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Patterson-Norrie T, Ramjan L, Sousa MS, Kezhekkekara S, George A. Oral health knowledge, attitudes and practices of dietitians in Australia: A national survey. Health Promot J Austr 2024. [PMID: 38192008 DOI: 10.1002/hpja.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
AIM Dietitians are a well-placed profession to be providing pre-emptive oral health promotion. Despite recommendations that oral health promotion should be routinely part of dietetic practice, there is limited data informing the current practices of clinical dietitians in this area across Australia. Hence, the aim of this study was to investigate the knowledge and practices of Australian dietitians and oral health promotion. METHODS A cross-sectional survey was undertaken involving registered clinical dietitians in Australia using purposive and snowballing sampling (social media/dietetic organisations/public databases). Data were analysed using descriptive and inferential statistics. RESULTS A total of 149 dietitians participated in the national survey. Overall, dietitians were knowledgeable about oral health risk factors and preventative measures across general health domains. Majority of dietitians agreed that oral health can affect nutrition interventions (95.5%) and dietitians should be discussing oral health (88.0%). However, nearly half were not confident in providing counselling or education and felt that undergraduate training for oral health promotion was inadequate (78.2%). A small proportion (6.0%) of dietitians were already providing oral health promotion regularly. Key barriers included a lack of clear guidelines for practice, limited training opportunities and indistinct referral pathways. CONCLUSION Dietitians have acknowledged that oral health promotion should be incorporated into their practice. However, they are challenged by a lack of resources and training to support this in clinical practice. SO WHAT?: Capacity building dietitians to promote oral health allows opportunity for improvement in the oral health, nutritional status and quality of life of priority population groups.
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Affiliation(s)
- Tiffany Patterson-Norrie
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Lucie Ramjan
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Mariana S Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Shwetha Kezhekkekara
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Christian B, George A, Veginadu P, Villarosa A, Makino Y, Kim WJ, Masood M, Martin R, Harada Y, Mijares-Majini MC. Strategies to integrate oral health into primary care: a systematic review. BMJ Open 2023; 13:e070622. [PMID: 37407034 PMCID: PMC10367016 DOI: 10.1136/bmjopen-2022-070622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/04/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Integration of oral health into primary care has been proposed as a primary healthcare approach for efficient and sustainable delivery of oral health services, and the effective management of oral diseases. This paper aimed to synthesise evidence on the effectiveness of strategies to integrate oral health into primary care. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, Embase, Scopus, ProQuest, Cochrane and Google Scholar were searched without date limits until the third week of June 2022. Reference lists of eligible studies were also searched. Experts in the field and existing professional networks were consulted. ELIGIBILITY CRITERIA Only studies that evaluated integration strategies were included in the review. Eligibility was restricted to English language studies published in academic peer-reviewed journals. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and performed the risk of bias assessments. A narrative synthesis approach was used to report review findings. Heterogeneity among included studies precluded a meta-analysis. RESULTS The search identified 8731 unique articles, of which 49 were included in the review. Majority of the studies explored provision of oral healthcare by primary care professionals in primary care settings, where integration was primarily via training/education and/or policy changes. Most studies reported results favouring the integration strategy, such as improvements in referral pathways, documentation processes, operating efficiencies, number of available health staff, number of visits to non-dental primary care professionals for oral health issues, proportion of children receiving fluoride varnish applications/other preventive treatment, proportion of visits to an oral health professional and dental caries estimates. CONCLUSION The findings from this review demonstrate that the majority of identified strategies were associated with improved outcomes and can be used to inform decision-making on strategy selection. However, more research and evaluation are required to identify best practice models of service integration. PROSPERO REGISTRATION NUMBER CRD42020203111.
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Affiliation(s)
- Bradley Christian
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
| | - Ajesh George
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Prabhakar Veginadu
- Menzies School of Health Research, Alice Springs, Northern Territory, Australia
| | - Amy Villarosa
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Yuka Makino
- Noncommunicable Diseases Team, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Warrick Junsuk Kim
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Mohd Masood
- Department of Rural Clinical Sciences, La Trobe University - Bendigo Campus, Bendigo, Victoria, Australia
| | - Rachel Martin
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yuriko Harada
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
- Oral Health Programme, Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
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Vamos CA, Foti TR, Reyes Martinez E, Pointer Z, Detman LA, Sappenfield WM. Identification of Clinician Training Techniques as an Implementation Strategy to Improve Maternal Health: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6003. [PMID: 37297607 PMCID: PMC10252379 DOI: 10.3390/ijerph20116003] [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: 03/15/2023] [Revised: 05/23/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Training is a key implementation strategy used in healthcare settings. This study aimed to identify a range of clinician training techniques that facilitate guideline implementation, promote clinician behavior change, optimize clinical outcomes, and address implicit biases to promote high-quality maternal and child health (MCH) care. A scoping review was conducted within PubMed, CINAHL, PsycInfo, and Cochrane databases using iterative searches related to (provider OR clinician) AND (education OR training). A total of 152 articles met the inclusion/exclusion criteria. The training involved multiple clinician types (e.g., physicians, nurses) and was predominantly implemented in hospitals (63%). Topics focused on maternal/fetal morbidity/mortality (26%), teamwork and communication (14%), and screening, assessment, and testing (12%). Common techniques included didactic (65%), simulation (39%), hands-on (e.g., scenario, role play) (28%), and discussion (27%). Under half (42%) of the reported training was based on guidelines or evidence-based practices. A minority of articles reported evaluating change in clinician knowledge (39%), confidence (37%), or clinical outcomes (31%). A secondary review identified 22 articles related to implicit bias training, which used other reflective approaches (e.g., implicit bias tests, role play, and patient observations). Although many training techniques were identified, future research is needed to ascertain the most effective training techniques, ultimately improving patient-centered care and outcomes.
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Affiliation(s)
- Cheryl A. Vamos
- USF’s Center of Excellence in Maternal and Child Health Education, Science & Practice, The Chiles Center, College of Public Health, University of South Florida, Tampa, FL 33612, USA
| | - Tara R. Foti
- College of Public Health, University of South Florida, Tampa, FL 33612, USA; (T.R.F.); (Z.P.)
| | - Estefanny Reyes Martinez
- College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA;
| | - Zoe Pointer
- College of Public Health, University of South Florida, Tampa, FL 33612, USA; (T.R.F.); (Z.P.)
| | - Linda A. Detman
- The Chiles Center, College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA; (L.A.D.); (W.M.S.)
| | - William M. Sappenfield
- The Chiles Center, College of Public Health, Florida Perinatal Quality Collaborative, University of South Florida, Tampa, FL 33612, USA; (L.A.D.); (W.M.S.)
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George A, Kong A, Sousa MS, Villarosa A, Ajwani S, Dahlen HG, Bhole S, Yaacoub A, Srinivas R, Johnson M. Long-term effectiveness of the midwifery initiated oral health-dental service program on maternal oral health knowledge, preventative dental behaviours and the oral health status of children in Australia. Acta Odontol Scand 2023; 81:164-175. [PMID: 36001600 DOI: 10.1080/00016357.2022.2108896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The Midwifery Initiated Oral Health-Dental Service was developed to train midwives to promote maternal oral health, and a large trial showed it substantially improved the oral health, knowledge and behaviours of pregnant women. AIM Evaluate the long-term effectiveness of the program (post-trial) on maternal oral health knowledge, dental behaviours, and early childhood caries in offspring. METHODS A prospective cohort study involving 204 women and children 3-4 years (followed after trial) was conducted in Sydney, Australia from 2017 to 2019. RESULTS The program did not have a significant impact on the study measures. Mothers who received the program did have comparatively better knowledge around preventative behaviours to reduce early childhood caries and significantly more mothers were engaging in a key behaviour of using a cup to feed their child. Overall maternal oral health knowledge and level of education did have a protective effect on the dental decay of children. Higher knowledge and levels of education reduced the odds of having a dmft of one or more by over half (OR 0.473), and almost 80% (OR 0.212) respectively. CONCLUSIONS Although the MIOH-DS program was not effective, there is still value in exploring other complementary interventions to improve maternal oral health, especially for disadvantaged families. Future research should focus on co-designing an antenatal and postnatal oral health intervention and exploring its long-term impact on the oral health of children.
