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Elsadek YE, Edwebi S, Turner A, Vinall-Collier K, Csikar J, Pavitt S. A systematic review of school-based student peer-led oral health interventions to promote the oral health of school children. BMC Oral Health 2023; 23:742. [PMID: 37817155 PMCID: PMC10566183 DOI: 10.1186/s12903-023-03482-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/03/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Poor oral health in children highlights the need for prevention and effective interventions. During late childhood and adolescence, peer relationships can play a vital role in adopting and maintaining positive health behaviours. AIM To identify the oral health outcomes of school-based student peer-led delivery of oral health interventions. METHODS A search strategy was developed, piloted, and run in four electronic databases: Medline via Ovid, Web of Science, CINAHL via EBSCO, and CENTRAL (Cochrane Central Register of Controlled Trials) using key concepts of peer, oral health and adolescent in the school context. Methodological quality was assessed using QuaDs quality assessment tool. All articles were independently screened by two researchers and data was analysed using narrative data synthesis. The PRISMA checklist complemented by aspects of the Synthesis Without Meta-analysis (SWiM) was used to report this systematic review. RESULTS There were 7572 identified, 24 studies progressed to full-text review, ten studies met the eligibility criteria and were included in the review. Only six studies based their interventions on psychological & behavioural theory. Intervention delivered by peers showed improvements in both clinical and self-reported outcomes when compared to other delivery methods (e.g., professionals). Quality of included studies was reported according to QuaDs guidance. CONCLUSION Peer-led interventions were more effective in improving oral health status and behaviours when compared to other modes of delivery. Future research should assess if a bi-directional impact of peer-led interventions can be seen. Specifically, if there is added value for school-based student peer-leader's including their own oral health knowledge, skills, attitude and preventative behaviours.
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Affiliation(s)
- Yasmen E Elsadek
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
| | - Sakina Edwebi
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Abigail Turner
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Karen Vinall-Collier
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Julia Csikar
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Sue Pavitt
- School of Dentistry, Faculty of Medicine and Health, University of Leeds, Leeds, UK
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Testa A, Mungia R, van den Berg A, C Hernandez D. Food deserts and dental care utilization in the United States. J Public Health Dent 2023; 83:389-396. [PMID: 38073040 DOI: 10.1111/jphd.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 09/15/2023] [Accepted: 11/03/2023] [Indexed: 12/18/2023]
Abstract
OBJECTIVES Although food deserts are known to impact health and healthcare utilization, no research has investigated the relationship between food deserts and dental care utilization. This study aimed to fill this gap by assessing the relationship between living in a food desert and self-reported dental care utilization in the past year. METHODS Data are from the National Longitudinal Study of Adolescent to Adult Health (N = 10,495). The association between food deserts and dental care utilization was assessed using covariate-adjusted multiple logistic regression. RESULTS Living in a food desert was associated with higher odds of not utilizing dental care in the past year. This association was concentrated among high-poverty areas (≥20% poverty rate). CONCLUSIONS The current study is the first to assess the relationship between living in a food desert and dental care utilization. The findings demonstrate that individuals living in low-income urban food deserts may be at increased risk for not utilizing dental care.
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Affiliation(s)
- Alexander Testa
- School of Public Health, Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Rahma Mungia
- School of Dentistry, Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Alexandra van den Berg
- School of Public Health, Department of Health Promotion & Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Daphne C Hernandez
- Cizik School of Nursing, Department of Research, University of Texas Health Science Center at Houston, Houston, Texas, USA
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Cénat JM, Broussard C, Darius WP, Onesi O, Auguste E, El Aouame AM, Ukwu G, Khodabocus SN, Labelle PR, Dalexis RD. Social mobilization, education, and prevention of the Ebola virus disease: A scoping review. Prev Med 2023; 166:107328. [PMID: 36356934 DOI: 10.1016/j.ypmed.2022.107328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 09/05/2022] [Accepted: 10/30/2022] [Indexed: 11/09/2022]
Abstract
The Ebola Virus Disease (EVD) remains a global public health concern with multiple outbreaks over the last five years. This scoping review aimed to synthesize the current state of knowledge on awareness, education, and community mobilization programs on EVD prevention. A comprehensive search strategy was executed in October 2021 across eight databases (APA PsycInfo, CINAHL, Cochrane CENTRAL, Embase, Global Health, MEDLINE, Scopus, and Web of Science). According to the PRISMA flow diagram, out of the 4815 studies generated by the search, 33 were retained for extraction and were included in this scoping review. Findings revealed that cultural practices that increased the risk of Ebola transmission remain very prevalent, even educational and awareness campaigns. Levels of Ebola-related knowledge by community members varied widely. A large proportion of the Ebola-affected populations were not aware of modes of transmission and half were unaware of signs and symptoms. Interventions with deep community mobilization, collaboration and engagement were effective in changing cultural practices, and reducing rates of infection. Interventions in the health sector helped increase willingness to practice preventive methods and the maintenance of social distancing and patient handwashing. A majority of the population members received their information about EVD from the community and mass media (in most instances, through broadcasting stations). Community interventions with a collaborative approach are effective to prevent EVD. It is needed to build trust between communities and health care, but also to use local resources and cultural factors combined with the use of technologies of information to prevent EVD.
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Affiliation(s)
- Jude Mary Cénat
- School of Psychology, University of Ottawa, Ontario, Canada; Interdisciplinary Centre for Black Health, University of Ottawa, Ottawa, Ontario, Canada; University of Ottawa Research Chair on Black Health, University of Ottawa, Ottawa, Ontario, Canada.
| | | | | | - Olivia Onesi
- School of Psychology, University of Ottawa, Ontario, Canada
| | | | | | - Gloria Ukwu
- School of Psychology, University of Ottawa, Ontario, Canada
| | | | | | - Rose Darly Dalexis
- Interdisciplinary School of Health Sciences, University of Ottawa, Ontario, Canada
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Tahani B, Asgari I, Golkar S, Ghorani A, Hasan Zadeh Tehrani N, Arezoo Moghadam F. Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran. BMC Oral Health 2022; 22:599. [PMID: 36510207 PMCID: PMC9744048 DOI: 10.1186/s12903-022-02644-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran. METHODS This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05). RESULTS The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4). CONCLUSION It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.
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Affiliation(s)
- Bahareh Tahani
- grid.411036.10000 0001 1498 685XDepartment of Oral Public Health, Dental Research Center, Dental research Institute,School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Imaneh Asgari
- grid.411036.10000 0001 1498 685XDepartment of Oral Public Health, Dental Material Research Center, Dental Research Institute,School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shayan Golkar
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Ghorani
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nooshin Hasan Zadeh Tehrani
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Arezoo Moghadam
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Aleksejūniene J, Dziaugyte-Eyeberdiyev L, Rasteniene R, Brukiene V. Self-determination theory guided oral self-care training for adolescents-A cluster randomised controlled trial. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5506-e5514. [PMID: 36000709 DOI: 10.1111/hsc.13974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 07/13/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Quality oral self-care is a key element in maintaining oral health, which is important for students' general health, their overall well-being and learning. The cluster randomised controlled trial tested the following hypotheses: (1) self-determination theory (SDT)-guided dental education is superior to conventional dental instruction in modifying oral self-care in adolescents; (2) after the discontinued dental education, improved oral self-care is only maintained for short rather than long term and (3) multiple predictors explain variations in adolescents' oral self-care at different observation periods. The intervention group (N = 97) received three face-to-face educational sessions to facilitate adolescents' intrinsic motivation, while the control group (N = 99) had one conventional dental instruction session. Dental plaque scores (% of tooth area covered by dental plaque) indicated a lack of oral self-care. Linear multivariable models tested the following predictors of oral self-care at different observation periods: socio-demographics (sex, socio-economic status, school) and self-determination attributes (autonomy, relatedness, competence). Results indicated that from baseline to the 6-month follow-up, dental plaque scores decreased (oral self-care improved) in the intervention group but not in the control group. At the 12-month follow-up point, there were no significant differences in mean plaque scores between the study groups. Baseline plaque levels (β = 0.807), the type of dental instruction (theory guided vs. conventional) (β = 0.208), relatedness (β = 0.106) and competence (β = 0.102) were significant predictors that explained 67.6% of the variance in dental plaque scores at the 12-month follow-up point. The theory-guided education was superior to conventional verbal instruction in improving adolescent oral self-care; however, this improvement was only maintained short term. Variations in adolescent oral self-care at short- and long-term observation points were explained by baseline oral self-care levels and two SDT components: relatedness and competence.
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Affiliation(s)
- Jolanta Aleksejūniene
- Faculty of Dentistry, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Ruta Rasteniene
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vilma Brukiene
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Akera P, Kennedy SE, Lingam R, Obwolo MJ, Schutte AE, Richmond R. Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: a systematic review and meta-analysis. BMC Oral Health 2022; 22:264. [PMID: 35768801 PMCID: PMC9245251 DOI: 10.1186/s12903-022-02291-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 06/20/2022] [Indexed: 11/25/2022] Open
Abstract
Background Risk factors for oral disease can potentially be ameliorated by school-based interventions. This review evaluates the effectiveness of primary school-based interventions in improving oral health among children in low-and middle-income countries (LMICs). Methods Our systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Medline, Embase, Global Health, CINAHL, Emcare, Scopus, Web of Science, WHO website, Google Advanced and Google Scholar were searched for experimental and observational studies published between 1995 and 2021 in English. Quality assessment and data extraction of the articles were performed by two independent reviewers. The primary outcome was decayed, missing, and filled teeth/surfaces [dmft(s)/DMFT(S)] scores. Seven meta-analyses were conducted. Results The search yielded 1178 publications and after removing duplicates, 753 remained. A further 648 publications were excluded after screening titles and abstracts. 105 publications were reviewed in full and 34 were included. Narrative synthesis showed school-based interventions had a positive effect on oral health outcomes. Meta-analysis showed a significant positive effect on dental caries measured by DMFT scores (standardised mean difference (SMD) = − 0.33; 95% CI − 0.56 to − 0.10; P = 0.005), net increment in DMFS scores (SMD = − 1.09; 95% CI − 1.91 to − 0.27; P = 0.009), dmft and DMFT/S score > 1 (Risk Ratio = 0.70; 95% CI 0.53 to 0.94; P = 0.02) and plaque scores (SMD = − 0.32; 95% CI − 0.46 to − 0.18; P < 0.00001). Non-significant positive effect was observed for dental caries measured by net increment in DMFT scores (SMD = − 0.34; 95% CI − 0.69 to 0.02; P = 0.06) and DMFS scores (SMD = − 0.26; 95% CI − 0.70 to 0.18; P = 0.24), and gingival health (SMD = 0.12; 95% CI − 0.32 to 0.55; P = 0.60). Certainty of evidence was assessed as very low for all oral health outcomes. Conclusion School-based interventions can be effective in reducing the burden of oral disease among primary school children in LMICs, with skills-based education, teacher training, provision of access to oral health services and parental engagement emerging as particularly promising. Further research is required to provide evidence of effectiveness of primary school-based interventions to improve oral health. Systematic review registration The title of this review was registered with PROSPERO (registration number: CRD42020202599). Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02291-2.
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Affiliation(s)
- Peter Akera
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia. .,Department of Public Health, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda.
| | - Sean E Kennedy
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Raghu Lingam
- School of Women's and Children's Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
| | - Mark J Obwolo
- Department of Public Health, Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, Uganda
| | - Aletta E Schutte
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.,The George Institute for Global Health, Sydney, Australia
| | - Robyn Richmond
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia
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Chandio N, Micheal S, Tadakmadla SK, Sohn W, Cartwright S, White R, Sanagavarapu P, Parmar JS, Arora A. Barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools: a systematic review. BMC Oral Health 2022; 22:242. [PMID: 35717199 PMCID: PMC9206278 DOI: 10.1186/s12903-022-02270-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/10/2022] [Indexed: 02/16/2024] Open
Abstract
Background Untreated dental caries negatively impacts a child's quality of life including overall health and wellbeing, growth and development, social interaction ability, and school attendance. School-based toothbrushing programs have been recognised as an effective intervention to reduce the burden of dental caries. However, limited information is available to understand the real-world enablers and challenges in the implementation and sustainability of toothbrushing programs. This review aims to understand the barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings and primary schools.
Methods Five electronic databases [i.e., CINAHL (EBSCO), Medline (EBSCO), EMBASE (Ovid), Web of Science, and PsycINFO] and backward citation chasing were performed. The last updated databases searches were conducted in May 2022. Studies reporting on barriers and enablers in the implementation and sustainability of toothbrushing programs in early childhood settings or primary schools were included in the review. The methodological quality of included studies was assessed by using Joanna Briggs Institute [JBI] and mixed methods appraisal tool [MMAT] critical appraisal tools and results were reported in accordance with PRISMA guidelines. Results A total of six studies met the eligibility criteria and were included in the review. Toothbrushing programs in early childhood settings and primary schools were mostly implemented under the supervision of staff and teachers. A positive attitude of the staff, the flexibility of toothbrushing sessions, involvement of community volunteers and parents were a few of the identified enablers. However, the timing of the communication of the program, inadequate transfer of information among staff, frequent staffing turnover, lack of parental support, and staff feeling overburdened while acting as pseudo parents were frequently reported as barriers. Conclusion The results of this systematic review identify key enablers and barriers for toothbrushing programs in early childhood settings and primary schools which need to be considered for developing oral health promotion initiatives. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02270-7.
