Planning and evaluating community oral health programs

Parent-perceived oral habits among a group of school children: prevalence and predictors

PURPOSE

Practicing oral habits beyond the normal age range is assumed to be due to underlying psychological disturbance and could result in a deformation of the orofacial structure. The first step in managing such a health condition is to evaluate its size. Thus, this study aimed primarily to assess the prevalence of oral habits among a group of school children aged from 5 to 7 years, in Cairo, Egypt. The secondary aim of the study was to investigate some possible related predictors along with the mother's perception of the child's oral health-related quality of life.

METHODS

A Google form questionnaire was designed, utilizing the third domain of Nordic Orofacial Test-Screen (NOT-S), to assess the presence or absence of oral habits and their types, if reported. Also, there were two global rating items to test the child's oral health-related quality of life from the mother's prospection, along with one item to inquire if the mother thinks that the oral habits are harmful to the child. A total number of 23 schools in Cairo, Egypt were randomly selected, and the link to the Google form was distributed through the parent's groups on social media. All high-quality complete responses were analyzed using the SPSS program, and a Log-binomial regression model was constructed, to determine the significant predictors of practicing oral habits in children.

RESULTS

Among the analyzed 1128 responses, the total number of answers to the third domain of interview part of NOT-S was 1235, with a response rate of (60.39%), no habits were reported in 635 children (51.4%), while nail biting was noted in 21.8%, bruxism in 17.9% and Sucking habits in 8.9%. In total, 63.8% of children who were reported by their parents to be the "only child" didn't practice any habit, and a higher prevalence of oral habits was detected in children with siblings. There was no detectable association between the mother's educational level and practicing any of the habits, although there was an association between the mother's educational level and their awareness of the harmful effect of oral habits on the child. The mothers' answers to the global rating items were not associated with any of the oral habits.

CONCLUSION

The most prevalent oral habit in the current study was the nail-biting habit. The presence of other siblings and the number of siblings were contributory factors in the occurrence of oral habits, while mothers' educational level was not associated with practicing oral habits. The mothers' awareness of the harmful effect of oral habits on the children was not satisfactory, and there was no association between oral health-related quality of life and the children's oral habits, from the mothers' perspective.

Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis

BACKGROUND

Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants.

METHODS

The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature.

RESULTS

The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth.

CONCLUSION

Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched.

TRIAL REGISTRATION

Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.

The Participation of Pediatric Dentists in Oral Health Promotion and Education in Serbia

Objectives

To identify the involvement of Serbian paediatric dentists in oral health promotion and education, and to propose further actions for the improvement of these activities.

Methods

This is an analysis of data collected by a cross-sectional, questionnaire-based survey of 445 dentists involved in the provision of dental health services to children at the primary healthcare level. We explored dentists' involvement in oral health education and promotion and the cooperation with other health professionals at the healthcare centre and the community level as well as their attitudes towards the importance of some factors influencing their work.

Results

Dentists estimate their cooperation with different services with ratings higher than 3 on the scale of 1 to 5. They reported the highest satisfaction in cooperation with paediatric services for preschool and schoolchildren (4.0±1.0). At the community level, they reported excellent cooperation with kindergartens (4.4±0.8), while collaboration with Roma health mediators (3.14±1.34) and nongovernmental organizations (2.5±1.4) received lower ratings. According to the average rating (4.7±0.7), dentists perceive the motivation of patients and/or their guardians for keeping good oral health as the factor with the highest importance for the quality of interventions they provide.

Conclusions

Dentists involved in the provision of dental healthcare for children and adolescents in primary healthcare centres in Serbia participate in different oral healthcare education and promotion activities in the community, and highlight the importance of strengthening cooperation with healthcare and other professionals and services aimed at vulnerable population groups, both within the health sector and nongovernmental organizations.

Assessment of dental caries among a group of institutionalized orphan children compared to parented school children: case-control study

BACKGROUND

It has been well documented that the absence of family support influences the general and oral health of children. Literature regarding the oral health status of institutionalized orphan children, who lost their families' support, especially in Egypt, remains vague. Therefore, the current study was carried out to assess dental caries among two groups of institutionalized orphan children, and compare their results with a group of parented school children in Giza, Egypt.

METHODS

A total of 156 children were included in this study, residing in a non-governmental orphanage, a governmental orphanage, and parented children attending private primary school. Written informed consent was obtained before the start of the study from the legal guardians or the child's parent. The dental examination was carried out as recommended by the WHO. DMF and def indices were used to assess dental caries for primary and permanent teeth. Also, the unmet treatment needs index, care index, and significant caries index were calculated.