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Affiliation(s)
- Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,La Trobe Rural Health School, La Trobe University, Bendigo, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | - Ariana Kong
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Mariana S Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Broadway, Australia
| | - Amy Villarosa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Shilpi Ajwani
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Sydney Dental Hospital, Oral Health Services, Sydney Local Health District, Surry Hills, Australia.,Sydney Institute for Women, Children and Families, Sydney Local Health District, Surry Hills, Australia
| | - Hannah G Dahlen
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | - Sameer Bhole
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Sydney Dental Hospital, Oral Health Services, Sydney Local Health District, Surry Hills, Australia.,Sydney Institute for Women, Children and Families, Sydney Local Health District, Surry Hills, Australia
| | - Albert Yaacoub
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Oral Health Services, Nepean Blue Mountains Local Health District, Kingswood, Australia
| | - Ravi Srinivas
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Oral Health Services, South Western Sydney Local Health District, Liverpool, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, North Sydney, Australia
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Stoica AM, Kovacs-Ivacson CA, Stoica OE, Beresescu L, Monea M. Clinical and Pathological Manifestation of the Oral Mucosa in Institutionalized Children from Romania. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15564. [PMID: 36497639 PMCID: PMC9740787 DOI: 10.3390/ijerph192315564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/20/2022] [Accepted: 11/22/2022] [Indexed: 06/17/2023]
Abstract
Institutionalized children, regardless of their age, are prone to psychiatric disorders, compared to those who live in two-parent families, due to the unfavorable physical and psychological conditions in which they develop. Unpropitious psychological conditions affect the child's general health and induce local manifestations that can be found in the oral cavity, affecting both soft tissues and teeth. Therefore, the purpose of our study was to assess and diagnose a series of pathological manifestations of the oral mucosa associated with poor living conditions or closely related to psychological stress. The clinical examination was performed by 4 specialist dentists, who consulted 150 children representing the study group and 52 children representing the control group, all having ages between 14 and 18 years old and meeting the same inclusion criteria. From the control group, 62.5% presented plaque-induced gingivitis (26.6% girls, 35.8% boys), 26.6% presented mucosal lesions produced by lip and cheek biting (23.3% girls, 35.8% boys), and 11.7% presented geographic tongue (6.6% girls, 5% boys), herpes simplex eruptions (3.3% girls, 4.2% boys) and oral ulcerations (12.5% girls, 10.8% boys). Morsicatio buccarul is a chronic, self-mutilating habit, currently becoming one of the most common tics encountered among institutionalized children. Furthermore, these children do not benefit from constant support and guidance to perform their dental hygiene, so the incidence of gingivitis induced by bacterial plaque and calculus is very high.
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Affiliation(s)
- Alexandra Mihaela Stoica
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540139 Târgu Mures, Romania
| | - Csinszka Andrea Kovacs-Ivacson
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540139 Târgu Mures, Romania
| | - Oana Elena Stoica
- Department of Pedodontics, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540139 Târgu Mures, Romania
| | - Liana Beresescu
- Department of Preventive and Community Dentistry, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540139 Târgu Mures, Romania
| | - Monica Monea
- Department of Odontology and Oral Pathology, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mures, 540139 Târgu Mures, Romania
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The Assessment of Early Server Childhood Caries Status in Abandoned Institutionalized Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148632. [PMID: 35886485 PMCID: PMC9322934 DOI: 10.3390/ijerph19148632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/12/2022] [Accepted: 07/14/2022] [Indexed: 02/05/2023]
Abstract
Oral health is a critical indicator of children’s quality of life, which at this early age, depends exclusively on the attention, involvement, and guidance of parents or caregivers. Assessing carious damage and measuring the prevalence of early severe tooth decay in temporary teeth in children is obtained by calculating the dmft index, giving the sum of an individual’s decayed, missing, and filled teeth. The aim of our study was to conduct a clinical examination of the oral status of institutionalized children from Romania. We selected and included in the study 144 children, both boys and girls in equal number, with ages of five or six years old, from which 110 were eligible for the study and met the inclusion criteria. Of all children, 20.90% were five years old girls, 27.27% five years old boys, 26.36% six years old girls, and 25.46% six years old boys. Of all, 10,45% had more than three incisors presenting decays, equally affected by gender. Of the boys’ group, 20% of age six had more de two canines affected, and 26.7% of five years old girls had more than three affected canines. Of the five years boys’ group, 24.3% had more than three affected temporary molars, 44.9% of six years boys had more than five. Of the five years old girls, 33.3% had more than four temporary molars affected and, 56.6% of the six years old girls’ group had more than five molars presenting carious lesions. The dental status and dmft values were similar for five years old and six years old children and similar boys and girls. Due to the vulnerability of young children that consists not only in their inability to identify, express, and address their own needs but also the lack of parental support, lack of an optimal diet for age, and proper hygiene, they reach adolescence with an impaired dental status, inappropriate for their age.
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Kong A, Dickson M, Ramjan L, Sousa MS, Jones N, Srinivas R, Chao J, Goulding J, George A. Aboriginal Health Workers Promoting Oral Health among Aboriginal and Torres Strait Islander Women during Pregnancy: Development and Pilot Testing of the Grinnin' Up Mums & Bubs Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9576. [PMID: 34574506 PMCID: PMC8471975 DOI: 10.3390/ijerph18189576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/30/2021] [Accepted: 09/09/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND this study aimed to develop and pilot test the model of care, Grinnin' Up Mums & Bubs, to train Aboriginal Health Workers to promote oral health among Aboriginal and Torres Strait Islander pregnant women. METHODS Participatory Action Research was employed to develop the different components of the model (oral health promotion resources, training workshop, and a culturally safe referral pathway to dental services). The model was piloted (pre-post), using an embedded mixed-methods design, to determine the acceptability, satisfaction, and any recommendations made by seven Aboriginal Health Workers at an antenatal service in Western Sydney, Australia. RESULTS there was a high level of satisfaction with the components of the model of care among the participants, who believed that the model could be integrated into practice. The training showed some improvement in oral health knowledge and confidence. The participants recommended strategies for discussing oral health with Aboriginal and Torres Strait Islander pregnant women, and changes in public health dental policy to ensure that all women would be able to access affordable dental services through the referral pathway. CONCLUSION the findings suggest a high level of satisfaction with the model of care among the Aboriginal Health Workers. Further evaluation is needed to confirm the short and long-term impact of the model.
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Affiliation(s)
- Ariana Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Michelle Dickson
- Faculty of Medicine and Health, Sydney School of Public Health, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- Translational Health Research Institute, Campbelltown, NSW 2560, Australia
| | - Mariana S. Sousa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- IMPACCT—Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, NSW 2007, Australia
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia;
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- Oral Health Services, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia
- Faculty of Medicine and Health, School of Dentistry, University of Sydney, Camperdown, NSW 2006, Australia
| | - Jemma Chao
- The Poche Centre for Indigenous Health, University of Sydney, Camperdown, NSW 2006, Australia;
| | - Joanne Goulding
- Primary and Community Services, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia;
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia; (L.R.); (M.S.S.); (R.S.); (A.G.)
