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Irigoyen‐Camacho ME, Villanueva‐Gutierrez T, Castano‐Seiquer A, Molina‐Frechero N, Zepeda‐Zepeda M, Sánchez‐Pérez L. Evaluating the changes in molar incisor hypomineralization prevalence: A comparison of two cross-sectional studies in two elementary schools in Mexico City between 2008 and 2017. Clin Exp Dent Res 2020; 6:82-89. [PMID: 32067391 PMCID: PMC7025996 DOI: 10.1002/cre2.252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 08/21/2019] [Accepted: 08/29/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Little information is available on the trends over time of the prevalence of molar incisor hypomineralization (MIH). This condition may be preventing dental caries decline. AIM (a) To compare the prevalence of MIH, in Mexico City schoolchildren, evaluated in 2008 with a group evaluated in 2017, (b) to identify the association of MIH with dental caries, and (c) to assess the mother's perception of her child's oral health status. DESIGN Two cross-sectional studies performed in 2008 and in 2017 were compared. The oral examiner and the selected schools were the same in both surveys. RESULTS A total of 549 schoolchildren were evaluated. The prevalence of MIH in the first survey was 20.3%, and 31.9 % in the second survey, (p = .002). Children with MIH were more likely to have dental caries. The odds ratio was 2.24 (p = .036) and 4.18 (p ˂ .001) in the first and second surveys, respectively. Mothers of children with MIH perceived worse oral health status of their children than the mothers whose children did not have MIH (odds ratio = 4.47, p ˂ .001). CONCLUSION The findings portray a clear increase in prevalence of MIH and highlight the need for increased awareness about this condition among dentists and the general population.
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Affiliation(s)
| | | | | | - Nelly Molina‐Frechero
- Health Care DepartmentMetropolitan Autonomous University‐XochimilcoMexico CityMexico
| | - Marco Zepeda‐Zepeda
- Health Care DepartmentMetropolitan Autonomous University‐XochimilcoMexico CityMexico
| | - Leonor Sánchez‐Pérez
- Health Care DepartmentMetropolitan Autonomous University‐XochimilcoMexico CityMexico
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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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Wilson AR, Brega AG, Thomas JF, Henderson WG, Lind KE, Braun PA, Batliner TS, Albino J. Validity of Measures Assessing Oral Health Beliefs of American Indian Parents. J Racial Ethn Health Disparities 2018; 5:1254-1263. [PMID: 29508373 PMCID: PMC6123310 DOI: 10.1007/s40615-018-0472-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 02/02/2018] [Accepted: 02/16/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVES This aimed to validate measures of constructs included in an extended Health Belief Model (EHBM) addressing oral health beliefs among American Indian (AI) parents. METHODS Questionnaire data were collected as part of a randomized controlled trial (n = 1016) aimed at reducing childhood caries. Participants were AI parents with a preschool-age child enrolled in the Navajo Nation Head Start program. Questionnaire items addressed five EHBM constructs: perceived susceptibility, severity, barriers, benefits, and parental self-efficacy. Subscales representing each construct underwent reliability and validity testing. Internal consistency reliability of each subscale was evaluated using Cronbach's alpha. Convergent validity was assessed using linear regression to evaluate the association of each EHBM subscale with oral health-related measures. RESULTS Internal consistency reliability was high for self-efficacy (α = 0.83) and perceived benefits (α = 0.83) compared to remaining EHBM subscales (α < 0.50). Parents with more education (p < 0.0001) and income (p = 0.0002) perceived dental caries as more severe younger parents (ps = 0.02) and those with more education (ps < 0.0001) perceived greater benefits and fewer barriers to following recommended oral health behavior. Female parents (p < 0.0001) and those with more education (p = 0.02) had higher levels of self-efficacy. Parental knowledge was associated with all EHBM measures (ps < 0.0001) excluding perceived susceptibility (p > 0.05). Parents with increased self-efficacy had greater behavioral adherence (p < 0.0001), whereas lower behavioral adherence was associated with parents who reported higher perceived barriers (p < 0.0001). Better pediatric oral health outcomes were associated with higher levels of self-efficacy (p < 0.0001) and lower levels of perceived severity (p = 0.02) and barriers (p = 0.05). CONCLUSIONS Results support the value of questionnaire items addressing the EHBM subscales, which functioned in a manner consistent with the EHBM theoretical framework in AI participants.