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Affiliation(s)
- Navira Chandio
- School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.,School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Sowbhagya Micheal
- School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Santosh Kumar Tadakmadla
- Department of Rural Clinical Sciences, Violet Vines Centre for Rural Health Research, La Trobe Rural Health School, Bendigo, VIC, 3550, Australia
| | - Woosung Sohn
- Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Surry Hills, 2010, Australia
| | - Susan Cartwright
- Colgate-Palmolive Pty Ltd., 345 George St., Sydney, 2001, Australia
| | - Rhiannon White
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Prathyusha Sanagavarapu
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia.,School of Education, Western Sydney University, Bankstown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Jinal Shashin Parmar
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia.,School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia
| | - Amit Arora
- Health Equity Laboratory, Campbelltown, NSW, 2560, Australia. .,School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW, 2751, Australia. .,Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia. .,Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
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Visualizing the Knowledge Domain in Health Education: A Scientometric Analysis Based on CiteSpace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116440. [PMID: 35682025 PMCID: PMC9180308 DOI: 10.3390/ijerph19116440] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/15/2022] [Accepted: 05/22/2022] [Indexed: 12/24/2022]
Abstract
Objectives: This study aimed to visualize the evidence in the global research on health education to better improve the nation’s health literacy and to guide future research. Method: We searched the Web of Science (Core Collection) electronic databases. The search strategies: topic: (“Health Education” OR “Education, Health” OR “Community Health Education” OR “Education, Community Health” OR “Health Education, Community”) AND document: (Article) AND language:(English). Articles of evidence from January 2011 to December 2021 with those words in the title or abstract or keywords will be included in this review. We used the Citespace 5.6.R5 (64-bit) to investigate and determine the thematic patterns, and emerging trends of the knowledge domain, and presented a narrative account of the findings. Result: We analyzed 10,273 eligible articles. It showed that BMC Public Health displays the most prolific journals. Author MARCO PAHOR is highlighted in health education. The University of Sydney has published the most studies about health education. The USA plays an important role in these studies. Specifically, the visualization shows several hotspots: disease prevalence surveys and a specific population of knowledge, attitude and practice surveys, health intervention, chronic and non-communicable management, youth-health action, sexual and reproductive health, and physical activity promotion. Furthermore, document co-citation analysis indicated that there are 10 main clusters, which means the research front in health education. Meanwhile, by the citation detected, COVID-19, has achieved universal health coverage in related studies, however, public health education and the health workforce might be more popular in the coming years. Conclusion: Health education is an effective measure to shift the concept of public health and improve healthy living standards. The present study facilitates an extensive understanding of the basic knowledge and research frontiers that are pivotal for the developmental process of health education and allows scholars to visualize the identification modes and tendencies.
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Chen Y, Yang B, Cheng L, Xu HHK, Li H, Huang Y, Zhang Q, Zhou X, Liang J, Zou J. Novel Giomers Incorporated with Antibacterial Quaternary Ammonium Monomers to Inhibit Secondary Caries. Pathogens 2022; 11:pathogens11050578. [PMID: 35631099 PMCID: PMC9147272 DOI: 10.3390/pathogens11050578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/04/2022] [Accepted: 05/11/2022] [Indexed: 02/04/2023] Open
Abstract
The objective of this study was to develop novel modified giomers by incorporating the antibacterial quaternary ammonium monomers (QAMs), dimethylaminododecyl methacrylate (DMADDM) or dimethylaminohexadecyl methacrylate (DMAHDM) into a commercial giomer. The material performances including mechanical properties, surface characteristics, color data, cytotoxicity and fluoride release of the novel giomers were evaluated. Antibacterial activity against severe early childhood caries (S-ECC) saliva-derived biofilms was assessed by lactic acid production measurement, MTT assay, biofilm staining and 16S rRNA sequencing. A rat model was developed and the anti-caries effect was investigated by micro-CT scanning and modified Keyes’ scoring. The results showed that the material properties of the QAMs groups were comparable to those of the control group. The novel giomers significantly inhibited lactic acid production and biofilm viability of S-ECC saliva-derived biofilms. Furthermore, caries-related genera such as Streptococcus and Lactobacillus reduced in QAMs groups, which showed their potential to change the microbial compositions. In the rat model, lesion depth, mineral loss and scoring of the QAMs groups were significantly reduced, without side effects on oral tissues. In conclusion, the novel giomers incorporated with antibacterial QAMs could inhibit the cariogenic biofilms and help prevent secondary caries, with great potential for future application in restorative treatment.
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Affiliation(s)
- Yandi Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Bina Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Lei Cheng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hockin H. K. Xu
- Department of Advanced Oral Sciences and Therapeutics, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA;
- Center for Stem Cell Biology and Regenerative Medicine, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
- Marlene and Stewart Greenebaum Cancer Center, School of Medicine, University of Maryland, Baltimore, MD 21201, USA
| | - Hao Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yuyao Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qiong Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Cariology and Endodontics, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jingou Liang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (J.L.); (J.Z.)
| | - Jing Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu 610041, China; (Y.C.); (B.Y.); (L.C.); (H.L.); (Y.H.); (Q.Z.); (X.Z.)
- Department of Pediatric Dentistry, West China School of Stomatology, Sichuan University, Chengdu 610041, China
- Correspondence: (J.L.); (J.Z.)
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Sanaeinasab H, Saffari M, Taghavi H, Karimi Zarchi A, Rahmati F, Al Zaben F, Koenig HG. An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial. BMC Oral Health 2022; 22:94. [PMID: 35346148 PMCID: PMC8962588 DOI: 10.1186/s12903-022-02132-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 03/17/2022] [Indexed: 11/30/2022] Open
Abstract
Background Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children. Methods A total of 112 children ages 6–12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student’s t-test and analysis of covariance.
Results All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = − 0.9 to − 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups. Conclusion An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.
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Czech and Slovak Dental Students' Oral Health-Related Knowledge, Attitudes, and Behaviours (KAB): Multi-Country Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052717. [PMID: 35270410 PMCID: PMC8910048 DOI: 10.3390/ijerph19052717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 02/01/2023]
Abstract
Dentists play a key role in the primary prevention of oral diseases and related systemic complications; therefore, their views on behavioural interventions need to be aligned with the current agendas for oral health. Likewise, dental students’ oral health-related knowledge, attitudes, and behaviours (KAB) are of practical importance, as they are the future opinion leaders for oral health in their respective communities. A cross-sectional survey-based study was designed to evaluate the oral health KAB of dental students in both the Czech Republic and Slovakia. The study utilized translated versions of the Hiroshima University Dental Behavioural Inventory (HU-DBI), and it aimed to recruit students from all Czech and Slovak dental schools. A total of 487 students were included in this study, out of which 372 (76.4%) were females, 271 (55.6%) were enrolled in preclinical years, 68 (14%) reported smoking tobacco at least once a week, and 430 (88.3%) reported problematic internet use. The mean HU-DBI score of Czech and Slovak dental students (8.18 ± 1.80) was comparable with the previously reported scores of dental students in Nordic and Western European countries. Czech students (9.34 ± 1.29) had a significantly higher score than their Slovak counterparts (7.56 ± 1.73). In both countries, preclinical students (8.04 vs. 8.35), the students who reported tobacco smoking (7.63 vs. 8.27), and those who reported problematic internet use (8.11 vs. 8.70) had significantly lower HU-DBI scores than their counterparts, respectively. In the Czech Republic, the significant increases in HU-DBI scores occurred after the first academic year when the students received preventive dentistry courses; therefore, one can put forward that early implementation of preventive elements in undergraduate dental curricula may yield better and more sustainable oral health gains for the students. Future research on Czech and Slovak dental curricula need to re-evaluate the oral hygiene and anti-smoking components and their impact on students’ views and attitudes.
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Tenelanda López D, Alban Hurtado C, Castelo Reyna M, Vinueza OF. Oral health status and sociofamiliar aspects among 12-year-old schoolchildren: A correlational study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_66_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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13
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Ijaz S, Nobles J, Johnson L, Moore T, Savović J, Jago R. Preventing Childhood Obesity in Primary Schools: A Realist Review from UK Perspective. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:13395. [PMID: 34949004 PMCID: PMC8702173 DOI: 10.3390/ijerph182413395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/10/2021] [Accepted: 12/14/2021] [Indexed: 12/02/2022]
Abstract
Childhood obesity is a global public health concern. While evidence from a recent comprehensive Cochrane review indicates school-based interventions can prevent obesity, we still do not know how or for whom these work best. We aimed to identify the contextual and mechanistic factors associated with obesity prevention interventions implementable in primary schools. A realist synthesis following the Realist And Meta-narrative Evidence Syntheses-Evolving Standards (RAMESES) guidance was with eligible studies from the 2019 Cochrane review on interventions in primary schools. The initial programme theory was developed through expert consensus and stakeholder input and refined with data from included studies to produce a final programme theory including all of the context-mechanism-outcome configurations. We included 24 studies (71 documents) in our synthesis. We found that baseline standardised body mass index (BMIz) affects intervention mechanisms variably as a contextual factor. Girls, older children and those with higher parental education consistently benefitted more from school-based interventions. The key mechanisms associated with beneficial effect were sufficient intervention dose, environmental modification and the intervention components working together as a whole. Education alone was not associated with favourable outcomes. Future interventions should go beyond education and incorporate a sufficient dose to trigger change in BMIz. Contextual factors deserve consideration when commissioning interventions to avoid widening health inequalities.
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Affiliation(s)
- Sharea Ijaz
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 2NT, UK; (J.N.); (T.M.); (J.S.); (R.J.)
- Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - James Nobles
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 2NT, UK; (J.N.); (T.M.); (J.S.); (R.J.)
- Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Laura Johnson
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
| | - Theresa Moore
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 2NT, UK; (J.N.); (T.M.); (J.S.); (R.J.)
- Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
- Cochrane UK Methods Support Unit, Editorial & Methods Department, London SW1Y 4QX, UK
| | - Jelena Savović
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 2NT, UK; (J.N.); (T.M.); (J.S.); (R.J.)
- Bristol Medical School, University of Bristol, Bristol BS8 2PS, UK
| | - Russell Jago
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol BS1 2NT, UK; (J.N.); (T.M.); (J.S.); (R.J.)
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK;
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Shaheen R, AlShulayyil M, Baseer MA, Saeed Bahamid AA, AlSaffan AD, Al Herbisch R. Self-Reported Basic Oral Health Knowledge of Primary School Students and Teachers in Rural Areas of Saudi Arabia. Clin Cosmet Investig Dent 2021; 13:521-529. [PMID: 34908879 PMCID: PMC8664646 DOI: 10.2147/ccide.s341240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/12/2021] [Indexed: 11/23/2022] Open
Abstract
Background Oral health knowledge is essential for establishing healthy behaviors. Aim The purpose of the study was to determine and compare the basic oral health knowledge of 3–6th grade government primary school students and teachers in rural areas of Saudi Arabia. Methods A cross-sectional study was conducted among government primary school students and teachers in a rural area (Thadig and Ad-Delam) of the Riyadh region of Saudi Arabia using validated, structured, close-ended and self-administered questionnaires. The questionnaire comprised demographic variables and 18 multiple-choice items. A convenience sampling methodology was employed to select the study sample. Results A total of 1864 subjects from rural area government primary schools [students (N = 1538) and teachers (N = 326)] participated in this study. The majority of the students were females 841 (54.7%), Saudi nationals 1376 (89.5%), and studying in 5th grade 446 (29%). Most teacher participants were females, 199 (61.0%), and Saudi nationals, 326 (100.0%). Teachers (12.62 ± 2.36) demonstrated significantly higher overall mean knowledge scores compared to the students (9.63 ± 2.36) (p < 0.001). Females and non-Saudi students showed significantly higher mean knowledge scores compared to their counterparts. However, 4th standard students showed significantly lower mean knowledge scores compared to other graders. Female teachers (13.17 ± 2.25) demonstrated significantly higher overall oral health knowledge scores compared to male teachers (11.75 ± 2.26) (p < 0.001). Conclusion Basic oral health knowledge was adequate among 3–6th grade government primary school students and teachers in rural areas of the Riyadh region.
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Affiliation(s)
- Rakan Shaheen
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | - Mohammad Abdul Baseer
- Department of Preventive Dentistry, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | | | | | - Reem Al Herbisch
- College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
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McClure JB, Anderson ML, Krakauer C, Blasi P, Bush T, Nelson J, Catz SL. Impact of a novel oral health promotion program on routine oral hygiene among socioeconomically disadvantaged smokers: results from a randomized semi-pragmatic trial. Transl Behav Med 2021; 10:469-477. [PMID: 30753662 PMCID: PMC7237541 DOI: 10.1093/tbm/ibz009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Smokers are at high risk of oral disease and report sub-optimal oral hygiene. Improving smokers’ oral hygiene could reduce their future disease risk. The purpose of this study is to assess the effects of a novel, multi-modal oral health promotion program (Oral Health 4 Life; OH4L) targeted to socioeconomically disadvantaged smokers and delivered through state-funded tobacco quitlines. Smokers (n = 718) were randomized to standard quitline care or standard care plus OH4L. OH4L recipients received a comprehensive behavioral intervention and were advised of the benefits of routine oral hygiene, encouraged to brush and floss daily (for better oral health and to manage cigarette cravings), and provided a toothbrush and floss. Participants were followed for 6 months to assess the intervention effects on routine oral hygiene (brushing and flossing) and changes in motivation and self-efficacy. Data were collected between 2015 and 2017. At 2-month follow-up, OH4L participants were more likely to meet the American Dental Association (ADA) recommendations for brushing twice daily (adjusted RR = 1.15 [1.04, 1.27], p = .006), flossing daily (adjusted RR = 1.20 [1.03, 1.39], p = .02), and for both brushing and flossing (adjusted RR = 1.33 [1.10, 1.61], p = .003). Daily flossing was more likely at 6-month follow-up (adjusted RR = 1.21 [1.04, 1.42], p = .02) among OH4L participants. The change in self-efficacy and motivation for daily flossing from baseline to 2 months was significantly greater among OH4L participants and mediated the intervention effect on flossing at 6 months. Integrating oral hygiene promotion with standard tobacco quitline services improved oral health self-care.