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
- Faculty of Medicine and Health, School of Dentistry, University of Sydney, Camperdown, NSW 2006, Australia
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Tannous KW, George A, Ahmed MU, Blinkhorn A, Dahlen HG, Skinner J, Ajwani S, Bhole S, Yaacoub A, Srinivas R, Johnson M. Economic evaluation of the Midwifery Initiated Oral Health-Dental Service programme in Australia. BMJ Open 2021; 11:e047072. [PMID: 34341045 PMCID: PMC8330572 DOI: 10.1136/bmjopen-2020-047072] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 07/19/2021] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To critically evaluate the cost-effectiveness of the Midwifery Initiated Oral Health-Dental Service (MIOH-DS) designed to improve oral health of pregnant Australian women. Previous efficacy and process evaluations of MIOH-DS showed positive outcomes and improvements across various measures. DESIGN AND SETTING The evaluation used a cost-utility model based on the initial study design of the MIOH-DS trial in Sydney, Australia from the perspective of public healthcare provider for a duration of 3 months to 4 years. PARTICIPANTS Data were sourced from pregnant women (n=638), midwives (n=17) and dentists (n=3) involved in the MIOH trial and long-term follow-up. COST MEASURES Data included in analysis were the cost of the time required by midwives and dentists to deliver the intervention and the cost of dental treatment provided. Costs were measured using data on utilisation and unit price of intervention components and obtained from a micro-costing approach. OUTCOME MEASURES Utility was measured as the number of Disability Adjusted Life Years (DALYs) from health-benefit components of the intervention. Three cost-effectiveness analyses were undertaken using different comparators, thresholds and time scenarios. RESULTS Compared with current practice, midwives only intervention meets the Australian threshold (A$50 000) of being cost-effective. The midwives and accessible/affordable dentists joint intervention was only 'cost-effective' in 6 months or beyond scenarios. When the midwife only intervention is the comparator, the midwife/dentist programme was 'cost-effective' in all scenarios except at 3 months scenario. CONCLUSIONS The midwives' only intervention providing oral health education, assessment and referral to existing dental services was cost-effective, and represents a low cost intervention. Midwives' and dentists' combined interventions were cost-effective when the benefits were considered over longer periods. The findings highlight short and long term economic benefits of the programme and support the need for policymakers to consider adding an oral health component into antenatal care Australia wide. TRIAL REGISTRATION NUMBER ACTRN12612001271897; Post-results.
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Affiliation(s)
- Kathy W Tannous
- Translational Health Research Institute, Digital Health Cooperative Research Centre, Economics, Finance and Property, School of Business, Western Sydney University, Penrith, New South Wales, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Moin Uddin Ahmed
- Translational Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Anthony Blinkhorn
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Hannah G Dahlen
- School of Nursing and Midwifery, Western Sydney University, Penrith, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - John Skinner
- Poche Centre for Indigenous Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Shilpi Ajwani
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, New South Wales, Australia
| | - Sameer Bhole
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, New South Wales, Australia
| | - Albert Yaacoub
- Oral Health Services, Nepean Blue Mountains Local Health District, Penrith, New South Wales, Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
- Oral Health Services, South Western Sydney Local Health District, Liverpool, New South Wales, Australia
| | - Maree Johnson
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Australian Catholic University, North Sydney, New South Wales, Australia
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Wilson A, Hoang H, Bridgman H, Bettiol S, Crocombe L. Factors Influencing the Provision of Oral Health Care Practices by Antenatal Care Providers: A Systematic Review. J Womens Health (Larchmt) 2021; 31:231-241. [PMID: 33960834 DOI: 10.1089/jwh.2020.8956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Antenatal care (ANC) providers are recommended to promote oral health care during pregnancy through the provision of oral health care practices, but studies have indicated that providers remain unclear and inconstant in adopting these practices into routine care. Therefore, the objectives were to undertake a systematic review of the current oral health care practices of ANC providers and identify factors (barriers and facilitators) that influence the provision of ANC providers' oral health care practices. Methods: Qualitative and quantitative studies were systematically searched within four databases (database inception, October 2020). Studies were selected if they were published in English and conducted in developed countries. Thematic analysis was employed where reported barriers and facilitators from the included studies were grouped by themes and were inductively categorized within a multilevel framework. Reported current oral health care practices were deductively categorized according to a predetermined "assess," "advise," and "refer" framework. Summative frequencies of oral health care practices, if reported, were also extracted. Results: A total of 3519 ANC providers were included across 26 studies. Rates of reported current oral health care practices among ANC providers varied considerably. The most reported barriers related to providers' limited oral health care knowledge, concerns with dental costs, and absence of organizational referral processes. The most reported facilitators related to providers' level of oral health care knowledge, patient prompt, and access to informational and educational resources. Conclusions: Further efforts are needed to address the range of barriers identified in this review and support ANC providers' clinical practice behaviors. This includes improved interprofessional education, training opportunities, and integrated health care models.
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Affiliation(s)
- Annika Wilson
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Ha Hoang
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Heather Bridgman
- Centre for Rural Health, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Silvana Bettiol
- Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Leonard Crocombe
- Dentistry & Oral Health, Rural Health School, La Trobe University, Bendigo, Victoria, Australia
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Carrillo-Díaz M, Ortega-Martínez AR, Ruiz-Guillén A, Romero-Maroto M, González-Olmo MJ. Impact of Breastfeeding and Cosleeping on Early Childhood Caries: A Cross-Sectional Study. J Clin Med 2021; 10:1561. [PMID: 33917683 PMCID: PMC8067957 DOI: 10.3390/jcm10081561] [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] [Received: 03/07/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/16/2022] Open
Abstract
The type and duration of breastfeeding can be key factors in the development of early childhood caries (ECC). The association between nighttime feeding and ECC was investigated. Specifically, whether cosleeping is a potential mediator of children's oral health was investigated, considering many of the etiological factors of caries. In this cross-sectional study, 212 children (aged 2-4 years) from Madrid (Spain) who breastfed at night were examined to assess the mean decayed/filled primary teeth (dft) index, and a questionnaire was administered to the mothers to collect data on the practice of breastfeeding and cosleeping and its duration, the number of nighttime feeding sessions, sugar content in the diet, dental hygiene habits, and age at first dental visit. The dft index was lower in the group that breastfed for less than 18 months (p = 0.02). In addition, there were significant differences in the dft index in the group breastfeeding for more than 18 months between those who coslept for 18 months or more and those who coslept for less than 18 months (p < 0.05), as well as between those who coslept for 18 months or more and those who did not cosleep (p < 0.01). In conclusion, breastfeeding at night from 18 months onwards is considered a risk factor for ECC.
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Affiliation(s)
- María Carrillo-Díaz
- Department of Nursing and Dentistry, Rey Juan Carlos University, 28922 Alcorcón, Spain;
| | | | - Ana Ruiz-Guillén
- Department of Nursing and Dentistry, Rey Juan Carlos University, 28922 Alcorcón, Spain;
| | - Martín Romero-Maroto
- Department of Orthodontics, Rey Juan Carlos University, 28922 Alcorcón, Spain; (M.R.-M.); (M.J.G.-O.)
| | - María José González-Olmo
- Department of Orthodontics, Rey Juan Carlos University, 28922 Alcorcón, Spain; (M.R.-M.); (M.J.G.-O.)
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McGrath R, Marino R, Satur J. Oral health promotion practices of Australian community mental health professionals: a cross sectional web-based survey. BMC Oral Health 2021; 21:85. [PMID: 33632192 PMCID: PMC7908706 DOI: 10.1186/s12903-021-01438-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 02/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explored the oral health promotion practices of Australian community mental health professionals working with people living with severe mental illness (SMI). METHODS An anonymous cross-sectional web-based survey was distributed to all Community Rehabilitation and Support Workers (CRSWs) working at Neami National (n = 471), an Australian community mental health service. The validated questionnaire assessed participants' self-rated oral health knowledge and confidence (7 questions); their perceived barriers (9 questions) and attitudes (5 questions) to oral health promotion; and their oral health promotion practices (7 questions). Differences in responses between groups were analysed using Chi-square, Fisher's exact and Mann-Whitney U tests. Logistic Regression Analysis served to explore the probability of providing oral health support to mental health consumers. RESULTS A total of 141 CRSWs were included in this study, achieving a response rate of 30 percent. Roughly two-fifths (39.0%) of participants had oral health training in the previous 12-months. The majority of CRSWs (89.3%) believed ('Agreed' or 'Strongly agreed') that mental health support workers have a role to play in promoting oral health. However, less than half (44.0%) of CRSWs practiced oral health promotion activities when working with mental health consumers. When asked about barriers to promoting oral health, 'lack of consumer interest' was the most prevalent issue. CRSWs who had oral health training were over three-times (OR 3.5, 95% CI 1.25-9.83, p = 0.017) more likely to provide oral health support. Results showed the provision of oral health support was most strongly associated with self-rated knowledge and confidence (OR 4.089, 95% CI 1.629-10.263, p = 0.003) and attitudes to oral health promotion (OR 3.906, 95% CI 1.77-8.65, p = 0.001). CONCLUSION The results of this study suggest that mental health support workers who have more positive attitudes to oral health promotion and who have higher self-rated oral health knowledge and confidence are more likely to provide oral health support in their professional role. Training for community mental health professionals is essential to build confidence and skills to promote oral health for mental health consumers.