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Affiliation(s)
- Anne R Wilson
- School of Dental Medicine, University of Colorado Anschutz Medical Campus, 13123 E. 16th Ave., B240, Aurora, CO, 80045, USA.
| | - Angela G Brega
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, W359-G, Aurora, CO, 80045, USA
| | - Jacob F Thomas
- Children's Outcomes Research/Colorado Health Outcomes Programs, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd., Suite 300 F443, Aurora, CO, 80045, USA
| | - William G Henderson
- Children's Outcomes Research/Colorado Health Outcomes Programs, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd., Suite 300 F443, Aurora, CO, 80045, USA
| | - Kimberly E Lind
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, W359-G, Aurora, CO, 80045, USA
- School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E. 17th Ave, Aurora, CO, 80045, USA
| | - Patricia A Braun
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, W359-G, Aurora, CO, 80045, USA
- School of Medicine, University of Colorado Anschutz Medical Campus, 12401 E. 17th Ave, Aurora, CO, 80045, USA
| | - Terrence S Batliner
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, W359-G, Aurora, CO, 80045, USA
| | - Judith Albino
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, 13199 E. Montview Blvd, Suite 300, W359-G, Aurora, CO, 80045, USA
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Arora A, Khattri S, Ismail NM, Kumbargere Nagraj S, Prashanti E. School dental screening programmes for oral health. Cochrane Database Syst Rev 2017; 12:CD012595. [PMID: 29267989 PMCID: PMC6485978 DOI: 10.1002/14651858.cd012595.pub2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND School dental screening refers to visual inspection of children's oral cavity in a school setting followed by making parents aware of their child's current oral health status and treatment needs. Screening at school intends to identify children at an earlier stage than symptomatic disease presentation, hence prompting preventive and therapeutic oral health care for the children. This review evaluates the effectiveness of school dental screening in improving oral health status. OBJECTIVES To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 March 2017), the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Register of Studies, to 15 March 2017), MEDLINE Ovid (1946 to 15 March 2017), and Embase Ovid (15 September 2016 to 15 March 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status when searching the electronic databases; however, the search of Embase was restricted to the last six months due to the Cochrane Centralised Search Project to identify all clinical trials and add them to CENTRAL. SELECTION CRITERIA We included randomised controlled trials (RCTs) (cluster or parallel) that evaluated school dental screening compared with no intervention or with one type of screening compared with another. DATA COLLECTION AND ANALYSIS We used standard methodological procedures expected by Cochrane. MAIN RESULTS We included six trials (four were cluster-RCTs) with 19,498 children who were 4 to 15 years of age. Four trials were conducted in the UK and two were based in India. We assessed two trials to be at low risk of bias, one trial to be at high risk of bias and three trials to be at unclear risk of bias.None of the six trials reported the proportion of children with untreated caries or other oral diseases.Four trials evaluated traditional screening versus no screening. We performed a meta-analysis for the outcome 'dental attendance' and found an inconclusive result with high heterogeneity. The heterogeneity was found it to be, in part, due to study design (three cluster-RCTs and one individual-level RCT). Due to the inconsistency, we downgraded the evidence to 'very low certainty' and are unable to draw conclusions about this comparison.Two cluster-RCTs (both four-arm trials) evaluated criteria-based screening versus no screening and showed a pooled effect estimate of RR 1.07 (95% CI 0.99 to 1.16), suggesting a possible benefit for screening (low-certainty evidence). There was no evidence of a difference when criteria-based screening was compared to traditional screening (RR 1.01, 95% CI 0.94 to 1.08) (very low-certainty evidence).In one trial, a specific (personalised) referral letter was compared to a non-specific one. Results favoured the specific referral letter with an effect estimate of RR 1.39 (95% CI 1.09 to 1.77) for attendance at general dentist services and effect estimate of RR 1.90 (95% CI 1.18 to 3.06) for attendance at specialist orthodontist services (low-certainty evidence).One trial compared screening supplemented with motivation to screening alone. Dental attendance was more likely after screening supplemented with motivation, with an effect estimate of RR 3.08 (95% CI 2.57 to 3.71) (low-certainty evidence).None of the trials had long-term follow-up to ascertain the lasting effects of school dental screening.None of the trials reported cost-effectiveness and adverse events. AUTHORS' CONCLUSIONS The trials included in this review evaluated short-term effects of screening, assessing follow-up periods of three to eight months. We found very low certainty evidence that was insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening there was no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) improves dental attendance in comparison to screening alone.We did not find any trials addressing cost-effectiveness and adverse effects of school dental screening.