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Affiliation(s)
- Jennifer B McClure
- Kaiser Permanente Washington Health Research Institute (formerly, Group Health Research Institute), Seattle, WA, USA
| | - Melissa L Anderson
- Kaiser Permanente Washington Health Research Institute (formerly, Group Health Research Institute), Seattle, WA, USA
| | - Chloe Krakauer
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Paula Blasi
- Kaiser Permanente Washington Health Research Institute (formerly, Group Health Research Institute), Seattle, WA, USA
| | - Terry Bush
- Optum Center for Wellbeing Research, Optum, Eden Prairie, MN
| | - Jennifer Nelson
- Kaiser Permanente Washington Health Research Institute (formerly, Group Health Research Institute), Seattle, WA, USA
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California, Davis, Sacramento, CA, USA
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Orekhova LY, Kudryavtseva TV, Berezkina IV, Shadrina KV, Petrov AA. Analysis of the effectiveness of school programs for the prevention of dental diseases: a literature review. Pediatr Dent 2021. [DOI: 10.33925/1683-3031-2021-21-2-76-87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Relevance. The high prevalence of dental diseases worldwide and their cumulative process from an early age entail effective strategies for healthy habits promotion. Schools are recommended to include oral health education programs in the curricula to develop a positive attitude to oral hygiene among students. The aim was to review the effectiveness of implementing programs in the school curricula to reduce the dental disease level among schoolchildren.Materials and methods. The research chose programs aimed at improving the dental health of schoolchildren. We considered educational measures on oral health protection, carried out by dentists, nurses or teachers within school programs and curative and preventive measures for schoolchildren aged 6-18 years. We searched the publications on the given topic published between 1999 and 2021 in the database e-LIBRARY.ru and between 2016 and 2021 in the PubMed database. When selecting articles, the full-text study was compulsory to check the article conformance degree to the inclusion criteria.Results. According to the keyword search, we found 76 publications in the database e-LIBRARY.ru. After the exclusion of duplicates and articles nonconforming to the selection criteria, the review included seven publications. Four studies revealed caries reduction, and two studies demonstrated the improvement of oral hygiene. In the PubMed database, 419 publications were found according to the keyword query. The analysis of the effectiveness of school dental programs included 12 articles. Four studies detected oral hygiene improvement, seven studies – caries reduction, and six studies – dental knowledge and skill improvement.Conclusions. According to Russian and international studies, education without curative and preventive measures isn't effective in dental disease prevention in schoolchildren. Along with instructions and training in practical oral hygiene skills, schoolchildren should use fluoride toothpaste. Fluoride varnish application and fissure sealing are the most effective measures in risk groups.
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Affiliation(s)
| | | | | | | | - A. A. Petrov
- Pavlov First Saint Petersburg State Medical University
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Alraqiq H, Eddali A, Boufis R. Prevalence of dental caries and associated factors among school-aged children in Tripoli, Libya: a cross-sectional study. BMC Oral Health 2021; 21:224. [PMID: 33931061 PMCID: PMC8086357 DOI: 10.1186/s12903-021-01545-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 04/04/2021] [Indexed: 11/19/2022] Open
Abstract
Background In many developing countries, the prevalence of dental caries has increased due to lifestyle changes, lack of preventive services, and inadequate access to dental care. In Arab countries, the increased prevalence of caries has correlated with economic growth over the past decades, resulting in greater access to unhealthy foods and higher consumption of sugar, particularly among children. However, few studies have assessed caries prevalence among pediatric populations in Arab countries. The objective of this study was to assess the prevalence of dental caries and factors associated with caries among children in Tripoli, Libya. Methods This cross-sectional study included a convenience sample of 1934 children in first grade (age 6–7 years, n = 1000) and seventh grade (age 11–12 years, n = 934). Four health centers in Tripoli were selected for screening based on location and participation in school-entry health examinations. Data were collected through self-administered parent surveys and visual dental screenings by trained examiners from September 24 to October 15, 2019. The survey comprised questions about socioeconomic characteristics and oral health behaviors, including toothbrushing, sugar consumption, and dental care history. During screenings, untreated decay, missing teeth, and filled teeth (DMFT or dmft) were recorded. Prevalence of tooth decay was calculated as the proportion of children with high DMFT/dmft scores. Binary logistic and negative binomial regression analyses (with significance at p ≤ 0.05) were used to assess factors associated with caries. Results Among 1000 first-grade children, 78.0% had decay in their primary teeth, with a mean dmft of 3.7. Among 934 seventh-grade children, 48.2% had caries in their permanent teeth, with a mean DMFT of 1.7. The most significant factors associated with caries prevalence were socioeconomic, such as screening site (first grade, p = 0.02; seventh grade, p < 0.001) and maternal employment (seventh grade, p = 0.02), and behavioral, such as toothbrushing duration (seventh grade, p = 0.01), past dental treatment (both grades, p < 0.001), and past emergency visit (both grades, p < 0.001). Conclusions Caries prevalence was associated with several behavioral and socioeconomic factors, including screening site, maternal employment, toothbrushing duration, past dental treatment, and past emergency visit. Efforts should be made to address these factors to minimize barriers and improve oral health behavior and care utilization. These findings can be used to evaluate current public health initiatives and inform future planning. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01545-9.
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Affiliation(s)
- Hosam Alraqiq
- Section of Growth and Development, Division of Pediatric Dentistry, College of Dental Medicine, Irving Medical Center, Columbia University, 622 W 168th St, New York, NY, 10032, USA.
| | | | - Reema Boufis
- College of Dental Medicine, Zawia University, Zawia, Libya
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Yu L, Yu X, Li Y, Yang F, Hong J, Qin D, Song G, Hua F. The additional benefit of professional fluoride application for children as an adjunct to regular fluoride toothpaste: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:3409-3419. [PMID: 33782769 DOI: 10.1007/s00784-021-03909-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/23/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess whether professional fluoride application (PFA) used in addition to regular fluoride toothpaste (RFT, ≥ 1,000 ppm) is more effective than RFT alone in children. MATERIALS AND METHODS A systematic search was conducted using the PubMed, Embase, Google Scholar and CENTRAL databases. Randomized controlled trials (RCTs) comparing the effectiveness of RFT + PFA and RFT alone were included. Meta-analyses with random-effects models were performed. The certainty of evidence was assessed using the GRADE approach. RESULTS A total of 2,729 records were identified from electronic and manual searches, which were screened by two reviewers independently and in duplicate. Six RCTs (5,034 participants) were included, of which four had high risk of bias and two had unclear risk of bias. The PFA used in all these trials was fluoride varnish (FV). In meta-analyses, no significant difference was observed between participants receiving FV + RFT and RFT alone of d(m/e)fs increment (mean difference (MD) - 0.17, 95% confidence interval (CI) - 0.60 to 0.26, P = 0.43, I2 = 38%; 6 trials, 5,034 participants, moderate certainty evidence), incidence of caries (risk ratio (RR) 0.91, 95% CI 0.80 to 1.05, P = 0.21, I2 = 41%; 4 trials, 4,487 participants, moderate certainty evidence) or changes in prevalence of caries (RR 0.89, 95% CI 0.78 to 1.01, P = 0.07, I2 = 0%, 4 trials, 4,189 participants, low certainty evidence). CONCLUSIONS Low to moderate certainty evidence suggests that FV does not have significant additional caries-preventive benefit for children (under 8 years old) when provided as an adjunct to daily tooth brushing with RFT (≥ 1,000 ppm). There is insufficient evidence regarding the additional benefit of other PFA interventions. CLINICAL RELEVANCE The decision to apply FV to children needs to be made in light of their actual usage of RFT. TRIAL REGISTRATION PROSPERO (CRD42020165270).
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Affiliation(s)
- Lintong Yu
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China
| | - Xueqian Yu
- Library, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yueyang Li
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Fengjiao Yang
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China
| | - Jialan Hong
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Danchen Qin
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Guangtai Song
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China.
| | - Fang Hua
- Centre for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, 430079, China.
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
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Flório FM, Dos Santos Klee L, Brandão Ramos AP, Ambrosano GMB, de Souza Fonseca Silva A. Use of Water by Schoolchildren: Impact of Indirectly Supervised Daily Toothbrushing-A Pilot Study. Int J Clin Pediatr Dent 2021; 13:513-517. [PMID: 33623340 PMCID: PMC7887171 DOI: 10.5005/jp-journals-10005-1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Aim This present longitudinal, quantitative, and analytical pilot study evaluated the impact of daily indirectly supervised toothbrushing on water consumption. Materials and methods The study was carried out in a social center that provided care to children aged 5–14 years in Campinas in the state of São Paulo. Calibrated hydrometers were installed on taps used by the children, and the daily volume of water used was measured for 25 school days (T0). An educational program was then implemented (T1), where supervised toothbrushing was explained, encouraged, and put into action. The next phase (T2) incorporated a recreational approach to the rational use of water, and the consumption was measured for another 25 school days. After six months (T3) without further educational interventions by the researchers, water consumption was measured for the same period of 25 school days. The data were analyzed based on the mixed models methodology for measures repeated over time. Results The water consumption did not change significantly (p > 0.05) between the different phases of the study (T0 = 0.43 ± 0.19, T1 = 0.38 ± 0.17, T2 = 0.39 ± 0.15, T1 = 0.48 ± 0.21 dm3/day/child). Conclusion The introduction of toothbrushing into the routine of the children, in the context of recreational and sustainable health education, did not have a detrimental impact on water consumption. Clinical significance Among the many recommendations for the introduction and implementation of supervised toothbrushing programs in school environments, there is no mention of the measures taken during such procedures aimed at economizing water, the rational use of which should be a daily practice irrespective of the water conditions of the surrounding region. The findings of this study contribute to the enhancement of educational and pedagogical activities in schools. How to cite this article Flório FM, dos Santos Klee L, Brandão Ramos AP, et al. Use of Water by Schoolchildren: Impact of Indirectly Supervised Daily Toothbrushing—A Pilot Study. Int J Clin Pediatr Dent 2020;13(5):513–517.
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Affiliation(s)
- Flávia Martão Flório
- Department of Preventive Dentistry, Faculdade São Leopoldo Mandic, Campinas, SP, Brazil; Department of Public Health, São Leopoldo Mandic School of Dentistry and Research Center, Campinas, Brazil
| | | | - Ana Paula Brandão Ramos
- Simplific Consultancy and Advisory in Health, Safety and Environment, Campinas, São Paulo, Brazi
| | - Gláucia Maria Bovi Ambrosano
- Department of Social Preventive Dentistry, Piracicaba School of Dentistry (UNICAMP), Piracicaba, São Paulo, Brazil
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Babaei A, Pakdaman A, Hessari H. Effect of an Oral Health Promotion Program Including Supervised Toothbrushing on 6 to 7-Year-Old School Children: A Randomized Controlled Trial. Front Dent 2021; 17:1-9. [PMID: 33615295 PMCID: PMC7883658 DOI: 10.18502/fid.v17i19.4313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 07/19/2020] [Indexed: 11/01/2022] Open
Abstract
Objectives The purpose was to evaluate the impact of an oral health promotion program including supervised toothbrushing and educational packages for parents on parent's knowledge and oral health status of 6- to 7-year-old schoolchildren. Materials and Methods A multi-stage cluster random sampling method was applied, and schools were allocated to intervention and control groups. After ethical clearance and baseline evaluation, an intervention package consisting of supervised toothbrushing at the school setting, an educational package for parents, and a home package containing toothbrush and fluoridated toothpaste (1000 parts-per-million) were delivered. A post-intervention evaluation was performed after one month on parents' oral health knowledge and oral hygiene of children using the Oral Hygiene Index Simplified (OHI-S). Schools were considered as a unit of randomization, and a generalized estimating equation (GEE) analysis was performed to apply the cluster effect. Descriptive and analytical analyses were performed using SPSS 22 software. Results Overall, 701 subjects were re-examined (response rate of 95%). At the one-month follow-up, being in the intervention group (P<0.001, B=-0.028, 95% confidence interval (CI)= -0.33, -0.23) and having higher socioeconomic status [P=0.01, B=-0.12, 95% CI=-0.22, -0.03) were significantly associated with improved oral hygiene status. In the post-test evaluation, parents' knowledge improvement score regarding oral health in the intervention group was not statistically different from that of the controls (0.51 vs. 0.23). However, the ΔOHI-S improved in the post-test evaluation (-0.27±0.02 vs. 0.02±0.02; P<0.001). Conclusion Children showed improved oral hygiene status, as measured by the OHI-S, after the program consisting of supervised toothbrushing.
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Affiliation(s)
- Azadeh Babaei
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Pakdaman
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Hessari
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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Shen A, Bernabé E, Sabbah W. Systematic Review of Intervention Studies Aiming at Reducing Inequality in Dental Caries among Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031300. [PMID: 33535581 PMCID: PMC7908536 DOI: 10.3390/ijerph18031300] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/25/2021] [Accepted: 01/28/2021] [Indexed: 11/24/2022]
Abstract
(1) Background: The objective is to systematically review the evidence on intervention programs aiming at reducing inequality in dental caries among children. (2) Methods: Two independent investigators searched MEDLINE, Cochrane library, and Ovid up to December 2020 to identify intervention studies assessing the impact on socioeconomic inequalities in dental caries among children. The interventions included any health promotion/preventive intervention aiming at reducing caries among children across different socioeconomic groups. Comparison groups included children with alternative or no intervention. Cochrane criteria were used to assess interventional studies for risk of bias. (3) Results: After removal of duplicate studies, 1235 articles were retained. Out of 43 relevant papers, 13 articles were identified and used in qualitative synthesis, and reported quantifiable outcomes. The included studies varied in measurements of interventions, sample size, age groups, and follow-up time. Five studies assessed oral health promotion or health-education, four assessed topical fluorides, and four assessed water fluoridation. Interventions targeting the whole population showed a consistent reduction of socioeconomic inequalities in dental caries among children. (4) Conclusion: The quality of included papers was moderate. High heterogeneity did not allow aggregation of the findings. The overall findings suggest that whole population interventions such as water fluoridation are more likely to reduce inequalities in children’s caries than target population and individual interventions.
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Affiliation(s)
- Anqi Shen
- Department of Preventive Dentistry, Beijing Stomatology Hospital, Capital Medical University, 4th Tiantanxili, Dongcheng District, Beijing 100050, China
- Correspondence: ; Tel.: +86-(010)-5709-9285
| | - Eduardo Bernabé
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (E.B.); (W.S.)
| | - Wael Sabbah
- Dental Public Health Group, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (E.B.); (W.S.)