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Affiliation(s)
- Roisin McGrath
- The Melbourne Dental School, The University of Melbourne, Melbourne, VIC, 3053, Australia.
| | - Rodrigo Marino
- The Melbourne Dental School, The University of Melbourne, Melbourne, VIC, 3053, Australia
| | - Julie Satur
- The Melbourne Dental School, The University of Melbourne, Melbourne, VIC, 3053, Australia
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Kong AC, Sousa MS, Ramjan L, Dickson M, Goulding J, Gwynne K, Talbot F, Jones N, Srinivas R, George A. "Got to build that trust": the perspectives and experiences of Aboriginal health staff on maternal oral health. Int J Equity Health 2020; 19:187. [PMID: 33097061 PMCID: PMC7585174 DOI: 10.1186/s12939-020-01301-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 10/14/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND In Australia, models of care have been developed to train antenatal care providers to promote oral health among pregnant women. However, these models are underpinned by Western values of maternity care that do not consider the cultural needs of Aboriginal and Torres Strait Islander women. This study aimed to explore the perceptions and experiences of Aboriginal health staff towards oral health care during pregnancy. It is part of a larger program of research to develop a new, culturally safe model of oral health care for Aboriginal women during pregnancy. METHODS A descriptive qualitative methodology informed the study. Focus groups were convened to yarn with Aboriginal Health Workers, Family Partnership Workers and Aboriginal management staff at two antenatal health services in Sydney, Australia. RESULTS A total of 14 people participated in the focus groups. There were four themes that were constructed. These focused on Aboriginal Health Workers and Family Partnership Workers identifying their role in promoting maternal oral health, where adequate training is provided and where trust has been developed with clients. Yet, because the Aboriginal health staff work in a system fundamentally driven by the legacy of colonisation, it has significantly contributed to the systemic barriers Aboriginal pregnant women continue to face in accessing health services, including dental care. The participants recommended that a priority dental referral pathway, that supported continuity of care, could provide increased accessibility to dental care. CONCLUSIONS The Aboriginal health staff identified the potential role of Aboriginal Health Workers and Family Partnership Workers promoting oral health among Aboriginal pregnant women. To develop an effective oral health model of care among Aboriginal women during pregnancy, there is the need for training of Aboriginal Health Workers and Family Partnership Workers in oral health. Including Aboriginal staff at every stage of a dental referral pathway could reduce the fear of accessing mainstream health institutions and also promote continuity of care. Although broader oral health policies still need to be changed, this model could mitigate some of the barriers between Aboriginal women and both dental care providers and healthcare systems.
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Affiliation(s)
- Ariana C. Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
| | - Mariana S. Sousa
- IMPACCT - Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, 2007 NSW Australia
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Translational Health Research Institute, Campbelltown, 2560 NSW Australia
| | - Michelle Dickson
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Joanne Goulding
- Primary and Community Services, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
| | - Kylie Gwynne
- Faculty of Medicine and Health Sciences, Macquarie University, Macquarie Park, 2109 NSW Australia
| | - Folau Talbot
- Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Oral Health Services, South Western Sydney Local Health District, Liverpool, 2170 NSW Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, 2170 NSW Australia
- Translational Health Research Institute, Campbelltown, 2560 NSW Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2006 NSW Australia
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Abstract
PurposeIntegrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care.Design/methodology/approachThe scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes.FindingsOverall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used.Research limitations/implicationsDespite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended.Originality/valueThe originality of this study is to provide evidence on integrated oral healthcare during pregnancy.
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George A, Kong AC, Villarosa A, Duff M, Sheehan A, Burns E, Priddis H, Chua C, Dahlen HG. Implementing and evaluating the effectiveness of an oral health module for the bachelor of midwifery program at an Australian university. NURSE EDUCATION TODAY 2020; 90:104457. [PMID: 32388200 DOI: 10.1016/j.nedt.2020.104457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/17/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Although guidelines recommend antenatal care providers such as midwives promote oral health during pregnancy, oral health training is not routinely provided in undergraduate midwifery curricula. The aim of this study was to implement an oral health module into an Australian undergraduate midwifery program, and evaluate its effectiveness in improving the oral health knowledge and confidence of midwifery students. DESIGN Pre-test post-test study (2015-2017). SETTING An undergraduate midwifery program within an Australian university. PARTICIPANTS All first-year undergraduate midwifery students enrolled in two core units at the above university (N = 56). METHODS Oral health modules were implemented into each of the two core units within the first year of the Bachelor of Midwifery course. Changes in knowledge and confidence were measured using a standardised questionnaire, administered at baseline, immediately following module completion, and at 2 and 3 years following module completion. RESULTS 44 students participated in the baseline survey (79% response rate), of which 41 completed the first post-module questionnaire, 21 completed the second post-questionnaire, and 24 completed the third post-questionnaire. Knowledge scores significantly increased from baseline (mean 13.12) to follow-up (mean 17.78, p < 0.001), with increases being retained through to the 3-year mark (mean 18.29, p < 0.001). Confidence scores also showed a sustained increase following the module, particularly regarding introducing oral health in the first antenatal appointment (62.1% increase, p < 0.001) and referring pregnant women to a dentist (48.2% increase, p < 0.001). However, the 48.2% increase (p < 0.001) in confidence in conducting a visual mouth check on a pregnant woman following the module was not sustained at subsequent time points, reducing to a 31.5% increase (p = 0.118) by the third year post-module. CONCLUSIONS The module is effective in improving and sustaining the knowledge and confidence of midwifery students to promote maternal oral health. Ongoing updates may be required to keep confidence high regarding visual mouth checks.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Translational Health Research Institute, Campbelltown, NSW 2560, Australia.
| | - Ariana C Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Amy Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Margaret Duff
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Athena Sheehan
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Elaine Burns
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Holly Priddis
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Clarity Chua
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Hannah G Dahlen
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
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15
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Knowledge, Attitudes and Practice Behaviour of Midwives Concerning Periodontal Health of Pregnant Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072246. [PMID: 32230709 PMCID: PMC7177424 DOI: 10.3390/ijerph17072246] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/23/2020] [Accepted: 03/23/2020] [Indexed: 12/14/2022]
Abstract
Maternal gum disease is associated with adverse pregnancy outcomes such as preterm birth and low birthweight. This study aims to evaluate the knowledge, attitudes and practice behaviour of Australian midwives regarding the periodontal health of pregnant women to inform interprofessional antenatal care. This was an observational, cross-sectional study. We circulated an online questionnaire to Australian midwives from August 2018 to February 2019. Key outcome variables were knowledge, attitudes, and practice behaviours related to oral health. Key predictor variables were years of practice, practice location, and dental history. We summarized responses with frequency tables and assigned tallied scores for analysis using non-parametric statistical tests. 100 responses were analysed, including from rural (n = 23) and urban (n = 77) midwives. Eighty percent of midwives agreed that maternal dental care can positively affect pregnancy outcomes. Fluoridated toothpaste use (19.1%) was incorrectly answered to prevent gum disease more often than psychological stress control (7.9%), a correct answer. Rural midwives demonstrated a significantly higher knowledge score (p = 0.001) and significantly more positive practice behaviours towards oral health (p = 0.014) than urban midwives. Australian midwives have positive attitudes towards antenatal oral health but misunderstand gum disease aetiology and prevention. This study highlights areas to improve interprofessional education for optimal oral health and pregnancy outcomes.