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Affiliation(s)
- Ankita Arora
- Faculty of Dentistry, Melaka‐Manipal Medical CollegeDepartment of Pedodontics and Preventive DentistryJalan Batu HamparBukit BaruMelakaMalaysia751501
| | - Shivi Khattri
- Subharti Dental College and HospitalDepartment of PeriodonticsSubhartipuram, NH‐58MeerutIndia250002
| | - Noorliza Mastura Ismail
- Faculty of Dentistry, Melaka‐Manipal Medical CollegeDepartment of Community DentistryJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Sumanth Kumbargere Nagraj
- Faculty of Dentistry, Melaka‐Manipal Medical CollegeDepartment of Oral Medicine and Oral RadiologyJalan Batu HamparBukit BaruMelakaMalaysia75150
| | - Eachempati Prashanti
- Faculty of Dentistry, Melaka‐Manipal Medical CollegeDepartment of ProsthodonticsJalan Batu HamparBukit BaruMelakaMalaysia75150
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Nelson S, Slusar MB, Albert JM, Riedy CA. Do baby teeth really matter? Changing parental perception and increasing dental care utilization for young children. Contemp Clin Trials 2017; 59:13-21. [PMID: 28479221 PMCID: PMC5514377 DOI: 10.1016/j.cct.2017.05.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/21/2017] [Accepted: 05/03/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Parent/caregivers' inability to recognize the importance of baby teeth has been associated with inadequate self-management of children's oral health (i.e. lower likelihood of preventive dental visits) which may result in dental caries and the need for more expensive caries-related restorative treatment under general anesthesia. Health behavior theories aid researchers in understanding the impact and effectiveness of interventions on changing health behaviors and health outcomes. One example is the Common-Sense Model of Self-Regulation (CSM) which focuses on understanding an individual's illness perception (i.e. illness and treatment representations), and subsequently has been used to develop behavioral interventions to change inaccurate perceptions and describe the processes involved in behavior change. METHODS We present two examples of randomized clinical trials that are currently testing oral health behavioral interventions to change parental illness perception and increase dental utilization for young children disproportionately impacted by dental caries in elementary schools and pediatric primary care settings. Additionally, we compared empiric data regarding parent/caregiver perception of the chronic nature of dental caries (captured by the illness perception questionnaire revised for dental: IPQ-RD constructs: identity, consequences, control, timeline, illness coherence, emotional representations) between parent/caregivers who did and did not believe baby teeth were important. RESULTS Caregivers who believed that baby teeth don't matter had significantly (P<0.05) less accurate perception in the majority of the IPQ-RD constructs (except timeline construct) compared to caregivers who believed baby teeth do matter. CONCLUSION These findings support our CSM-based behavioral interventions to modify caregiver caries perception, and improve dental utilization for young children.
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Affiliation(s)
- Suchitra Nelson
- Case Western Reserve University School of Dental Medicine, Department of Community Dentistry, 10900 Euclid Ave., Cleveland, OH 44106-4905, USA.
| | - Mary Beth Slusar
- Case Western Reserve University School of Dental Medicine, Department of Community Dentistry, 10900 Euclid Ave., Cleveland, OH 44106-4905, USA.
| | - Jeffrey M Albert
- Case Western Reserve University School of Medicine, Department of Epidemiology and Biostatistics, 10900 Euclid Ave., Cleveland, OH 44106-4945, USA.
| | - Christine A Riedy
- Harvard School of Dental Medicine, 188 Longwood Ave., Boston, MA 02115, USA.
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Dudovitz RN, Valiente JE, Espinosa G, Yepes C, Padilla C, Puffer M, Slavkin HC, Chung PJ. A school-based public health model to reduce oral health disparities. J Public Health Dent 2017; 78:9-16. [DOI: 10.1111/jphd.12216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 03/08/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Rebecca N. Dudovitz
- Department of Pediatrics, David Geffen School of Medicine; Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California Los Angeles
| | | | | | | | - Cesar Padilla
- Department of Pediatrics, David Geffen School of Medicine; Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California Los Angeles
| | | | - Harold C. Slavkin
- Ostrow School of Dentistry; University of Southern California; Los Angeles
| | - Paul J. Chung
- Department of Pediatrics, David Geffen School of Medicine; Children's Discovery & Innovation Institute, Mattel Children's Hospital, University of California Los Angeles
- RAND Health; RAND Corporation
- Fielding School of Public Health; University of California; Los Angeles
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Slusar MB, Nelson S. Caregiver Illness Perception of Their Child's Early Childhood Caries. Pediatr Dent 2016; 38:425-431. [PMID: 28206900 PMCID: PMC5315002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
PURPOSE The purpose of this case-control study was to evaluate the association between parent/caregivers' illness perception and early childhood caries (ECC). METHODS Parent/caregivers of children younger than six years old were recruited at the dental clinic of an urban children's hospital between June 2013 and September 2015. Cases were caregivers of ECC children; controls were caregivers of children without ECC. Caregivers completed the Illness Perception Questionnaire-Revised for Dental (IPQ-RD) assessing cognitive (identity, consequences, control, timeline, illness coherence, cause) and emotional representations of dental caries. Twelve IPQ-RD construct-specific summary scores were calculated; higher scores represented a less accurate perception. Logistic regression models examined the relationship between IPQ-RD constructs and ECC. RESULTS The sample included a total of 165 parent/caregivers: 54 had children (33 percent) without ECC; 111 had ECC children (67 percent). Two of the 12 constructs were related to ECC status. Controlling for caregiver age, education, race/ethnicity, and child age, caregivers of ECC children had a less accurate perception of the consequences of dental caries (odds ratio [OR] equals 2.24; 95 percent confidence interval [CI] equals 1.07 to 4.69) and a more accurate perception of the controllability of caries (OR equals 0.29; 95 percent CI equals 0.11 to 0.76) compared to caregivers of children without ECC. CONCLUSION Clinicians should emphasize the consequences and controllability of ECC to help caregivers self-manage their children's oral health.
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Affiliation(s)
- Mary Beth Slusar
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA.
| | - Suchitra Nelson
- Department of Community Dentistry, Case Western Reserve University School of Dental Medicine, Cleveland, Ohio, USA
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