RESULTS

The results revealed that mean values for DMF total score were 1.86 ± 2.96, 1.80 ± 2.54, and 0.7 5 ± 1.29 for, non-governmental, governmental orphanages, and school children respectively. While the mean def total scores were 1.69 ± 2.58, 0.41 ± 0.89, and 0.85 ± 1.79 for non-governmental, governmental orphanages, and school children, respectively. There was a high level of unmet treatment needs, especially among orphans. The significant caries index was 2.5, 4.29, and 2.17 for, non-governmental, governmental orphanages, and school children, respectively.

CONCLUSIONS

Within the limitation of this case-control study, the institutionalized orphanage children had a high prevalence of dental caries and worse caries experience compared to parented school children. Effective oral health preventive strategies are required to improve the oral health status and oral health practices of those children.

TRIAL REGISTRATION

The trial was registered on ClinicalTrial.gov (ID: NCT05652231).

A collaborative communitywide health fair: the process and impacts on the community

The purpose of this article is to describe the process of conducting a collaborative communitywide health fair, and the impacts of such health intervention programs on community members. A community health fair addresses the health access needs of underserved populations. The success or effectiveness of such community-based programs requires systematic approach to assessment, planning, implementation, and evaluation. The PRECEDE˜PROCEED model was used as the guiding framework. The health fair described in this article was coordinated by nurses and drew resources from multiple health providers and organizations. The fair provided opportunities for vulnerable populations to access and utilize appropriate and comprehensive health services, resources and education.

A proposed model for infant and child oral health promotion in India

Dental caries is an increasing burden in the developing countries. A proper budgetary allocation for treating dental diseases in an enormous population such as India is impractical, where resources are inadequate for major health challenges such as malnutrition and gastrointestinal and respiratory infections in children. An integrated, directed population approach targeting children is much needed. The existing machinery of successful public health campaigns such as the “Pulse Polio” and the “Mid-Day-Meals Scheme” of the Government of India can be used for oral health promotion for children. India has about 300 dental colleges and countrywide branches of the Indian Dental Association that can provide manpower for the program. An innovative, large-scale “Fit for School” program in Philippines is a model for an integrated approach for children's health and has proved to be cost-effective and viable. A model for oral health promotion in infants and children of India, combining age-specific initiatives for health education, nutrition, hygiene, and fluoride use, is proposed. The model could be implemented to evaluate the oral health status of children, knowledge and knowledge gain of the community health workers, and acceptability and sustainability of the preventive programs (fluoride varnish and preschool and school tooth brushing) pragmatically.

Assessing the community clinic replacement effect on private Medicaid practices in oral health care within rural environments

OBJECTIVES

Children in Medicaid/CHIP public coverage programs who reside in rural counties have limited access to dental care services. Shortages of dental professionals in rural areas impede utilization of dental care. Public and private initiatives are attempting to address this crisis. Missourians instituted deregulatory policies and invested in community-based initiatives.

METHODS

Using a Medicaid/CHIP claims administrative dataset from 2004 to 2007, this research explored patterns of utilization to assess the impact of these efforts.

RESULTS

The number of participating private dental office providers declined over the study period, and the number of children utilizing clinics increased. Trends are being observed within the public health dental care market demonstrating clinics are replacing private dentists as providers of Medicaid/CHIP dental services.

CONCLUSIONS

Allowing greater market entry through deregulation could provide states with greater improvements to their public dental health infrastructure.

Evaluation of Pacific Islands Early Childhood Caries Prevention Project: Republic of the Marshall Islands

OBJECTIVES

This communication reports an outcomes evaluation of the Pacific Islands Early Childhood Caries Prevention Project.

METHODS

The evaluation includes children in three conditions: a) topical fluoride varnish three times per school year; b) varnish plus twice-per-day toothbrushing; and c) intervention 2 plus three-times-per-day xylitol containing gummy bear snacks at school and home visits to encourage parental involvement. For this evaluation, groups 2 and 3 have been combined.

RESULTS

One year after project implementation, mean decayed, extracted, or filled primary teeth was 10.3 [standard deviation (SD)= 4.3] teeth for group 1, and 8.2 (SD = 4.0) teeth for the combination of groups 2 and 3 (P < 0.05). Twenty-four percent of group 1 had cavitated lesions in any permanent molar versus 12.8 percent in groups 2 and 3 combined (P > 0.05).

CONCLUSION

Evaluation confirms the outcome of a program including both in-school twice-daily toothbrushing with fluoridated toothpaste and frequent applications of fluoride varnish.