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Koirala A, O'Connor E, Widmer R, Kilpatrick N, Goldfeld S. Oral health care: The experience of Australian paediatricians. J Paediatr Child Health 2019; 55:1374-1380. [PMID: 30868700 DOI: 10.1111/jpc.14426] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 02/04/2019] [Accepted: 02/10/2019] [Indexed: 11/29/2022]
Abstract
AIM Many Australian children have dental decay in their deciduous teeth. Poor oral health can negatively impact a child's ability to eat, speak, sleep and socialise, with adverse impacts later in life. Paediatricians are well placed to examine children's teeth and to provide advice and education about oral health. Using a sample of Australian paediatricians, we aimed to determine: (i) self-reported oral health knowledge and skills, (ii) frequency of office-based oral health-related discussions, (iii) perceived role of paediatricians and (iv) barriers to oral health-related discussions. METHODS Members of a national network of paediatricians - the Australian Paediatric Research Network - completed a multi-topic survey, which included questions designed to assess oral health knowledge, current practice and barriers to oral health-related discussions. RESULTS Of 430 active members, 178 (41%) completed the survey. Few paediatricians reported very good/excellent ability to assess plaque build-up (8%) and dental caries (17%). Only 10% reported broaching the issue of oral health with all patients. Significant barriers included lack of professional training (52%) and other more pressing issues needing to be addressed (67%). CONCLUSIONS The increasing (and inequitable) rates of dental decay in Australian children mean that paediatricians should play a key role in the management of children's oral health. Many paediatricians reported a lack of specific training in oral health and limited ability to assess children and educate families. Despite the traditional divide between medicine and oral health, this study highlights the opportunity for Australian paediatricians to improve oral health through early intervention in the consultation room and beyond.
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Affiliation(s)
- Archana Koirala
- National Centre of Immunisation Research and Surveillance, University of Sydney, Sydney, New South Wales, Australia.,Department of Women and Children, University of Sydney, Sydney, New South Wales, Australia
| | - Elodie O'Connor
- Department of Paediatric Dentistry, Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Richard Widmer
- Centre for Community Child Health, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Nicky Kilpatrick
- Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Plastic Surgery Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Sharon Goldfeld
- Department of Paediatric Dentistry, Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
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George A, Sousa MS, Kong AC, Blinkhorn A, Patterson Norrie T, Foster J, Dahlen HG, Ajwani S, Johnson M. Effectiveness of preventive dental programs offered to mothers by non-dental professionals to control early childhood dental caries: a review. BMC Oral Health 2019; 19:172. [PMID: 31375106 PMCID: PMC6679429 DOI: 10.1186/s12903-019-0862-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/24/2019] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Early childhood caries is a common chronic childhood disease and maternal oral health is a risk factor. Improving the oral health behaviours of pregnant women/young mothers can positively influence the oral health of children and reduce their caries risk. Such preventative strategies have been undertaken by non-dental professionals producing mixed results encompassing various interventions across the perinatal period. However, no comprehensive review of these studies has been undertaken. The aim of this review was to assess the effectiveness of maternal oral health programs undertaken during the antenatal and/or postnatal period by non-dental health professionals to reduce early childhood caries. METHODS A systematic search of five databases was undertaken using key search terms. Studies were included if they (a) involved quantitative study designs with a control; (b) were published in English; (c) reported on interventions delivered by non-dental professionals (d) delivered the intervention to expectant mothers or mothers with young infants up to 24 months; (e) measured outcomes when the child was under 5 years; (f) measured changes in oral health outcomes of children clinically and oral health behaviours of mothers or children. No restrictions were placed on the study quality and setting. RESULTS Nine studies met the inclusion criteria and involved interventions delivered by diverse non-dental professionals across the antenatal (n = 1), postnatal (n = 6) and perinatal period (n = 2). Most studies were of low methodological quality (n = 6). The interventions focussed on oral health education (n = 8), dental referrals (n = 3) and oral health assessments (n = 1). Interventions conducted in either the postnatal or antenatal periods showed meaningful improvements in children's clinical and mother's behavioural oral health outcomes. The outcomes appear to be sustained when a suite of interventions were used along with referral reminders. There were mixed results from interventions across the perinatal period. CONCLUSIONS Non-dental professionals can promote maternal oral health by providing oral health education, risk assessment and referrals. Combining these interventions could provide a sustained improvement in oral health outcomes for children although current evidence is weak. More high-quality studies are needed to confirm these findings and determine whether the antenatal and/or postnatal period is best suited to deliver these interventions.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
- Translational Health Research Institute, Campbelltown, NSW 2560 Australia
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2050 Australia
| | - Mariana S. Sousa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Ariana C. Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Anthony Blinkhorn
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2050 Australia
| | - Tiffany Patterson Norrie
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District, Liverpool, NSW 2170 Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
| | - Jann Foster
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW 2560 Australia
| | - Hannah G. Dahlen
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW 2560 Australia
| | - Shilpi Ajwani
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, 2050 Australia
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital/University of Sydney, Sydney, 2010 Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, North Sydney, NSW 2060 Australia
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18
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Ajwani S, Sousa MS, Villarosa AC, Bhole S, Johnson M, Dahlen HG, Hoolsema J, Blinkhorn A, Srinivas R, Yaacoub A, Milat A, Skinner J, George A. Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of dental professionals. Health Promot J Austr 2018; 30:333-343. [PMID: 30512207 DOI: 10.1002/hpja.224] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 11/30/2018] [Indexed: 01/31/2023] Open
Abstract
ISSUE ADDRESSED All pregnant women should have a comprehensive oral health evaluation. Unfortunately, many pregnant women seldom seek dental care and some dentists are hesitant to treat during pregnancy. To address these issues, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in Australia. The aim of this study was to undertake a process evaluation and explore the perceptions of dental professionals involved in the program to determine the acceptability, feasibility and effectiveness of the program if it were to be upscaled. METHODS A qualitative approach using content analysis was conducted on data from two focus groups involving 12 dental professionals. RESULTS All participants were supportive of the MIOH-DS program. They thought pregnant women were receptive to their care, and reported markedly improved oral health. The provision of free dental care and the involvement of midwives were cited as major factors that improved the uptake of the program. Some of the challenges encountered were the prevailing misconceptions about the safety of dental treatment and pregnancy-related impairments. CONCLUSIONS Dental professionals found the MIOH-DS to be acceptable, feasible and effective in improving oral health of pregnant women and their uptake of dental services. However, some challenges need to be addressed as the MIOH-DS program is upscaled into a cost-effective model. SO WHAT?: Dental professionals are important stakeholders in the MIOH-DS model. The process evaluation of the successful dental intervention is necessary to understand how and why such interventions work, and is an important step in scaling up to a population-wide intervention.
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Affiliation(s)
- Shilpi Ajwani
- Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, Sydney Research, Sydney, NSW, Australia
| | - Mariana S Sousa
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research/Prince of Wales Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Ariana C Villarosa
- COHORT, Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services/Sydney Dental Hospital/University of Sydney, Sydney Research, Sydney, NSW, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University/Ingham Institute Applied Medical Research, Sydney, NSW, Australia
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University/Ingham Institute Applied Medical Research, Parramatta, NSW, Australia
| | - Julia Hoolsema
- COHORT, Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | | | - Ravi Srinivas
- COHORT, South Western Sydney Local Health District Oral Health Services, Western Sydney University/Ingham Institute Applied Medical Research/University of Sydney, Liverpool, NSW, Australia
| | - Albert Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Penrith, NSW, Australia
| | - Andrew Milat
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - John Skinner
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Ajesh George
- COHORT, Western Sydney University/South Western Sydney Local Health District/University of Sydney/Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, NSW, Australia
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20
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Perceptions and Practices of Diabetes Educators in Providing Oral Health Care: A Qualitative Study. DIABETES EDUCATOR 2018; 44:454-464. [PMID: 30141382 DOI: 10.1177/0145721718796055] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Purpose The purpose of this study was to explore the current perceptions and practices of diabetes educators (DEs) in providing oral health care to people with diabetes. Methods A qualitative study design involving focus groups was used to gather data. Purposive sampling was used to recruit DEs working across 3 metropolitan hospitals in South Western Sydney, Australia. Results Fourteen DEs participated in 3 focus groups. Participants had a mean ± SD age of 44.4 ± 9.2 years and 5.2 ± 5.3 years of work experience in diabetes care. Four main themes were identified: perceptions about oral health care and diabetes current oral health care practices, perceptions on incorporating oral health, and suggested model of care. DEs agreed that promoting oral health in diabetes clinics is important, and they reported seeing patients frequently with oral health problems. However, the majority do not include oral health care in consultations, primarily because they have limited knowledge in this area and have not received any formal oral health education or training. Additional barriers were the lack of referral pathways and resources for patient education. DEs were receptive to incorporating oral health provided that the current barriers were addressed. DEs also suggested a multidisciplinary team care approach to promote oral health. Conclusions Current practices of DEs in oral health care are limited, but they are willing to address oral health. A suggested model of oral health care should include capacity building of diabetes care providers, appropriate dental referral pathways, and a team approach within multidisciplinary diabetes care.