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Molete M, Stewart A, Igumbor J. Implementation fidelity of school oral health programs at a District in South Africa. PLoS One 2020; 15:e0241988. [PMID: 33201899 PMCID: PMC7671500 DOI: 10.1371/journal.pone.0241988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/26/2020] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND It is important that components contributing to success of a program are well understood to ensure better outcomes and strengthen interventions. Hence the purpose of the study was to assess the level of fidelity achieved by school oral health programs in our study district and to determine elements of fidelity that predict the risk of dental decay. METHODS A cross-sectional study design was utilised. A multistage sampling technique was employed to randomly select 10 schools, two grades in each school were selected and all pupils in the selected grades were included in an oral health examination. Ten oral hygienists were observed and interviewed as they carried out the activities of the program and records were reviewed. Data collection tools included an oral health examination form, and an implementation fidelity checklist. RESULTS The average level of fidelity obtained was 40% and it was shown to be inversely correlated with levels of decay, as decay was predicted to decrease with increasing levels of fidelity. The fidelity elements that were found to directly predict the outcome of decay included duration (IRR, 0.49; p = 0.02) coverage (IRR, 0.54; p = 008), content (IRR, 1.36; p = 0.03) and age (IRR, 2.14; p = 0.00). Moderating factors of fidelity which indirectly influenced the outcome of decay included facilitation strategy, duration and age. These were predicted to reduce the risk of decay by 92%, 83% and 48% respectively. CONCLUSION The school oral health programs exhibited high levels of pupil coverage, however, the content of the programs offered was low (28%). Coverage was high in the context of lack of dental assistance and time. Multi-sectoral participation is therefore necessary to re-organise the program for improving implementation fidelity and bringing about quality implementation.
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Affiliation(s)
- Mpho Molete
- Department of Community Dentistry, University of the Witwatersrand, School of Oral Health Sciences, Johannesburg, South Africa
| | - Aimee Stewart
- University of the Witwatersrand, School of Therapeutic Sciences, Johannesburg, South Africa
| | - Jude Igumbor
- University of the Witwatersrand, School of Public Health, Johannesburg, South Africa
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Duijster D, Buxton H, Benzian H, Dimaisip-Nabuab J, Monse B, Volgenant C, Dreibelbis R. Impact of a school-based water, sanitation and hygiene programme on children's independent handwashing and toothbrushing habits: a cluster-randomised trial. Int J Public Health 2020; 65:1699-1709. [PMID: 33141327 PMCID: PMC7717050 DOI: 10.1007/s00038-020-01514-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 07/17/2020] [Accepted: 10/13/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives To explore whether a school-based water, sanitation and hygiene programme, which includes group hygiene activities, contributes to the formation of independent handwashing and toothbrushing habits among Filipino children. Methods In this cluster-randomised trial, twenty primary schools were randomly allocated to the intervention or control arm. Intervention schools received group handwashing facilities and implemented daily group handwashing and toothbrushing activities. A soap use to toilet event ratio was calculated to measure children’s independent handwashing behaviour after toilet use, and dental plaque accumulation on Monday morning was measured as a proxy indicator for children’s independent toothbrushing behaviour at home. Results Four months after implementation, handwashing and toothbrushing behaviours did not significantly differ between intervention and control schools. The mean soap use in intervention schools and control schools was 0.41 g and 0.30 g per toilet event, respectively (p = 0.637). Compared to baseline, mean plaque scores reduced by 4.2% and 3.5% in intervention and control schools, respectively (p = 0.857). Conclusions Although health benefits have been established, school-based group handwashing and toothbrushing may not be sufficient to increase children’s uptake of independent hygiene behaviours. Electronic supplementary material The online version of this article (10.1007/s00038-020-01514-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Denise Duijster
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Helen Buxton
- Disease Control Department, School of Hygiene and Tropical Medicine London, London, UK
| | - Habib Benzian
- Department of Epidemiology and Health Promotion, WHO Collaborating Center for Quality Improvement and Evidence-based Dentistry, College of Dentistry, New York University, New York, USA
| | - Jed Dimaisip-Nabuab
- Gesellschaft für Internationale Zusammenarbeit (GIZ), Metro Manila, Philippines
| | - Bella Monse
- Gesellschaft für Internationale Zusammenarbeit (GIZ), Metro Manila, Philippines
| | - Catherine Volgenant
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Robert Dreibelbis
- Disease Control Department, School of Hygiene and Tropical Medicine London, London, UK
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Yu L, Yu X, Li Y, Li J, Hua F, Song G. Is it necessary for children to receive professional fluoride in addition to regular fluoride toothpaste? Protocol for a systematic review. BMJ Open 2020; 10:e037422. [PMID: 32958490 PMCID: PMC7507841 DOI: 10.1136/bmjopen-2020-037422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Regular toothbrushing with fluoride toothpaste is a fundamental intervention for caries prevention. Professional fluoride application (PFA) is widely considered a beneficial supplement to the routine use of fluoride toothpaste. However, some recent studies have failed to demonstrate the preventive effect of PFA. In addition, an increasing number of studies have highlighted the potential adverse effects of fluoride. However, little information exists on the effectiveness of additional PFA. The objective of this review is to systematically analyse the efficacy of PFA in addition to regular fluoride toothpaste among children under the age of 16. METHOD AND ANALYSIS We will search the PubMed, Embase, Google Scholar and Cochrane Central Register of Controlled Trials databases for randomised controlled trials without language or publication date restrictions. Additional studies will be identified by manually searching the reference lists of the included studies and relevant reviews. At least two authors will carry out the selection of studies independently and in duplicate. The Cochrane Risk of Bias tool will be used to assess the risk of bias of the included studies. The random effects model will be used for meta-analyses. The data synthesis will be conducted using Review Manager software (RevMan V.5.3). The Grading of Recommendation, Assessment, Development and Evaluation will be used to assess the quality of supporting evidence for each major comparison. ETHICS AND DISSEMINATION There is no need for ethical approval. The results of this review will be disseminated through peer-reviewed publications and social networks. PROSPERO REGISTRATION NUMBER CRD42020165270.
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Affiliation(s)
- Lintong Yu
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xueqian Yu
- Library, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yueyang Li
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jun Li
- Library, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fang Hua
- Centre for Evidence-Based Stomatology, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Guangtai Song
- Department of Paediatric Dentistry, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Soldo M, Matijević J, Malčić Ivanišević A, Čuković-Bagić I, Marks L, Nikolov Borić D, Jukić Krmek S. Impact of oral hygiene instructions on plaque index in adolescents. Cent Eur J Public Health 2020; 28:103-107. [PMID: 32592553 DOI: 10.21101/cejph.a5066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 03/11/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The objective of the study, which consisted of a motivational lecture and hands-on training, was to evaluate the role of oral hygiene education for adolescents. METHODS The study population included sixty-two high school students between fourteen and fifteen years of age (thirty males and thirty-two females). The response rate was 76.5%. The measurement of oral hygiene level was performed using the modified Green Vermilion Index (GVI). The values were recorded at baseline, one week, three months, and six months after education through motivational lecture and hands-on training was performed. Descriptive and nonparametric statistical methods were used in statistical analysis. Level of significance was 0.05. RESULTS At the beginning of the study, the GVI of all examined subjects was 3.52 (SD = 0.70). One week after the motivational lecture and training, it decreased to 2.64 (SD = 0.69). Three months later, the level of plaque index had the lowest value (1.44; SD = 0.66). At the end of the study the level of plaque index increased to 2.52 (SD = 0.86). CONCLUSIONS A significant oral hygiene improvement in adolescents as a result of education was presented. However, due to a decline in oral hygiene level six months after the education, there is a need for educational programmes continuity.
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Affiliation(s)
- Mirko Soldo
- Department of Orthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Jurica Matijević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ana Malčić Ivanišević
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivana Čuković-Bagić
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Luc Marks
- Centre for Special Care in Dentistry, Ghent University Hospital, Ghent, Belgium
| | | | - Silvana Jukić Krmek
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
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Staszczyk M, Jurczak A, Magacz M, Kościelniak D, Gregorczyk-Maga I, Jamka-Kasprzyk M, Kępisty M, Kołodziej I, Kukurba-Setkowicz M, Krzyściak W. Effect of Polyols and Selected Dental Materials on the Ability to Create a Cariogenic Biofilm-On Children Caries-Associated Streptococcus Mutans Isolates. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103720. [PMID: 32466155 PMCID: PMC7277333 DOI: 10.3390/ijerph17103720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/13/2020] [Accepted: 05/21/2020] [Indexed: 01/13/2023]
Abstract
Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to assess the effect of sweeteners on the ability of clinical Streptococcus mutans strains to form biofilm on dental materials. Strains were isolated from plaque samples from 40 pediatric patients from the 3-6 ICADS II group. The ability to form biofilm was tested on composite and glass ionomer dental materials used for milk teeth filling in the presence of sucrose, xylitol, sorbitol, and erythritol. The bacterial film mass after 12, 24, 48, and 72 h and the number of bacterial colonies significantly decreased (p < 0.01) compared to the initial value for 5% erythritol and sorbitol on examined materials. A greater inhibitory effect was noted for glass ionomers compared to composites. Sucrose and xylitol supported biofilm formation, while erythritol had the best inhibitory effect. The use of fluoride-releasing glass ionomers exerted an effect synergistic to erythritol, i.e., inhibited plaque formation and the amount of cariogenic S. mutans. Selection of proper type of dental material together with replacing sucrose with polyols can significantly decrease risk of secondary caries development. Erithritol in combination with glass ionomer seems to be the most effective in secondary caries prevention.
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Affiliation(s)
- Małgorzata Staszczyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Anna Jurczak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Marcin Magacz
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Doctoral School of Health and Medical Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland
| | - Dorota Kościelniak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Iwona Gregorczyk-Maga
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Małgorzata Jamka-Kasprzyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Magdalena Kępisty
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Iwona Kołodziej
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Magdalena Kukurba-Setkowicz
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland; (M.S.); (A.J.); (D.K.); (I.G.-M.); (M.J.-K.); (M.K.); (I.K.); (M.K.-S.)
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland;
- Correspondence: ; Tel.: +48-12-620-57-60
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Xiang B, Wong HM, Perfecto AP, McGrath CPJ. The effectiveness of behavioral interventions to improve oral health in adolescents at different periods of follow-up: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2020; 103:725-733. [PMID: 31813713 DOI: 10.1016/j.pec.2019.11.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/19/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this review was to examine the effectiveness of behavioral interventions at different follow-up periods to improve adolescents' oral health. METHODS CENTRAL, MEDLINE, EMBASE and other databases were systematically searched. Inclusion criteria were as follows: participants aged 10-19 years old, randomized controlled trials using behavioral interventions, outcome measurements including oral health knowledge, attitudes, practices, and oral health status. For each included study, behavior change techniques (BCT) were identified and the quality and risk of bias assessments obtained. PROSPERO reference: CRD42018090341. RESULTS After searching and screening, 17 clinical trials were included in the systematic review. The most commonly used BCTs were behavior health link, information on consequences, and social comparisons. A significant reduction of plaque index was detected (SMD:-0.46; 95 % CI:-0.82∼-0.10) for 3 months and (SMD:-0.71; 95 % CI:-1.08∼-0.33) for 6 months. The reduction of gingival index after 6 months was also significant (SMD:-0.90; 95 % CI:-1.33∼-0.47). Oral health knowledge and oral health-related behavior were also improved after behavioral interventions. CONCLUSION There is moderate evidence that behavioral interventions are effective in promoting oral health in adolescents. To establish more evidence-based conclusions, further research should focus on: quality control of interventions, full descriptions regarding the BCT, long-term follow-ups, and behavior change reinforcements. PRACTICAL VALUE Given the need of early prevention of oral diseases, well-designed oral health promotion programme are needed to improve behavior and outcome of adolescents' oral health.
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Affiliation(s)
- Bilu Xiang
- Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Hai Ming Wong
- Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Antonio P Perfecto
- Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Colman P J McGrath
- Department of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Alkhodairi A, Alseweed M, Alwashmi S, Elmoazen RA. Clinical Evaluation of the Retention of Resin and Glass Ionomer Sealants Applied as a Part of School-Based Caries Prevention Program. Open Access Maced J Med Sci 2019; 7:4127-4130. [PMID: 32165964 PMCID: PMC7061390 DOI: 10.3889/oamjms.2019.869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/24/2019] [Accepted: 11/25/2019] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND: Using of sealant on pits and fissures is likely one of the most generally well-known strategies by the new cavity-prevention systems. AIM: The purpose of this research is to measure the retentiveness of sealants of resin-modified ionomer glass cement (GIC) and resin pits and fissures, on the first permanent molars of special patients as a part of caries prevention program in schools. METHODS: The sample was comprised by 60 molars. Resin-based sealants on one side and glass-ionomer sealant on the contralateral side of the mouth. The molars were examined in three and six months after application for retention with three standards: TR: Totally Retained; PR: Partially Retained; and CL: Completely Lost. RESULTS: by the end of the study 60% of resin sealant was present. While 55% of GIC were retentive after 6 months. CONCLUSION: Resin sealants are more retentive than glass ionomer sealants in school-based carries prevention program.
