste nor discourage its use. o-Cymen-5-ol and zinc chloride have been incorporated into a sodium fluoride (NaF)/silica toothpaste at 0.1%w/w and 0.6%w/w respectively to provide additional benefits. These include improved gingival health maintenance, in terms of the reduction of plaque, gingival index and bleeding, and an immediate and long lasting reduction in volatile sulfur compounds (VSCs) measured on breath. These benefits can be attributed to the antimicrobial and neutralisation actions of the toothpaste. The use of established fluoride models demonstrated no compromise in NaF bioavailability. The toothpaste was formulated without compromising product aesthetics. The combination of o-cymen-5-ol and zinc chloride in toothpaste gave superior maintenance of gingival health and reduction in malodour related VSCs without compromising the primary health benefits of the toothpaste or diminishing attributes preferred for the product's use.
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Affiliation(s)
- Craig S Newby
- GlaxoSmithKline Consumer Healthcare, Weybridge, Surrey, UK.
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Benzian H, Hobdell M, Holmgren C, Yee R, Monse B, Barnard JT, van Palenstein Helderman W. Political priority of global oral health: an analysis of reasons for international neglect. Int Dent J 2011; 61:124-30. [PMID: 21692782 DOI: 10.1111/j.1875-595x.2011.00028.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Global Oral Health suffers from a lack of political attention, particularly in low- and middle-income countries. This paper analyses the reasons for this political neglect through the lens of four areas of political power: the power of the ideas, the power of the issue, the power of the actors, and the power of the political context (using a modified Political Power Framework by Shiffman and Smith. Lancet370 [2007] 1370). The analysis reveals that political priority for global oral health is low, resulting from a set of complex issues deeply rooted in the current global oral health sector, its stakeholders and their remit, the lack of coherence and coalescence; as well as the lack of agreement on the problem, its portrayal and possible solutions. The shortcomings and weaknesses demonstrated in the analysis range from rather basic matters, such as defining the issue in an agreed way, to complex and multi-levelled issues concerning appropriate data collection and agreement on adequate solutions. The political priority of Global Oral Health can only be improved by addressing the underlying reasons that resulted in the wide disconnection between the international health discourse and the small sector of Global Oral Health. We hope that this analysis may serve as a starting point for a long overdue, broad and candid international analysis of political, social, cultural, communication, financial and other factors related to better prioritisation of oral health. Without such an analysis and the resulting concerted action the inequities in Global Oral Health will grow and increasingly impact on health systems, development and, most importantly, human lives.
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Affiliation(s)
- Habib Benzian
- The Health Bureau Ltd, Berlin, Germany Department of Epidemiology & Public Health, University College London, UK.
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