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Affiliation(s)
- Prakash Poudel
- COHORT Research Group (Centre for Oral Health Outcomes and Research Translation), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Rhonda Griffiths
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Vincent W Wong
- South Western Sydney Local Health District, South Western Clinical School, University of New South Wales, Liverpool, Australia
- Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, Penrith, Australia
- Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, South Western Clinical School, University of New South Wales, Liverpool, Australia
- School of Medicine, Western Sydney University, Campbelltown, Australia
| | - Chee L Khoo
- Health Focus Family Practice, Ingleburn, Australia
| | - Ajesh George
- COHORT Research Group (Centre for Oral Health Outcomes and Research Translation), School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
- South Western Sydney Local Health District, Ingham Institute for Applied Medical Research, Liverpool, Australia
- School of Dentistry, University of Sydney, Camperdown, Australia
- Translational Health Research Institute, Penrith, Australia
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21
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Dahlen HG, Johnson M, Hoolsema J, Norrie TP, Ajwani S, Blinkhorn A, Bhole S, Ellis S, Srinivas R, Yaacoub A, Milat A, Skinner J, George A. Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of midwives in Greater Western Sydney, Australia. Women Birth 2018; 32:e159-e165. [PMID: 30025676 DOI: 10.1016/j.wombi.2018.06.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite links between poor maternal oral health, adverse pregnancy outcomes and early childhood decay there is limited emphasis on maternal oral health in Australia. To address this, the Midwifery Initiated Oral Health Dental Service (MIOH-DS) program was developed in collaboration with the Australian College of Midwives. AIMS To undertake a process evaluation and explore perceptions of midwives involved in the MIOH-DS program to determine its practicability, acceptability and feasibility if it were to be up-scaled and implemented into clinical practice. METHODS Qualitative content analysis was undertaken on data from three focus groups with 21 midwives. FINDINGS Midwives generally found the MIOH-DS to be acceptable and feasible with potential for widespread scalability. The trust women had in midwives was an important factor in gaining women's attention about oral health in pregnancy. The program assisted in increasing midwives' knowledge and awareness, though some felt it was outside their scope of practice. The oral health assessment tool was acceptable to midwives but some concerns were expressed about undertaking a visual oral inspection. Most midwives stated they were now confident with referring individuals to a dentist. Significant barriers to widespread implementation included the cost of dental care and the continued lack of awareness and misconceptions pregnant women had towards oral health. CONCLUSION Midwives found the MIOH-DS to be acceptable and feasible which are two important barriers to potential implementation at scale. Misconceptions over the importance of oral health by women and cost of accessing dental services still need resolving.
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Affiliation(s)
- Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta 2150, Australia.
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney 2060, Australia.
| | - Julia Hoolsema
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool 1871, Australia.
| | - Tiffany Patterson Norrie
- COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool 1871, Australia.
| | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney Research, Sydney 2010, Australia.
| | - Anthony Blinkhorn
- Faculty of Dentistry, University of Sydney, Sydney, 2006, Australia.
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney Research, Sydney 2010, Australia.
| | - Sharon Ellis
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, 2170, Australia.
| | - Ravi Srinivas
- South Western Sydney Local Health District Oral Health Services, COHORT, Western Sydney University, University of Sydney, Ingham Institute Applied Medical Research, Liverpool, Australia.
| | - Albert Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Penrith, Australia.
| | - Andrew Milat
- Centre for Epidemiology and Evidence, NSW Ministry of Health, University of Sydney, Australia.
| | - John Skinner
- Faculty of Dentistry, University of Sydney, Sydney, 2006, Australia.
| | - Ajesh George
- COHORT, Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool 1871, Australia.
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22
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Poudel P, Griffiths R, Wong VW, Arora A, Flack JR, Khoo CL, George A. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health 2018; 18:577. [PMID: 29716561 PMCID: PMC5930945 DOI: 10.1186/s12889-018-5485-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 04/19/2018] [Indexed: 01/26/2023] Open
Abstract
Background People with uncontrolled diabetes are at greater risk for several oral health problems, particularly periodontal (gum) disease. Periodontal disease also impacts diabetes control. Good oral hygiene and regular dental visits are recommended to prevent and manage oral health problems. Several studies have been conducted to assess the oral health knowledge, attitudes, and practices of people with diabetes yet a review of these findings has not yet been undertaken. The aim of this systematic review was to synthesize current evidence on the knowledge, attitudes and practices of people with diabetes in relation to their oral health care. Methods A systematic search of all literature was carried out in five databases using key search terms. The inclusion criteria were: 1) published in the English language; 2) from 2000 to November, 2017; 3) conducted on persons with any type of diabetes and of all ages; 4) explored at least one study outcome (knowledge or attitude or practices toward oral health care); and 5) used quantitative methods of data collection. No restrictions were placed on the quality and setting of the study. Results A total of 28 studies met the inclusion criteria. The studies included a total of 27,894 people with diabetes and were conducted in 14 countries. The review found that people with diabetes have inadequate oral health knowledge, poor oral health attitudes, and fewer dental visits. They rarely receive oral health education and dental referrals from their care providers. Provision of oral health education by diabetes care providers and referral to dentists when required, was associated with improved oral health behaviours among patients. Conclusions Overall, people with diabetes have limited oral health knowledge and poor oral health behaviours. It is therefore essential to educate patients about their increased risk for oral health problems, motivate them for good oral health behaviours and facilitate access to dental care. Electronic supplementary material The online version of this article (10.1186/s12889-018-5485-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Prakash Poudel
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia. .,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia. .,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.
| | - Rhonda Griffiths
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
| | - Vincent W Wong
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Amit Arora
- Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,School of Science and Health, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Oral Health Services and Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia.,Discipline of Child and Adolescent Health, Sydney Medical School, Westmead, NSW, 2145, Australia
| | - Jeff R Flack
- South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, 2052, Australia.,School of Medicine, Western Sydney University, Locked Bag 1797, Penrith, NSW, 1797, Australia
| | - Chee L Khoo
- Health Focus Family Practice, The Royal Australian College of General Practitioners (RACGP), National Association of Diabetes Centres (NADC), Ingleburn, NSW, 2565, Australia.,Diabetes , Obesity and Metabolism Translational Research Unit (DOMTRU), Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia.,Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool, 1871, NSW, Australia.,South Western Sydney Local Health District, Liverpool, 2170, NSW, Australia.,Faculty of Dentistry, University of Sydney, Camperdown, 2050, NSW, Australia.,Translational Health Research Institute, Western Sydney University, Locked Bag 1797, Penrith, 2751, NSW, Australia
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23
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Villarosa AC, Villarosa AR, Salamonson Y, Ramjan LM, Sousa MS, Srinivas R, Jones N, George A. The role of indigenous health workers in promoting oral health during pregnancy: a scoping review. BMC Public Health 2018; 18:381. [PMID: 29558933 PMCID: PMC5859720 DOI: 10.1186/s12889-018-5281-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 03/08/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Early childhood caries is the most common chronic childhood disease worldwide. Australian Aboriginal and Torres Strait Islander children are twice more likely to develop dental decay, and contributing factors include poor maternal oral health and underutilisation of dental services. Globally, Indigenous health workers are in a unique position to deliver culturally competent oral healthcare because they have a contextual understanding of the needs of the community. METHODS This scoping review aimed to identify the role of Indigenous health workers in promoting maternal oral health globally. A systematic search was undertaken of six electronic databases for relevant published literature and grey literature, and expanded to include non-dental health professionals and other Indigenous populations across the lifespan when limited studies were identified. RESULTS Twenty-two papers met the inclusion criteria, focussing on the role of Indigenous health workers in maternal oral healthcare, types of oral health training programs and screening tools to evaluate program effectiveness. There was a paucity of peer-reviewed evidence on the role of Indigenous health workers in promoting maternal oral health, with most studies focusing on other non-dental health professionals. Nevertheless, there were reports of Indigenous health workers supporting oral health in early childhood. Although some oral health screening tools and training programs were identified for non-dental health professionals during the antenatal period, no specific screening tool has been developed for use by Indigenous health workers. CONCLUSIONS While the role of health workers from Indigenous communities in promoting maternal oral health is yet to be clearly defined, they have the potential to play a crucial role in 'driving' screening and education of maternal oral health especially when there is adequate organisational support, warranting further research.