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Affiliation(s)
- Asem Alkhodairi
- College of Dentistry, Qassim University, Quassim, Saudi Arabia
| | | | | | - Ramy A Elmoazen
- College of Dentistry, Qassim University, Quassim, Saudi Arabia
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Ganss C, Heins M, Schlueter N. An oral care programme for adults- Evaluation after 15 years. PLoS One 2019; 14:e0223960. [PMID: 31805062 PMCID: PMC6894800 DOI: 10.1371/journal.pone.0223960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 10/02/2019] [Indexed: 11/18/2022] Open
Abstract
The present retrospective analysis sought to investigate the impact of the oral care programme (OCP) for adults provided at the Department of Conservative and Preventive Dentistry, Justus-Liebig-University of Giessen, Germany, on oral health parameters. The OCP was modular and included oral hygiene instruction/professional toothcleaning, nutrition counselling, fluoridation and re-motivation. From 1999–2014, data from 1665 patients (55.1% female, 44.9% male; median age 33 years, range 15;80) were available. Type/date of modules, % of proximal sites with plaque (PP) and with bleeding after probing (PB) and D3/4MFT/D3/4MFS were recorded. PP and PB values are given as median (min;max). Overall, 60.2% of the patients attended the OCP once, 19.1% twice, and 20.7% ≥ three times. Initially, PP/PB were 0.68(0;1)/0.08(0;1) resp. decreasing at visit two (0.62(0;1)/0.07(0;1) resp.; p≤0.001 each) with no further improvement over next visits. Patients with poor oral hygiene improved, but those with good oral hygiene worsened (p≤0.001 each). Shorter intervals between visits were more effective than longer intervals. Attendance patterns changed significantly over the years: earlier, patients attended more visits with different modules; later, patients preferred the oral hygiene module and the intervals between visits lengthened. Prevalence and incidence of caries was associated with higher PP levels. Attendance patterns changed over time and had a significant impact on the outcome of the OCP. The improvement of oral hygiene was limited and occurred within the first two visits; repeated sessions maintained this improvement. The results indicate the need for new strategies improving patients’ skills for efficient hygiene techniques.
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Affiliation(s)
- Carolina Ganss
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany
- * E-mail:
| | - Marie Heins
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany
| | - Nadine Schlueter
- Department of Conservative and Preventive Dentistry, Dental Clinic of the Justus-Liebig-University Giessen, Giessen, Germany
- Division for Cariology, Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center—University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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Alsumait A, ElSalhy M, Behzadi S, Raine KD, Gokiert R, Cor K, Almutawa S, Amin M. Impact evaluation of a school-based oral health program: Kuwait National Program. BMC Oral Health 2019; 19:202. [PMID: 31477082 PMCID: PMC6720988 DOI: 10.1186/s12903-019-0895-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study evaluated the relationship between enrolment in a school-based oral health prevention program (SOHP) and: 1) children's dental health status and oral health-related quality of life (OHRQoL), and 2) mothers' oral health (OH) knowledge, attitude, practice, and OHRQoL. METHODS This cross-sectional study, in the Kuwait Capital, included 440 primary school children aged 11 to 12 years and their mothers. Participants were classified into two groups: SOHP and non-SOHP. The SOHP group had been enrolled in the prevention program for at least 3 years: children had twice-a-year applications of fluoride varnish and fissure sealants if needed; mothers had, at least, one oral health education session. The non-SOHP group had negative consents and had not been exposed to the prevention program activities. Dental examinations were performed at schools using portable dental units. Caries experience was determined using the decayed (D/d), missing (M/m), and filled (F/f) teeth (T/t)/surface (S/s) indices. Children's OHRQoL was assessed using a self-administered validated Child Perceptions Questionnaire 11-14 (CPQ11-14). Mothers' OH knowledge, attitude, practice, and OHRQoL were also assessed. After Bonferroni correction, a p-value of less than 0.05 was considered statistically significant for caries experience measures while a p-value of less than 0.013 was considered statistically significant for OHRQoL subscales and mothers' OH knowledge, attitude, practice, and OHRQoL. RESULTS Mean (SD) DT/dt, DMFT/dmft and DMFS/dmfs were 1.41 (1.66), 2.35 (2.33), and 4.41 (5.86) for SOHP children, respectively. For non-SOHP children, the means were 2.61 (2.63), 3.56 (3.05), and 7.24 (7.78), respectively. The difference between the SOHP and non-SOHP was statistically significant (p < 0.001). Children enrolled in the program had a higher number of sealed and restored teeth. No significant differences were found in CPQ11-14 scores or subscale scores between the two groups. No significant difference in mothers' OH knowledge, attitude, practices or OHRQoL was found between SOHP and non-SOHP groups (P > 0.013). CONCLUSION Enrolment in the SOHP prevention services was associated with a positive impact on children's caries level with no significant impact on mothers' knowledge, attitude, practice, or OHRQoL.
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Affiliation(s)
- Aishah Alsumait
- National School Oral Health Program, Ministry of Health, PO Box No 5338, 22064, Salmiya, Kuwait.
| | - Mohamed ElSalhy
- College of Dental Medicine, University of New England, Portland, ME, USA
| | - Sahar Behzadi
- National School Oral Health Program, Ministry of Health, PO Box No 5338, 22064, Salmiya, Kuwait
| | - Kim D Raine
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Rebecca Gokiert
- Faculty of Extension, University of Alberta, Edmonton, Alberta, Canada
| | - Ken Cor
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Sabiha Almutawa
- National School Oral Health Program, Ministry of Health, PO Box No 5338, 22064, Salmiya, Kuwait
| | - Maryam Amin
- School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Maharani DA, Zhang S, Gao SS, Chu CH, Rahardjo A. Dental Caries and the Erosive Tooth Wear Status of 12-Year-Old Children in Jakarta, Indonesia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162994. [PMID: 31434265 PMCID: PMC6720660 DOI: 10.3390/ijerph16162994] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 08/17/2019] [Accepted: 08/18/2019] [Indexed: 11/30/2022]
Abstract
Background: Indonesia has the largest population of all countries in southeast Asia. However, little information is available on the oral health status of Indonesian children. The aims of this study were to assess dental caries and erosive tooth wear in 12-year-old children in Jakarta, Indonesia and to investigate the associated risk factors. Methods: Samples were selected using cluster sampling. Parents were asked to complete a self-administered questionnaire regarding their oral health knowledge, demographic information, their child’s dietary habits, and oral health-related behaviors. Experience of caries and erosive tooth wear were recorded using the Decayed, Missing (due to caries), and Filled Teeth (DMFT) index and the Basic Erosive Wear Examination (BEWE) index, respectively. Results: Of 779 children invited, 696 participated in the survey. Of these, 61% had experienced caries, and the mean DMFT score was 1.58. Almost all decay was untreated. Children who were female, who had a high frequency of soft drink intake, and whose father’s educational level was low were more likely to have dental caries. Most children had at least one lesion of erosive tooth wear. Children whose mother’s educational level was low were more likely to have erosive tooth wear. Conclusions: The prevalence of dental caries and erosive tooth wear was high in 12-year-old children in Jakarta. Their dietary habits and parental level of education were associated with the presence of these dental conditions.
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Affiliation(s)
- Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia
| | - Shinan Zhang
- Faculty of Stomatology, Kunming Medical University, Yunnan 650500, China
| | - Shiqian Sherry Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Chun-Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Anton Rahardjo
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia.
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Calderón Larrañaga S, Expósito Ruiz M, Cruz Vela P, Cuadrado Conde A, Alquézar Villarroya L, Garach Gómez A, Ruiz Hernández A, Toral López I. [Primary Care and oral health promotion: Assessment of an educational intervention in school children]. Aten Primaria 2019; 51:416-423. [PMID: 30316564 PMCID: PMC6839536 DOI: 10.1016/j.aprim.2018.05.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 05/08/2018] [Accepted: 05/15/2018] [Indexed: 11/17/2022] Open
Abstract
Objetivo Evaluar a corto y medio plazo la efectividad de una intervención de promoción de la salud bucodental impulsada desde Atención Primaria. Diseño Ensayo comunitario de intervención no aleatorizado. Emplazamiento Tres centros educativos de características sociodemográficas similares de un barrio empobrecido de Granada. Participantes Participaron en el estudio 82 alumnos de entre 5 y 6 años del colegio intervención (CI) y 109 de los colegios control (CC), así como los profesores y padres/madres de los alumnos del CI. Intervención Actividades escolares de promoción de la salud bucodental dirigidas a los alumnos, y reuniones periódicas con los profesores y padres/madres del CI durante 2 cursos consecutivos. Mediciones principales Conocimientos sobre salud bucodental y hábitos higiénico-dietéticos de los alumnos, valorados mediante cuestionarios distribuidos antes de la intervención y transcurridos 6 y 18 meses. Resultados Transcurridos 18 meses, los conocimientos adquiridos fueron significativamente superiores en el CI (OR 3,54; IC 95% 1,46-8,58) en comparación con los CC. El consumo de alimentos saludables aumentó significativamente en el desayuno (OR 2,95; IC 95% 1,26-6,89) y la merienda (OR 3,67; IC 95% 1,49-9,05) y disminuyó el consumo de bollería (OR 4,05; IC 95% 1,68-9,81) y refrescos azucarados (OR 3,79; IC 95% 1,57-9,12) respecto a los CC. No se observaron mejoras en relación con la higiene bucodental en el CI. Conclusiones Las intervenciones escolares de educación sanitaria, desarrolladas de forma intersectorial, participativa y considerando los contextos socioeconómicos particulares, resultan eficaces en la mejora del conocimiento y los hábitos dietéticos de los alumnos.
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Affiliation(s)
| | - Manuela Expósito Ruiz
- Fundación para la Investigación Biosanitaria de Andalucía Oriental (FIBAO), Granada, España
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Levinson J, Kohl K, Baltag V, Ross DA. Investigating the effectiveness of school health services delivered by a health provider: A systematic review of systematic reviews. PLoS One 2019; 14:e0212603. [PMID: 31188826 PMCID: PMC6561551 DOI: 10.1371/journal.pone.0212603] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 05/27/2019] [Indexed: 01/08/2023] Open
Abstract
Schools are the only institution regularly reaching the majority of school-age children and adolescents across the globe. Although at least 102 countries have school health services, there is no rigorous, evidence-based guidance on which school health services are effective and should be implemented in schools. To investigate the effectiveness of school health services for improving the health of school-age children and adolescents, a systematic review of systematic reviews (overview) was conducted. Five databases were searched through June 2018. Systematic reviews of intervention studies that evaluated school-based or school-linked health services delivered by a health provider were included. Review quality was assessed using a modified Ballard and Montgomery four-item checklist. 1654 references were screened and 20 systematic reviews containing 270 primary studies were assessed narratively. Interventions with evidence for effectiveness addressed autism, depression, anxiety, obesity, dental caries, visual acuity, asthma, and sleep. No review evaluated the effectiveness of a multi-component school health services intervention addressing multiple health areas. From the limited amount of information available in existing systematic reviews, the strongest evidence supports implementation of anxiety prevention programs, indicated asthma education, and vision screening with provision of free spectacles. Additional systematic reviews are needed that analyze the effectiveness of comprehensive school health services, and specific services for under-researched health areas relevant for this population.
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Affiliation(s)
- Julia Levinson
- Institute for Medical Informatics, Biometrics and Epidemiology, Ludwig-Maximilians-Universität (LMU) Munich, Munich, Bavaria, Germany
| | - Kid Kohl
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Valentina Baltag
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - David Anthony Ross
- Department of Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
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Waldron C, Nunn J, Mac Giolla Phadraig C, Comiskey C, Guerin S, van Harten MT, Donnelly‐Swift E, Clarke MJ. Oral hygiene interventions for people with intellectual disabilities. Cochrane Database Syst Rev 2019; 5:CD012628. [PMID: 31149734 PMCID: PMC6543590 DOI: 10.1002/14651858.cd012628.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Periodontal (gum) disease and dental caries (tooth decay) are the most common causes of tooth loss; dental plaque plays a major role in the development of these diseases. Effective oral hygiene involves removing dental plaque, for example, by regular toothbrushing. People with intellectual disabilities (ID) can have poor oral hygiene and oral health outcomes. OBJECTIVES To assess the effects (benefits and harms) of oral hygiene interventions, specifically the mechanical removal of plaque, for people with intellectual disabilities (ID). SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases to 4 February 2019: Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL; Cochrane Register of Studies), MEDLINE Ovid, Embase Ovid and PsycINFO Ovid. ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. The Embase search was restricted by date due to the Cochrane Centralised Search Project, which makes available clinical trials indexed in Embase through CENTRAL. We handsearched specialist conference abstracts from the International Association of Disability and Oral Health (2006 to 2016). SELECTION CRITERIA We included randomised controlled trials (RCTs) and some types of non-randomised studies (NRS) (non-RCTs, controlled before-after studies, interrupted time series studies and repeated measures studies) that evaluated oral hygiene interventions targeted at people with ID or their carers, or both. We used the definition of ID in the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). We defined oral hygiene as the mechanical removal of plaque. We excluded studies that evaluated chemical removal of plaque, or mechanical and chemical removal of plaque combined. DATA COLLECTION AND ANALYSIS At least two review authors independently screened search records, identified relevant studies, extracted data, assessed risk of bias and judged the certainty of the evidence according to GRADE criteria. We contacted study authors for additional information if required. We reported RCTs and NRSs separately. MAIN RESULTS We included 19 RCTs and 15 NRSs involving 1795 adults and children with ID and 354 carers. Interventions evaluated were: special manual toothbrushes, electric toothbrushes, oral hygiene training, scheduled dental visits plus supervised toothbrushing, discussion of clinical photographs showing plaque, varied frequency of toothbrushing, plaque-disclosing agents and individualised care plans. We categorised results as short (six weeks or less), medium (between six weeks and 12 months) and long term (more than 12 months).Most studies were small; all were at overall high or unclear risk of bias. None of the studies reported quality of life or dental caries. We present below the evidence available from RCTs (or NRS if the comparison had no RCTs) for gingival health (inflammation and plaque) and adverse effects, as well as knowledge and behaviour outcomes for the training studies.Very low-certainty evidence suggested a special manual toothbrush (the Superbrush) reduced gingival inflammation (GI), and possibly plaque, more than a conventional toothbrush in the medium term (GI: mean difference (MD) -12.40, 95% CI -24.31 to -0.49; plaque: MD -0.44, 95% CI -0.93 to 0.05; 1 RCT, 18 participants); brushing was carried out by the carers. In the short term, neither toothbrush showed superiority (GI: MD -0.10, 95% CI -0.77 to 0.57; plaque: MD 0.20, 95% CI -0.45 to 0.85; 1 RCT, 25 participants; low- to very low-certainty evidence).Moderate- and low-certainty evidence found no difference between electric and manual toothbrushes for reducing GI or plaque, respectively, in the medium term (GI: MD 0.02, 95% CI -0.06 to 0.09; plaque: standardised mean difference 0.29, 95% CI -0.07 to 0.65; 2 RCTs, 120 participants). Short-term findings were inconsistent (4 RCTs; low- to very low-certainty evidence).Low-certainty evidence suggested training carers in oral hygiene care had no detectable effect on levels of GI or plaque in the medium term (GI: MD -0.09, 95% CI -0.63 to 0.45; plaque: MD -0.07, 95% CI -0.26 to 0.13; 2 RCTs, 99 participants). Low-certainty evidence suggested oral hygiene knowledge of carers was better in the medium term after training (MD 0.69, 95% CI 0.31 to 1.06; 2 RCTs, 189 participants); this was not found in the short term, and results for changes in behaviour, attitude and self-efficacy were mixed.One RCT (10 participants) found that training people with ID in oral hygiene care reduced plaque but not GI in the short term (GI: MD -0.28, 95% CI -0.90 to 0.34; plaque: MD -0.47, 95% CI -0.92 to -0.02; very low-certainty evidence).One RCT (304 participants) found that scheduled dental recall visits (at 1-, 3- or 6-month intervals) plus supervised daily toothbrushing were more likely than usual care to reduce GI (pocketing but not bleeding) and plaque in the long term (low-certainty evidence).One RCT (29 participants) found that motivating people with ID about oral hygiene by discussing photographs of their teeth with plaque highlighted by a plaque-disclosing agent, did not reduce plaque in the medium term (very low-certainty evidence).One RCT (80 participants) found daily toothbrushing by dental students was more effective for reducing plaque in people with ID than once- or twice-weekly toothbrushing in the short term (low-certainty evidence).A benefit to gingival health was found by one NRS that evaluated toothpaste with a plaque-disclosing agent and one that evaluated individualised oral care plans (very low-certainty evidence).Most studies did not report adverse effects; of those that did, only one study considered them as a formal outcome. Some studies reported participant difficulties using the electric or special manual toothbrushes. AUTHORS' CONCLUSIONS Although some oral hygiene interventions for people with ID show benefits, the clinical importance of these benefits is unclear. The evidence is mainly low or very low certainty. Moderate-certainty evidence was available for only one finding: electric and manual toothbrushes were similarly effective for reducing gingival inflammation in people with ID in the medium term. Larger, higher-quality RCTs are recommended to endorse or refute the findings of this review. In the meantime, oral hygiene care and advice should be based on professional expertise and the needs and preferences of the individual with ID and their carers.
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Affiliation(s)
- Catherine Waldron
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | - June Nunn
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | | | - Catherine Comiskey
- Trinity College Dublin, University of DublinSchool of Nursing and Midwifery24 D'Olier StDublinIrelandD02 T283
| | - Suzanne Guerin
- University College DublinSchool of PsychologyDublinIrelandDO4 V1W8
| | - Maria Theresa van Harten
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | - Erica Donnelly‐Swift
- Trinity College Dublin, University of DublinSchool of Dental ScienceLincoln PlaceDublinIrelandD02 F859
| | - Mike J Clarke
- Queen's University BelfastCentre for Public HealthInstitute of Clinical Sciences, Block B, Royal Victoria HospitalGrosvenor RoadBelfastNorthern IrelandUKBT12 6BJ
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Deinzer R, Cordes O, Weber J, Hassebrauck L, Weik U, Krämer N, Pieper K, Margraf-Stiksrud J. Toothbrushing behavior in children - an observational study of toothbrushing performance in 12 year olds. BMC Oral Health 2019; 19:68. [PMID: 31035974 PMCID: PMC6489256 DOI: 10.1186/s12903-019-0755-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/03/2019] [Indexed: 12/02/2022] Open
Abstract
Background Many countries offer systematic group prevention programs in kindergarten and school in order to promote children’s oral health. Little is known, however, about the actual toothbrushing abilities of children when group prevention programs end. Methods In Germany, all children take advantage from a nationwide group prevention program (called “Gruppenprophylaxe”) lasting from kindergarten up to sixth grade (12 years of age). Standardized recommendations are given concerning brushing systematics and brushing movements. N = 174 children at the age of 12 were thus randomly selected from two German towns and were asked to perform toothbrushing to the best of their abilities in front of a mirror which also served as a camera. Brushing behavior was analyzed by video analysis. Results Children brushed their teeth for an average of 200 s ± 80.48 s (mean ± SD). Still, more than 55% missed at least one sextant when brushing inner surfaces, 16% missed them all. Only 7.5% of the children brushed both inner and outer surfaces by the intended movements (vertical movements on the inner surfaces and circular movements on the outer surfaces) for at least 90% of the respective brushing time. Instead, horizontal brushing was very common on the lateral surfaces. Conclusions The present analysis indicates that children have low efficiency to adopt the tooth-brushing recommendations given in prevention programs. This is surprising as great endeavors are made to help children internalize the recommendations. Future research is needed to better understand which factors impede adoption of toothbrushing recommendations in children and which efforts are necessary to improve their toothbrushing abilities. Electronic supplementary material The online version of this article (10.1186/s12903-019-0755-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Renate Deinzer
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany.
| | - Oliver Cordes
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Julia Weber
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Lisa Hassebrauck
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Ulrike Weik
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Norbert Krämer
- Institute of Medical Psychology, Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, D-35392, Giessen, Germany
| | - Klaus Pieper
- Department of Medicine, Philipps University of Marburg, Georg-Voigt-Straße 3, D-35039, Marburg, Germany
| | - Jutta Margraf-Stiksrud
- Department of Psychology, Philipps University of Marburg, Gutenbergstr. 18, D-35032, Marburg, Germany
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Nelson S, Milgrom P, Albert JM, Selvaraj D, Cunha-Cruz J, Curtan S, Copeland T, Heima M, Rothen M, Beck G, Ferretti G, Riedy C. Randomized Trial Based on the Common-Sense Model of Self-regulation to Increase Child Dental Visits. JDR Clin Trans Res 2019; 4:323-332. [PMID: 30931720 DOI: 10.1177/2380084419830662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION School screening and the note home (pinned to a backpack) informing parents/caregivers that their child needs to see a dentist have not been effective. OBJECTIVES The Family Access to a Dentist Study (FADS) evaluated the effectiveness of school interventions based on the common-sense model of self-regulation (CSM) among K-4 children needing restorative treatment. METHODS FADS was a multisite double-blind randomized controlled trial with 5 arms. FADS tested a CSM-driven referral letter and dental information guide (DIG) to move caregivers from inaccurate to accurate perceptions of dental caries. Six school districts from Ohio and Washington (14 schools) participated in school years 2015 to 2016 and 2016 to 2017. A total of 611 caregivers were randomized, and 86% (n = 597 children) completed the exit examination. The primary outcome was receipt of care based on a change in oral health status determined clinically within 1 school year. RESULTS In accordance with our primary aims, 5 arms were collapsed into 3: CSM letter and reduced CSM letter (combined), CSM letter + DIG and reduced CSM letter + reduced DIG (combined), and standard letter. Among all sites, 39.7% received restorative care (237 of 597). Combined analysis of sites revealed that the CSM referral letter (with and without the DIG) did not increase dental visits when compared with the standard letter. However, for combined sites (East Cleveland, Ohio; Washington), the CSM + DIG increased dental visits when compared with standard letter in univariate analysis (51.3% vs. 40.9%), indicating 1.6-times increased odds of a dental visit (95% CI, 0.97 to 2.58) after imputation and adjustment for covariates. The CSM + DIG group had 1.9-times increased odds (95% CI, 1.21 to 3.08) of care when compared the CSM letter alone. CONCLUSION A CSM-driven approach to informing caregivers of the chronic nature of caries with resources in an illustrative manner can increase the benefit of school oral health screening (ClinicalTrials.gov NCT02395120). KNOWLEDGE TRANSFER STATEMENT A school dental referral (note home) that tells a parent that the child has cavities has not been effective. In this trial, a referral based on the common-sense model of self-regulation increased follow-up care for children with restorative needs.
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Affiliation(s)
- S Nelson
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - P Milgrom
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - J M Albert
- Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - D Selvaraj
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - J Cunha-Cruz
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - S Curtan
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - T Copeland
- Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - M Heima
- Department of Pediatric Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - M Rothen
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - G Beck
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - G Ferretti
- Department of Pediatric Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - C Riedy
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA
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Bartosova M, Svetlak M, Kukletova M, Borilova Linhartova P, Dusek L, Izakovicova Holla L. Emotional stimuli candidates for behavioural intervention in the prevention of early childhood caries: a pilot study. BMC Oral Health 2019; 19:33. [PMID: 30777061 PMCID: PMC6379970 DOI: 10.1186/s12903-019-0718-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 01/21/2019] [Indexed: 11/10/2022] Open
Abstract
Background Oral diseases, such as early childhood caries (ECC), have a complex etiology with common, behaviour-related risk factors. Appropriately targeted behavioural intervention using effective tools can help to eliminate risk behaviour leading to ECC. The aim of this study was to ascertain which visual stimuli with a supporting text evoke the strongest emotional response in infants’ mothers and, therefore, are suitable candidates for inclusion in behavioural interventions within the prevention of ECC. Methods Thirty-nine mothers of one-year-old children who filled out an originally designed electronic questionnaire, containing 20 visual stimuli with accompanying texts related to dental caries (10/10 with positive/negative intended emotional response), were included in this cross-sectional study. The emotional impact of each stimulus in the mothers was evaluated using the Self-Assessment Manikin (SAM) technique, which represents three emotional dimensions: valence, arousal, and dominance. Results Each of the stimuli was assessed by the mothers of infants based on its emotional impact. The real emotional response (evaluated according to the median of valence) was in line with the primarily intended response in 90% of cases (p < 0.05). The text with a warning evoked a greater emotional response (evaluated according to the median of arousal) in mothers than only the informative instruction (p < 0.05). The relationship between arousal and valence (r = − 0.99; p < 0.05) indicates that the more aversive stimuli raise higher arousal. The significant correlation between valence and dominance shows that the more positive the stimuli, the higher feeling of control over the evoked emotion the mothers have (r = 0.83; p < 0.05), and, on the contrary, the lowest control over emotion is correlated with higher arousal (r = − 0.85; p < 0.05). Generally, mothers rated themselves as in high control of their emotions over the individual stimuli. Conclusions This pilot study proved that negative pictorial and text warnings about the risks of developing caries had the potential to evoke strong emotional responses in the mothers of infants. We identified three visual stimuli that could be included in future extensive motivation material in an attempt to affect the preventive behaviour of mothers, and thus the oral health of their infants. Electronic supplementary material The online version of this article (10.1186/s12903-019-0718-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Michaela Bartosova
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Miroslav Svetlak
- Department of Psychology and Psychosomatics, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martina Kukletova
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petra Borilova Linhartova
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Ladislav Dusek
- Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic
| | - Lydie Izakovicova Holla
- Clinic of Stomatology, Institution Shared with St. Anne's Faculty Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic. .,Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic. .,RECETOX - Research Center for Toxic Compounds, Faculty of Science, Masaryk University, Brno, Czech Republic.
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Phanthavong S, Nonaka D, Phonaphone T, Kanda K, Sombouaphan P, Wake N, Sayavong S, Nakasone T, Phongsavath K, Arasaki A. Oral health behavior of children and guardians' beliefs about children's dental caries in Vientiane, Lao People's Democratic Republic (Lao PDR). PLoS One 2019; 14:e0211257. [PMID: 30682133 PMCID: PMC6347166 DOI: 10.1371/journal.pone.0211257] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/10/2019] [Indexed: 11/25/2022] Open
Abstract
Dental caries is considered a major health problem among schoolchildren in Lao People’s Democratic Republic (Lao PDR). According to Health Belief Model (HBM)-based research, children’s oral health behavior can be determined by their guardians’ beliefs. This study aimed to describe children’s oral health behavior and its association with childhood dental caries, as well as to assess associations between children’s tooth-brushing behavior and guardians’ beliefs in an urban area of Lao PDR, using HBM. Data were collected from ten primary schools in the Sisattanak district, the Vientiane capital, between 2013 and 2014. Ten dentists with the help of dental hygienists and schoolteachers conducted dental health check-ups at the schools that diagnosed dental caries based on visual inspection. They also conducted a questionnaire-based survey with the schoolchildren’s guardians to collect data including socio-economic and demographic information, their children’s oral health behavior, and guardians’ beliefs derived from HBM, including perceived susceptibility to and perceived severity of child dental caries, perceived benefit of and perceived barrier to child’s tooth brushing, and self-efficacy in making their children brush their teeth twice daily. A mixed-effects logistic regression model assessed the association between dental caries and children’s oral health behavior and between children’s tooth-brushing behavior and guardians’ beliefs. Data from 1161 of 1304 (89.0%) children registered at the schools were used. The prevalence of dental caries was 82%. Children who brushed their teeth ≥ twice/day were significantly less likely to have dental caries than those brushing once or seldom (OR: 0.64, 95% CI: 0.45 to 0.91). The number of children who brushed twice daily also significantly increased with the increased level of guardians’ self-efficacy (OR: 2.14, 95% CI: 1.91 to 2.41). In conclusion, childhood dental caries was associated with daily tooth brushing. Children’s tooth-brushing behavior was associated with guardians’ self-efficacy in making their children brush twice daily.