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Affiliation(s)
- Ariana C. Villarosa
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
| | - Amy R. Villarosa
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
| | - Yenna Salamonson
- School of Nursing & Midwifery, Western Sydney University, Penrith, 2751 Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
- Centre for Applied Nursing Research (CANR), Liverpool, 1871 Australia
| | - Lucie M. Ramjan
- School of Nursing & Midwifery, Western Sydney University, Penrith, 2751 Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
- Centre for Applied Nursing Research (CANR), Liverpool, 1871 Australia
| | - Mariana S. Sousa
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- South Western Sydney Local Health District, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
- Centre for Applied Nursing Research (CANR), Liverpool, 1871 Australia
- Prince of Wales Clinical School, University of New South Wales, Sydney, 2052 Australia
| | - Ravi Srinivas
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
- Faculty of Dentistry, University of Sydney, Camperdown, 2050 Australia
| | - Nathan Jones
- South Western Sydney Local Health District, Liverpool, NSW Australia
| | - Ajesh George
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Ingham Institute for Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871 Australia
- School of Nursing & Midwifery, Western Sydney University, Penrith, 2751 Australia
- South Western Sydney Local Health District, Liverpool, NSW Australia
- Ingham Institute for Applied Medical Research, Liverpool, 1871 Australia
- Faculty of Dentistry, University of Sydney, Camperdown, 2050 Australia
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24
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George A, Dahlen HG, Blinkhorn A, Ajwani S, Bhole S, Ellis S, Yeo A, Elcombe E, Johnson M. Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A multi-centre randomised controlled trial. Int J Nurs Stud 2018; 82:49-57. [PMID: 29605753 DOI: 10.1016/j.ijnurstu.2018.03.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/19/2018] [Accepted: 03/05/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Oral health care during pregnancy is important for the health of the mother and child. However, pregnant women have limited knowledge about maternal oral health and seldom seek dental care. Further, due to limited training antenatal care providers like midwives rarely discuss oral health with pregnant women. The Midwifery-Initiated Oral Health Dental Service program was developed to address current gaps in oral promotional interventions during pregnancy. OBJECTIVES To assess the effectiveness of a Midwifery-Initiated Oral Health Dental Service program in improving uptake of dental services, oral health knowledge, quality of oral health, oral health status and birth outcomes of pregnant women. DESIGN Multi-centre randomised controlled trial. SETTING Three large metropolitan public hospitals in Sydney, Australia. PARTICIPANTS Pregnant women attending their first antenatal appointment who were at least 18 years old and had a single low risk pregnancy between 12 and 20 weeks gestation. METHODS 638 pregnant women were allocated to three groups using block randomisation (n = 211) control group, intervention group 1 (n = 215), intervention group 2 (n = 212) and followed up till birth. Study investigators and data collectors were blinded to group allocation. Intervention group 1 received a midwifery intervention from trained midwives involving oral health education, screening and referrals to existing dental pathways. Intervention group 2 received the midwifery intervention and a dental intervention involving assessment/treatment from cost free local dental services. The control group received oral health information at recruitment. Primary outcome was uptake of dental services. Secondary outcomes included oral health knowledge, quality of oral health, oral health status and birth outcomes. RESULTS Substantial improvements in the use of dental services (20.2% Control Group; 28.3% Intervention group 1; 87.2% Intervention group 2; Odds Ratio Intervention group 2 vs Control Group = 29.72, 95% CI 15.02-58.53, p < 0.001), women's oral health knowledge (p = 0.03); quality of oral health (p < 0.001) and oral health outcomes (sulcus bleeding, dental plaque, clinical attachment loss, decayed/filled teeth- p < 0.001) were found in Intervention group 2. No difference in the rate of preterm or low-birth weight was found. CONCLUSIONS The Midwifery-Initiated Oral Health Dental Service program (Intervention group 2) improved the uptake of dental services and oral health of pregnant women and is recommended during antenatal care. A cause and effect relationship between this intervention and improved birth outcomes was not supported.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Western Sydney University, South Western Sydney Local Health District Oral Health Services, University of Sydney, Ingham Institute Applied Medical Research, Liverpool 1871, Australia.
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta 2150, Australia
| | | | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney 2010, Australia; Sydney Research, Sydney 2010, Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney 2010, Australia; Sydney Research, Sydney 2010, Australia
| | - Sharon Ellis
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Campbelltown 2170, Australia
| | - Anthony Yeo
- School of Nursing & Midwifery, University of Western Sydney, Liverpool, 1871, Australia
| | - Emma Elcombe
- Western Sydney University, University of New South Wales, Ingham Institute Applied Medical Research, Liverpool 1871, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney 2060, Australia; Ingham Institute Applied Medical Research, Liverpool 1871, Australia
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25
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Poudel P, Griffiths R, Wong VW, Arora A, George A. Knowledge and practices of diabetes care providers in oral health care and their potential role in oral health promotion: A scoping review. Diabetes Res Clin Pract 2017; 130:266-277. [PMID: 28662464 DOI: 10.1016/j.diabres.2017.06.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 04/21/2017] [Accepted: 06/06/2017] [Indexed: 12/17/2022]
Abstract
AIM Oral health complications are common in people with diabetes yet very little is reported about the oral health care provided in diabetes care setting. This study reviewed global evidence on the oral health care knowledge and practices of diabetes care providers and the role of non-dental health professionals in oral health promotion. METHODS A systematic search of five databases was undertaken with key search terms using a scoping review framework. Relevant studies published till October 2016 in the English language were included (n=30) and no restrictions were placed on the study design, quality or setting. RESULTS Most diabetes care providers are not addressing oral health care with the main barriers being time constraints and limited oral health knowledge. Diabetes educators (DEs) could engage in oral health promotion with few studies showing this model of care can translate into improved patient outcomes. However, no appropriate oral health training programs and assessment tools exist for DEs. With proper training, non-dental professionals like nurses have successfully incorporated oral healthcare in other settings. CONCLUSIONS DEs are well placed to promote oral health in diabetes care setting. Further research is needed to identify barriers and oral health resources to support DEs in this role.
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Affiliation(s)
- Prakash Poudel
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool 1871, Australia.
| | - Rhonda Griffiths
- School of Nursing & Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 1797, Australia
| | - Vincent W Wong
- Diabetes and Endocrine Service, Liverpool Hospital, Liverpool Diabetes Collaborative Research Unit, Ingham Institute Applied Medical Research, South Western Clinical School, University of New South Wales, Locked Bag 7103, Liverpool BC, NSW 1871, Australia
| | - Amit Arora
- School of Science and Health, Western Sydney University, COHORTE Research Group, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Sydney Medical School, University of Sydney, Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, Building 24.2.97, Campbelltown Campus, WSU, NSW 2560, Australia
| | - Ajesh George
- COHORTE Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney, Locked Bag 7103, Liverpool 1871, Australia
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26
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Sanchez P, Everett B, Salamonson Y, Ajwani S, Bhole S, Bishop J, Lintern K, Nolan S, Rajaratnam R, Redfern J, Sheehan M, Skarligos F, Spencer L, Srinivas R, George A. Oral health and cardiovascular care: Perceptions of people with cardiovascular disease. PLoS One 2017; 12:e0181189. [PMID: 28727751 PMCID: PMC5519046 DOI: 10.1371/journal.pone.0181189] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 06/26/2017] [Indexed: 01/01/2023] Open
Abstract
MAIN OBJECTIVE The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. METHOD A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews. Data was analysed using thematic analysis. RESULTS Results suggested that while oral health was considered relevant there was high prevalence of poor oral health among participants, especially those from socioeconomic disadvantaged background. Awareness regarding the importance of oral health care its impact on cardiovascular outcomes was poor among participants. Oral health issues were rarely discussed in the cardiac setting. Main barriers deterring participants from seeking oral health care included lack of awareness, high cost of dental care and difficulties in accessing the public dental service. Findings also revealed that participants were interested in receiving further information about oral health and suggested various mediums for information delivery. The concept of cardiac care clinicians, especially nurses providing education, assessment and referrals to ongoing dental care was well received by participants who felt the post-acute period was the most appropriate time to receive oral health care advice. The issues of oral health training for non-dental clinicians and how to address existing barriers were highlighted by participants. RELEVANCE TO CLINICAL PRACTICE The lack of oral health education being provided to patients with cardiovascular disease offers an opportunity to improve care and potentially, outcomes. In view of the evidence linking poor oral health with cardiovascular disease, cardiac care clinicians, especially nurses, should be appropriately trained to promote oral health in their practice. Affordable and accessible dental care services for people with cardiovascular disease should be considered and offered by health services in Australia.
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Affiliation(s)
- Paula Sanchez
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Centre for Applied Nursing Research, Liverpool, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Centre for Applied Nursing Research, Liverpool, Australia
| | - Shilpi Ajwani
- Sydney Local Health District, Sydney, Australia.,Oral Health Services, Sydney Dental Hospital, Sydney, Australia.,Faculty of Dentistry, The University of Sydney, Sydney, Australia
| | - Sameer Bhole
- Sydney Local Health District, Sydney, Australia.,Oral Health Services, Sydney Dental Hospital, Sydney, Australia.,Faculty of Dentistry, The University of Sydney, Sydney, Australia
| | | | - Karen Lintern
- South Western Sydney Local Health District, Sydney, Australia
| | | | - Rohan Rajaratnam
- South Western Sydney Local Health District, Sydney, Australia.,School of Medicine, Western Sydney University, Sydney, Australia.,University of New South Wales, Sydney, Australia
| | - Julie Redfern
- The George Institute for Global Health, Sydney, Australia.,Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Maria Sheehan
- South Western Sydney Local Health District, Sydney, Australia
| | | | | | - Ravi Srinivas
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Ajesh George
- School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.,South Western Sydney Local Health District, Sydney, Australia.,Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,Faculty of Dentistry, The University of Sydney, Sydney, Australia
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27
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George A, Ajwani S, Bhole S, Dahlen HG, Reath J, Korda A, Ng Chok H, Miranda C, Villarosa A, Johnson M. Knowledge, attitude and practises of dentists towards oral health care during pregnancy: A cross sectional survey in New South Wales, Australia. Aust Dent J 2017; 62:301-310. [DOI: 10.1111/adj.12505] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2017] [Indexed: 01/23/2023]
Affiliation(s)
- A George
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group; Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney; Liverpool New South Wales Australia
| | - S Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney; Sydney New South Wales Australia
| | - S Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital/University of Sydney; Sydney New South Wales Australia
| | - HG Dahlen
- School of Nursing and Midwifery; Western Sydney University/Ingham Institute Applied Medical Research; Parramatta New South Wales Australia
| | - J Reath
- Peter Brennan Chair of General Practice, School of Medicine, Western Sydney University; Campbelltown New South Wales Australia
| | - A Korda
- Obstetrics and Gynaecology, School of Medicine, Western Sydney University; Campbelltown New South Wales Australia
| | - H Ng Chok
- Centre for Nursing Research and Practice Development; Western Sydney University/Nepean Blue Mountains Local Health District; Penrith New South Wales Australia
| | - C Miranda
- College of Professional Psychology; Crows Nest New South Wales Australia
| | - A Villarosa
- COHORTE Research Group; Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research; Liverpool New South Wales Australia
| | - M Johnson
- Faculty of Health Sciences; Australian Catholic University, Ingham Institute Applied Medical Research; Sydney New South Wales Australia
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Duff M, Dahlen HG, Burns E, Priddis H, Schmied V, George A. Designing an oral health module for the Bachelor of Midwifery program at an Australian University. Nurse Educ Pract 2017; 23:76-81. [PMID: 28273559 DOI: 10.1016/j.nepr.2017.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 02/04/2017] [Accepted: 02/08/2017] [Indexed: 01/22/2023]
Abstract
Maternal oral health is important yet many pregnant women are unaware of its significance. Midwives are advised to promote oral health during pregnancy and are supported to do this in Australia through the Midwifery Initiated Oral Health training program. However, limited undergraduate education is being provided to midwifery students in this area. The objective of this paper is to describe how an innovative oral health education module for an undergraduate midwifery course in Australia was designed using a multidisciplinary approach. Midwives experienced in curriculum development and key investigators from the Midwifery Initiated Oral Health program designed the module using existing literature. Constructive alignment, blended learning and scaffolding were used in the design process. The draft module was then reviewed by midwifery academics and their feedback incorporated. The final module involves 4 h of teaching and learning and contains three components incorporated into first year course units. Each component is aligned with existing learning outcomes and incorporates blended learning approaches and tutorials/class activities as well as online quizzes and personal reflection. The module details key information (current evidence; basic anatomy/physiology; common oral conditions; and guidelines during pregnancy) that could better prepare students to promote oral health in clinical practice. This is the first time such an innovative, multidisciplinary approach has been undertaken embedding oral health in an undergraduate midwifery program in Australia.
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Affiliation(s)
- Margaret Duff
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Sydney, NSW 2150, Australia
| | - Elaine Burns
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Holly Priddis
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Virginia Schmied
- School of Nursing & Midwifery, Western Sydney University, Sydney, NSW 2150, Australia
| | - Ajesh George
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney, Locked Bag 7103, Liverpool BC, NSW 1871, Australia.
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George A, Dahlen HG, Blinkhorn A, Ajwani S, Bhole S, Ellis S, Yeo A, Elcombe E, Sadozai A, Johnson M. Measuring oral health during pregnancy: sensitivity and specificity of a maternal oral screening (MOS) tool. BMC Pregnancy Childbirth 2016; 16:347. [PMID: 27829388 PMCID: PMC5103484 DOI: 10.1186/s12884-016-1140-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Accepted: 10/30/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Midwives can play a key role in promoting the oral health of pregnant women and assessing their oral health status. A maternal oral assessment tool (MOS) was developed and pilot tested by the study investigators to assist midwives in this role and the results were promising. The aim of this study was to undertake further sensitivity and specificity assessment of the MOS tool using two-comparison approaches- the longer oral health screening tool known as the Oral Health Impact Profile (OHIP-14) and an oral assessment by trained study dentists. METHODS Pregnant women were recruited for this study as part of a larger randomised controlled trial of a Midwifery Initiated Oral Health (MIOH) program. Pregnant women completed the MOS and OHIP-14 as part of their initial assessment undertaken by 38 trained and accredited midwives. A dental assessment was conducted for all women in the intervention group using three trained study dentists with high inter rater reliability. RESULTS Two hundred and eleven pregnant women participated in the validation of the MOS tool. Results from both approaches found the MOS tool to have high sensitivity, correctly identifying 88-94 % of women at risk of poor dental health, and low specificity (14-21 %). CONCLUSIONS This study has shown that the MOS tool can be successfully implemented by midwives during a woman's first antenatal visit and can identify up to 94 % of women at risk of poor oral health and needing a dental referral. The tool has the potential to be transferable to other antenatal care providers and could be incorporated into hospital obstetric database systems. TRIAL REGISTRATION NUMBER ACTRN12612001271897 , 6th Dec 2012, retrospectively registered.
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Affiliation(s)
- Ajesh George
- Collaboration for Oral Health Outcomes, Research Translation and Evaluation (COHORTE) Research Group, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, University of Sydney, Liverpool BC, Locked Bag 7103, Liverpool, NSW 1871 Australia
| | - Hannah G. Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta, 2150 Australia
| | | | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney, 2010 Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney, 2010 Australia
| | - Sharon Ellis
- Antenatal Services, Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Campbelltown, 2560 Australia
| | - Anthony Yeo
- School of Nursing & Midwifery, Western Sydney University, Parramatta, 2150 Australia
| | - Emma Elcombe
- Western Sydney University, University of New South Wales, Ingham Institute Applied Medical Research, Liverpool, 2170 Australia
| | - Ayesha Sadozai
- Centre for Applied Nursing Research, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, 1871 Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney, 2060 Australia
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