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Affiliation(s)
- Somphone Phanthavong
- Dental Division, Setthathirath Hospital, Vientiane, Lao PDR
- Faculty of Dentistry, University of Health Sciences, Vientiane, Lao PDR
| | - Daisuke Nonaka
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
- * E-mail:
| | | | - Kyoko Kanda
- International Collaboration Section, General Strategic Planning Division, University of the Ryukyus, Okinawa, Japan
| | | | - Norie Wake
- School of Health Sciences, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
| | | | - Toshiyuki Nakasone
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, Okinawa, University of the Ryukyus, Japan
| | | | - Akira Arasaki
- Department of Oral and Maxillofacial Functional Rehabilitation, Graduate School of Medicine, Okinawa, University of the Ryukyus, Japan
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Lalloo R, Tadakamadla SK, Kroon J, Tut O, Kularatna S, Boase R, Kapellas K, Gilchrist D, Cobbledick E, Rogers J, Johnson NW. Salivary characteristics and dental caries experience in remote Indigenous children in Australia: a cross-sectional study. BMC Oral Health 2019; 19:21. [PMID: 30654791 PMCID: PMC6337781 DOI: 10.1186/s12903-018-0692-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 12/12/2018] [Indexed: 01/15/2023] Open
Abstract
Background While associations between salivary characteristics and dental caries have been well studied, we are not aware of this being assessed in a remote Indigenous child population, where lifestyles may be different from urban children. Our aim was to assess associations between caries experience and putative biomarkers in saliva, accounting for oral hygiene and dietary habits. Methods Children attending schools in an Indigenous community in remote north Queensland, Australia were invited to an oral examination by qualified and calibrated examiners. Salivary flow rate, pH, buffering capacity and loads of mutans streptococci (MS), lactobacilli (LB) and yeasts were determined. Also, data on tooth brushing frequency and soft drinks consumption were obtained via a questionnaire. Caries experience was recorded by the International Caries Detection and Assessment System (ICDAS-II), and quantified as decayed, missing and filled surfaces. Relationships between the salivary variables and the cumulative caries experience (dmfs+DMFS) in the deciduous and permanent dentitions were examined by multivariate analyses to control the effect of confounders. Results The mean cumulative decayed (DS + ds), missing (MS + ms) and filled (FS + fs) surfaces were 3.64 (SD: 4.97), 1.08 (4.38) and 0.79 (1.84) respectively. Higher salivary MS and LB counts, low tooth brushing frequency and daily soft drink consumption were significantly related to greater caries experience. Caries experience was about twice in those with ≥10^5 CFU/ml saliva counts of MS (mean = 6.33, SD: 8.40 vs 3.11, 5.77) and LB (7.03, 7.49 vs 4.41, 8.00). In the fully-adjusted multivariate model, caries experience in those with higher counts of MS and LB were 51 and 52% more than those with lower counts. Conclusions As with studies in other populations, childhood salivary counts of MS and LB were significantly associated with greater caries experience in this remote Indigenous community. To address the serious burden of oral disease, we are researching ways to promote a healthy oral environment by encouraging good dietary habits, and emphasising the importance of daily tooth brushing with a fluoridated toothpaste. Our ongoing longitudinal studies will indicate the success of measures employed to reduce the counts of bacteria closely associated with cariogenesis and their impact on caries increment. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR), No: ACTRN12615000693527; date of registration: 3rd July 2015.
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Affiliation(s)
- R Lalloo
- School of Dentistry, The University of Queensland, Brisbane, Australia
| | - S K Tadakamadla
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia
| | - J Kroon
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia.,School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - O Tut
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia
| | - S Kularatna
- Australian Centre for Health Service Innovation, School of Public Health and Social Work, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD, 4059, Australia
| | - R Boase
- School of Dentistry, James Cook University, Cairns, Australia
| | - K Kapellas
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, Australia
| | - D Gilchrist
- School of Dentistry, James Cook University, Cairns, Australia
| | - E Cobbledick
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia
| | - J Rogers
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia
| | - N W Johnson
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Gold Coast, Queensland, 4222, Australia. .,School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia. .,King's College London Dental Institute, London, UK.
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Nagashima Y, Shigeishi H, Fukada E, Amano H, Urade M, Sugiyama M. Self-check with plaque disclosing solution improves oral hygiene in schoolchildren living in a children's home. ACTA ACUST UNITED AC 2018; 76:50. [PMID: 30214722 PMCID: PMC6130122 DOI: 10.1186/s13690-018-0296-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 07/12/2018] [Indexed: 11/10/2022]
Abstract
Background The effectiveness of an oral hygiene program for children living in a children's home has been reported. However, to the best of our knowledge, no studies have evaluated the possible effects of self-checking of oral health among children residing in a children's home. The objective of this study was to examine if self-checking using plaque disclosing solution improves oral hygiene in schoolchildren living in a children's home. Methods We enrolled nine schoolchildren (six girls) without untreated decayed teeth living in a children's home in Japan. This preliminary study was designed as a 5-month program comprising group and individual instructions and self-checking using plaque disclosing solution. Paired t-test and Wilcoxon signed-rank test were used for statistical analysis to evaluate the change of Plaque Control Record (PCR) and Patient Hygiene Performance (PHP). Results The mean PCR significantly decreased to 38.7% after 3 months of self-checking using disclosing solution compared with that before self-checking (i.e., at 1 month) (60.7%) (P < 0.01). PHP score significantly decreased to 1.4 at 4 months compared with that at baseline (2.8) and at 1 month (2.7) (P = 0.012 and P = 0.018). Improvement of oral hygiene status was evaluated according to the ratio of PCR at 4 months to that at 1 month. The average improvement ratio was 0.4 ± 0.35 (range: 0.0-1.0). Significant correlation was not found between improvement rate and school grade (r = 0.63, P = 0.070). Conclusions Our results suggest that self-checking with disclosing solution may be effective in improving oral hygiene among schoolchildren at a children's home.
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Affiliation(s)
- Yukiko Nagashima
- 1Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan.,Hyogo Dental Hygienist College, Hyogo, Japan
| | - Hideo Shigeishi
- 1Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan
| | - Eri Fukada
- 1Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan
| | - Hideaki Amano
- 3Department of Maxillofacial Functional Development, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | | | - Masaru Sugiyama
- 1Department of Public Oral Health, Program of Oral Health Sciences, Graduate School of Biomedical & Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553 Japan
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Kaewkamnerdpong I, Krisdapong S. The Associations of School Oral Health-Related Environments with Oral Health Behaviours and Dental Caries in Children. Caries Res 2018; 52:166-175. [DOI: 10.1159/000485747] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 11/20/2017] [Indexed: 11/19/2022] Open
Abstract
Creating supportive oral health-related environments in schools is an important strategy for promoting schoolchildren’s oral health. This study determined the associations between school environments and children’s oral behaviour and dental caries. The data on school oral health-related environments were obtained through observation and interviews. Oral behaviour and dental caries data were collected through interviews and oral examinations of 984 sixth grade children. χ2 and multiple logistic regression, adjusted for sociodemographic and economic status, other school environment variables, and oral behaviour were used. Providing fresh fruit with school meals was associated with low sweets consumption and low caries levels. Children’s daily sweets consumption was positively associated with sweetened milk sales in schools. Selling sweetened beverages, including sweetened milk, sweetened drinks, and soft drinks, was associated with high caries levels, while selling meat and crispy packed snacks was associated with low caries levels. Children in schools with integrated oral health education were significantly more likely to brush their teeth twice a day and to brush after lunch. In conclusion, school oral health-related environments, especially available food choices, were associated with sweets consumption behaviour and caries levels. Children in schools with integrated oral health education had better brushing habits.
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Harris R, Raison H, Christian B, Bakare L, Okwundu CI, Burnside G. Interventions for improving adults' use of primary oral health care services. Hippokratia 2017. [DOI: 10.1002/14651858.cd012771] [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]
Affiliation(s)
- Rebecca Harris
- University of Liverpool; Department of Health Services Research; Waterhouse Building, Block B, 1st Floor, Room B113 1-5 Brownlow Street Liverpool UK L69 3GL
| | - Heather Raison
- University of Liverpool; Department of Health Services Research; Waterhouse Building, Block B, 1st Floor, Room B113 1-5 Brownlow Street Liverpool UK L69 3GL
| | - Bradley Christian
- La Trobe University; Department of Dentistry and Oral Health, La Trobe Rural Health School; Bendigo Australia
| | - Lawal Bakare
- HEIT Solutions; 58B Itolo Street, Off Eric Moore Surulere Lagos Nigeria
| | - Charles I Okwundu
- Stellenbosch University; Centre for Evidence-based Health Care, Faculty of Medicine and Health Sciences; Francie van Zijl Drive Tygerberg Cape Town South Africa 7505
| | - Girvan Burnside
- University of Liverpool; Department of Biostatistics, Institute of Translational Medicine, Faculty of Health and Life Sciences; Liverpool UK
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Lin YL, Davies K, Callery P. Experience of maintaining tooth brushing for children born with a cleft lip and/or palate. BMC Oral Health 2017; 17:120. [PMID: 28836989 PMCID: PMC5571587 DOI: 10.1186/s12903-017-0412-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 08/16/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Children with a Cleft Lip and/or Palate (CL/P) have been reported to have poorer oral health than those without the condition. The consequences for these children can be particularly problematic due to implications for future treatments. Tooth brushing is an important behaviour contributing to children's oral health, but is under researched in the CL/P population. The aim of the study is to explore the experience of maintaining tooth brushing among children in the United Kingdom (UK) with a CL/P and their parents. METHODS Semi-structured interviews were carried out with twenty-two parents and sixteen children with a CL/P (5-11 years), recruited at a cleft centre in the UK. Thematic analysis was used for data analysis. RESULTS Three key themes were drawn from the qualitative data: first, parents of children with a CL/P generally had strong motivation to look after their children's teeth but children's motivation was inconsistent. Second, parents were primary enablers of children's tooth brushing behaviour, often employing approaches adapted to their child's characteristics to encourage tooth brushing. Third, a range of obstacles were encountered by parents and children in maintaining regular tooth brushing behaviours. They reported obstacles such as issues related to CL/P, 'forgetting' and childhood illness. CONCLUSIONS The paper suggests that parents of children with a CL/P need support to enact their intention to maintain regular tooth brushing and prioritise tooth brushing within the context of demanding and dynamic family life.
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Affiliation(s)
- Yin-Ling Lin
- Division of Dentistry, The University of Manchester, JR Moore Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Karen Davies
- Division of Human Communication, Development and Hearing, The University of Manchester, Ellen Wilkinson Building, Oxford Road, Manchester, M13 9PL, UK
| | - Peter Callery
- Division of Nursing, Midwifery and Social Work, The University of Manchester, Jean McFarlane Building, Oxford Road, Manchester, M13 9PL, UK
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Cartes-Velasquez R, Araya C, Flores R, Luengo L, Castillo F, Bustos A. A motivational interview intervention delivered at home to improve the oral health literacy and reduce the morbidity of Chilean disadvantaged families: a study protocol for a community trial. BMJ Open 2017; 7:e011819. [PMID: 28710202 PMCID: PMC5577873 DOI: 10.1136/bmjopen-2016-011819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Oral health education/promotion interventions have been identified as cost-efficient tools to improve the oral health of the population. These interventions are regularly made in contexts where the target population is captive, for example, in health centres. In Chile, there are no oral health interventions delivered at home. METHODS AND ANALYSIS This community trial covers two disadvantaged urban areas in the province of Concepción. Both sectors have public preschool education coverage with a traditional programme (TP) to promote oral health. The intervention will comprise four to six visits by dental hygienists trained in the delivery of a standardised oral health promotion programme using motivational interviewing (MI) at home. The experimental group will receive TP and MI, while the control group will receive only TP. If a positive and significant effect of MI is found, this will be administered to the control group. For a 50% reduction in the incidence of caries, a sample size of 120 preschoolers per group is estimated. Data will be gathered on demographic and socioeconomic variables; oral health outcomes using WHO oral health indicators (the prevalence and severity of caries, periodontal disease, dentofacial anomalies and oral hygiene); the oral health literacy of caregivers, measured by the Rapid Estimation of Adult Literacy in Dentistry and the Oral Health Literacy Instrument, both validated for the Chilean population. Assessments will take place at baseline and at 12-month follow-up. ETHICS AND DISSEMINATION The university bioethics committee approved this study (EI/21/2014). We will submit the trial's results for presentation at international scientific meetings and to peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12615000450516.
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Affiliation(s)
- Ricardo Cartes-Velasquez
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Carlos Araya
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Raúl Flores
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Luis Luengo
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Francisca Castillo
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
| | - Alex Bustos
- Department of Preventive and Public Health Dentistry, Universidad de Concepción, School of Dentistry, Concepcion, Chile
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Effect of a School-Based Supervised Tooth Brushing Program In Mexico City: A Cluster Randomized Intervention. J Clin Pediatr Dent 2017; 41:204-213. [PMID: 28422600 DOI: 10.17796/1053-4628-41.3.204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Large-scale school-based programs effectively provide health education and preventive strategies. SaludARTE is a school-based program, including supervised tooth brushing, implemented in 51 elementary schools in Mexico City. OBJECTIVES To assess the three-month efficacy of supervised tooth brushing in reducing dental plaque, gingival inflammation, and bleeding on probing in schoolchildren participating in SaludARTE. STUDY DESIGN This was a pragmatic cluster randomized intervention, with two parallel branches. Four randomly selected schools participating in SaludARTE (n=200) and one control school, which did not participate in the program (CG) (n=50), were assessed. Clusters were not randomly allocated to intervention. The main outcomes were as follows: mean percentage gingival units with no inflammation, dental surfaces with no dental plaque, and gingival margins with no bleeding. The independent variable was supervised tooth brushing at school once a day after a meal. Guardians and children responded to a questionnaire on sociodemographic and oral hygiene practices, and children were examined dentally. Mean percentage differences were compared (baseline and follow-up). RESULTS A total of 75% of guardians from the intervention group (IG) and 77% from the CG answered the questionnaire. Of these, 89.3% were women, with a mean age of 36.9±8.5 years. No differences in sociodemographic variables were observed between groups, and 151 children from the IG and 35 from the CG were examined at baseline and follow-up. Mean percentage differences for plaque-free surfaces (8.8±28.5%) and healthy gingival units (23.3%±23.2%) were significantly higher in the IG. CONCLUSION The school-supervised tooth brushing program is effective in improving oral hygiene and had a greater impact on plaque and gingivitis than on gingival bleeding. It is necessary to reinforce the oral health education component of the program.
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Rush E, Obolonkin V, Young L, Kirk M, Tseng M. Under 5 Energize: Tracking Progress of a Preschool Nutrition and Physical Activity Programme with Regional Measures of Body Size and Dental Health at Age of Four Years. Nutrients 2017; 9:E456. [PMID: 28471396 PMCID: PMC5452186 DOI: 10.3390/nu9050456] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/13/2017] [Accepted: 05/03/2017] [Indexed: 11/17/2022] Open
Abstract
To reduce weight gain and encourage healthy eating including reduced sugar intake, Under 5 Energize (U5E) was introduced to 121 early-childhood-centres in the Waikato region of New Zealand in July 2013. Using anonymized data collected from January 2013 to September 2016 through free physical assessments of all 4-year-olds provided by the NZ Ministry of Health, the prevalence of obesity and dental decay children measured in the Waikato region was examined. Data were divided into four periods representing pre-implementation and 3 years of gradual implementation. Obesity was defined according to International Obesity Task Force criteria. Of 18,774 Waikato children included in the analysis, 32% were indigenous Māori, and 32% attended an U5E centre. Pre-implementation prevalences of obesity (4%) and visible dental decay (11%) of children attending and not-attending U5E centres were not different. While obesity prevalence did not change significantly over time, prevalence of dental decay decreased among children at U5E (trend p = 0.003) but not non-U5E (trend p = 0.14) centres, such that prevalences were significantly different between children at U5E vs. non-U5E centres at Year 3 (p = 0.02). The U5E intervention is a small but arguably effective part of the wider system approach that is required to improve children's future health.
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Affiliation(s)
- Elaine Rush
- Child Health Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0640, New Zealand.
| | - Vladimir Obolonkin
- Child Health Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0640, New Zealand.
| | - Leanne Young
- Child Health Research, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0640, New Zealand.
| | | | - Marilyn Tseng
- Kinesiology Department, California Polytechnic State University, San Luis Obispo, CA 93407-0386, USA.
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Waldron C, MacGiolla Phadraig C, Nunn J, Comiskey C, Donnelly-Swift E, Guerin S, Clarke MJ. Oral hygiene programmes for people with intellectual disabilities. Hippokratia 2017. [DOI: 10.1002/14651858.cd012628] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Catherine Waldron
- Trinity College Dublin, University of Dublin; School of Dental Science; Lincoln Place Dublin Ireland D02 F859
| | - Caoimhin MacGiolla Phadraig
- Trinity College Dublin, University of Dublin; School of Dental Science; Lincoln Place Dublin Ireland D02 F859
| | - June Nunn
- Trinity College Dublin, University of Dublin; School of Dental Science; Lincoln Place Dublin Ireland D02 F859
| | - Catherine Comiskey
- Trinity College Dublin, University of Dublin; School of Nursing and Midwifery; 24 D'Olier St Dublin Ireland D02 T283
| | - Erica Donnelly-Swift
- Trinity College Dublin, University of Dublin; School of Dental Science; Lincoln Place Dublin Ireland D02 F859
| | - Suzanne Guerin
- University College Dublin; School of Psychology; Dublin Ireland DO4 V1W8
| | - Mike J Clarke
- Queen's University Belfast; Centre for Public Health; Institute of Clinical Sciences, Block B, Royal Victoria Hospital Grosvenor Road Belfast Northern Ireland UK BT12 6BJ
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de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, Morrice HR, Riggs E, Leong PM, Meyenn LK, Yousefi-Nooraie R. WITHDRAWN: Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016; 12:CD009837. [PMID: 28004389 PMCID: PMC6463845 DOI: 10.1002/14651858.cd009837.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. SEARCH METHODS We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. SELECTION CRITERIA Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for both intervention and control groups. Interventions were excluded if they were solely of a chemical nature (e.g. chlorhexidine, fluoride varnish), were delivered primarily in a dental clinical setting or comprised solely fluoridation. DATA COLLECTION AND ANALYSIS Two review authors independently performed screening, data extraction and assessment of risk of bias of included studies (a team of six review authors - four review authors and two research assistants - assessed all studies). We calculated mean differences with 95% confidence intervals for continuous data. When data permitted, we undertook meta-analysis of primary outcome measures using a fixed-effect model to summarise results across studies. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS This review includes findings from 38 studies (total n = 119,789 children, including one national study of 99,071 children, which contributed 80% of total participants) on community-based oral health promotion interventions delivered in a variety of settings and incorporating a range of health promotion strategies (e.g. policy, educational activities, professional oral health care, supervised toothbrushing programmes, motivational interviewing). We categorised interventions as dietary interventions (n = 3), oral health education (OHE) alone (n = 17), OHE in combination with supervised toothbrushing with fluoridated toothpaste (n = 8) and OHE in combination with a variety of other interventions (including professional preventive oral health care, n = 10). Interventions generally were implemented for less than one year (n = 26), and only 11 studies were RCTs. We graded the evidence as having moderate to very low quality.We conducted meta-analyses examining impact on dental caries of each intervention type, although not all studies provided sufficient data to allow pooling of effects across similar interventions. Meta-analyses of the effects of OHE alone on caries may show little or no effect on DMFT (two studies, mean difference (MD) 0.12, 95% confidence interval (CI) -0.11 to 0.36, low-quality evidence), dmft (three studies, MD -0.3, 95% CI -1.11 to 0.52, low-quality evidence) and DMFS (one study, MD -0.01, 95% CI -0.24 to 0.22, very low-quality evidence). Analysis of studies testing OHE in combination with supervised toothbrushing with fluoridated toothpaste may show a beneficial effect on dmfs (three studies, MD -1.59, 95% CI -2.67 to -0.52, low-quality evidence) and dmft (two studies, MD -0.97, 95% CI -1.06 to -0.89, low-quality evidence) but may show little effect on DMFS (two studies, MD -0.02, 95% CI -0.13 to 0.10, low-quality evidence) and DMFT (three studies, MD -0.02, 95% CI -0.11 to 0.07, moderate-quality evidence). Meta-analyses of two studies of OHE in an educational setting combined with professional preventive oral care in a dental clinic setting probably show a very small effect on DMFT (-0.09 weighted mean difference (WMD), 95% CI -0.1 to -0.08, moderate-quality evidence). Data were inadequate for meta-analyses on gingival health, although positive impact was reported. AUTHORS' CONCLUSIONS This review provides evidence of low certainty suggesting that community-based oral health promotion interventions that combine oral health education with supervised toothbrushing or professional preventive oral care can reduce dental caries in children. Other interventions, such as those that aim to promote access to fluoride, improve children's diets or provide oral health education alone, show only limited impact. We found no clear indication of when is the most effective time to intervene during childhood. Cost-effectiveness, long-term sustainability and equity of impacts and adverse outcomes were not widely reported by study authors, limiting our ability to make inferences on these aspects. More rigorous measurement and reporting of study results would improve the quality of the evidence.
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Affiliation(s)
- Andrea M de Silva
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Carlton, Victoria, Australia, 3053
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
| | - Shalika Hegde
- Centre for Applied Oral Health Research (Corporate Level), Dental Health Services Victoria, The Royal Dental Hospital of Melbourne, Carlton, Melbourne, Victoria, Australia, 3053
- School of Health & Social Development, Faculty of Health, Melbourne Burwood Campus, Deakin University, Burwood, Victoria, Australia
| | - Bridget Akudo Nwagbara
- Independent consultant, Abuja, Nigeria
- Nigerian Branch of the South African Cochrane Centre, Calabar, Nigeria
| | - Hanny Calache
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
- Clinical Leadership, Dental Health Services Victoria, 720 Swanston Sreet, Carlton, Victoria, Australia
- School of Dentistry and Oral Health, La Trobe University, Bendigo, Victoria, Australia
| | - Mark G Gussy
- Dept of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, Victoria, Australia, 3552
| | - Mona Nasser
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, The John Bull Building, Tamar Science Park,, Plymouth, UK, PL6 8BU
| | - Hannah R Morrice
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Elisha Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, Australia, 3052
- General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Pamela M Leong
- Early Life Epigenetics, Murdoch Childrens Research Institute, Flemington Road, Carlton, Victoria, Australia, 3053
| | - Lisa K Meyenn
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Carlton, Victoria, Australia, 3053
| | - Reza Yousefi-Nooraie
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, Canada, M5T 3M6
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Sicca C, Bobbio E, Quartuccio N, Nicolò G, Cistaro A. Prevention of dental caries: A review of effective treatments. J Clin Exp Dent 2016; 8:e604-e610. [PMID: 27957278 PMCID: PMC5149099 DOI: 10.4317/jced.52890] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/12/2016] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The objective of this study is to review medical and non medical treatments for prevention of caries. MATERIAL AND METHODS A comprehensive literature search of the most relevant and updated published studies from 01/01/2002 through December 2015 in PubMed/MEDLINE, Embase and Scopus databases regarding the efficacy of strategies and treatments aiming to prevent the development of caries was performed selecting papers on the basis of the Evidence-based Medicine Criteria. RESULTS We identified thirty systematic reviews on prevention of caries. Analyzing the data the retrieved literature, performance of prevention treatments seems to be high. CONCLUSIONS Prevention treatments may have a relevant impact on the avoiding the development of caries planning. Key words:Dental caries, prevention, fluoride.
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Affiliation(s)
- Claudio Sicca
- MD, Indipendent Clinical Dentistry, Forno Canavese and Bruino, Turin, Italy
| | | | - Natale Quartuccio
- MD, Nuclear Medicine Unit Department of Biomedical Sciences and of Mophologic and Functional Images, University of Messina, Italy
| | - Giovanni Nicolò
- MD, Indipendent Clinical Dentistry, Forno Canavese and Bruino, Turin, Italy
| | - Angelina Cistaro
- MD, Ph, Positron Emission Tomography Centre IRMET S.p.A., Affidea, Turin, Italy, PET Pediatric AIMN InterGroup, Italy, Institute of Cognitive Sciences and Technologies, CNR, Rome, Italy
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de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, Morrice HR, Riggs E, Leong PM, Meyenn LK, Yousefi‐Nooraie R. Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016; 9:CD009837. [PMID: 27629283 PMCID: PMC6457580 DOI: 10.1002/14651858.cd009837.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. SEARCH METHODS We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. SELECTION CRITERIA Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for both intervention and control groups. Interventions were excluded if they were solely of a chemical nature (e.g. chlorhexidine, fluoride varnish), were delivered primarily in a dental clinical setting or comprised solely fluoridation. DATA COLLECTION AND ANALYSIS Two review authors independently performed screening, data extraction and assessment of risk of bias of included studies (a team of six review authors - four review authors and two research assistants - assessed all studies). We calculated mean differences with 95% confidence intervals for continuous data. When data permitted, we undertook meta-analysis of primary outcome measures using a fixed-effect model to summarise results across studies. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS This review includes findings from 38 studies (total n = 119,789 children, including one national study of 99,071 children, which contributed 80% of total participants) on community-based oral health promotion interventions delivered in a variety of settings and incorporating a range of health promotion strategies (e.g. policy, educational activities, professional oral health care, supervised toothbrushing programmes, motivational interviewing). We categorised interventions as dietary interventions (n = 3), oral health education (OHE) alone (n = 17), OHE in combination with supervised toothbrushing with fluoridated toothpaste (n = 8) and OHE in combination with a variety of other interventions (including professional preventive oral health care, n = 10). Interventions generally were implemented for less than one year (n = 26), and only 11 studies were RCTs. We graded the evidence as having moderate to very low quality.We conducted meta-analyses examining impact on dental caries of each intervention type, although not all studies provided sufficient data to allow pooling of effects across similar interventions. Meta-analyses of the effects of OHE alone on caries may show little or no effect on DMFT (two studies, mean difference (MD) 0.12, 95% confidence interval (CI) -0.11 to 0.36, low-quality evidence), dmft (three studies, MD -0.3, 95% CI -1.11 to 0.52, low-quality evidence) and DMFS (one study, MD -0.01, 95% CI -0.24 to 0.22, very low-quality evidence). Analysis of studies testing OHE in combination with supervised toothbrushing with fluoridated toothpaste may show a beneficial effect on dmfs (three studies, MD -1.59, 95% CI -2.67 to -0.52, low-quality evidence) and dmft (two studies, MD -0.97, 95% CI -1.06 to -0.89, low-quality evidence) but may show little effect on DMFS (two studies, MD -0.02, 95% CI -0.13 to 0.10, low-quality evidence) and DMFT (three studies, MD -0.02, 95% CI -0.11 to 0.07, moderate-quality evidence). Meta-analyses of two studies of OHE in an educational setting combined with professional preventive oral care in a dental clinic setting probably show a very small effect on DMFT (-0.09 weighted mean difference (WMD), 95% CI -0.1 to -0.08, moderate-quality evidence). Data were inadequate for meta-analyses on gingival health, although positive impact was reported. AUTHORS' CONCLUSIONS This review provides evidence of low certainty suggesting that community-based oral health promotion interventions that combine oral health education with supervised toothbrushing or professional preventive oral care can reduce dental caries in children. Other interventions, such as those that aim to promote access to fluoride, improve children's diets or provide oral health education alone, show only limited impact. We found no clear indication of when is the most effective time to intervene during childhood. Cost-effectiveness, long-term sustainability and equity of impacts and adverse outcomes were not widely reported by study authors, limiting our ability to make inferences on these aspects. More rigorous measurement and reporting of study results would improve the quality of the evidence.
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Affiliation(s)
| | | | | | | | - Mark G Gussy
- La Trobe UniversityDept of Dentistry and Oral Health, La Trobe Rural Health SchoolPO Box 199BendigoAustralia3552
| | - Mona Nasser
- Plymouth University Peninsula Schools of Medicine and DentistryPeninsula Dental SchoolThe John Bull Building, Tamar Science Park,PlymouthUKPL6 8BU
| | - Hannah R Morrice
- University of MelbourneJack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global HealthCarltonAustralia
| | | | - Pamela M Leong
- Murdoch Childrens Research InstituteEarly Life EpigeneticsFlemington RoadCarltonAustralia3053
| | - Lisa K Meyenn
- Dental Health Services VictoriaCentre for Applied Oral Health ResearchCarltonAustralia3053
| | - Reza Yousefi‐Nooraie
- University of TorontoInstitute of Health Policy, Management and Evaluation155 College StreetTorontoCanadaM5T 3M6
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