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Gomersall JC, Slack-Smith L, Kilpatrick N, Muthu MS, Riggs E. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2024; 5:CD012155. [PMID: 38753314 PMCID: PMC11098061 DOI: 10.1002/14651858.cd012155.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Dental caries, a common chronic disease of childhood, is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). This review updates one published in 2019. OBJECTIVES To assess the effects of interventions undertaken with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years). SEARCH METHODS We searched Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL EBSCO, the US National Institutes of Health Ongoing Trials Register (clinicaltrials.gov) and WHO International Clinical Trials Registry Platform (apps.who.int/trialsearch). The latest searches were run on 3 January, 2023. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing interventions with pregnant women, or new mothers and other primary caregivers of infants in the first year of life, against standard care, placebo or another intervention, reporting on a primary outcome: caries presence in primary teeth, dmfs (decayed, missing, filled primary surfaces index), or dmft (decayed, missing, filled teeth index), in children up to six years of age. Intervention types include clinical, oral health promotion/education (hygiene education, breastfeeding and other dietary advice) and policy or service. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence (GRADE). MAIN RESULTS We included 23 RCTs (5 cluster-randomised), involving 25,953 caregivers (mainly mothers) and their children. Fifteen trials assessed oral health education/promotion interventions against standard care. Six trials assessed a clinical intervention for mother dentition, against placebo, or a different type of clinical intervention. Two trials assessed oral health/education promotion plus clinical intervention (for mother's dentition) against standard care. At most, five trials (maximum of 1326 children and 130 mothers) contributed data to any comparison. Enamel-only caries were included in the diagnosis of caries in some studies. For many trials, the risk of bias was unclear due to lack of methodological details reported. In thirteen trials, participants were socioeconomically disadvantaged. No trial indicated receiving funding that was likely to have influenced their results. Oral health education/promotion interventions Child diet and feeding practice advice versus standard care: We observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a slightly lower mean dmfs (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, the evidence is very uncertain regarding the difference between groups in mean dmft (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). Breastfeeding promotion and support versus standard care: We observed little or no difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence) and in mean dmft (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). dmfs was not reported. Child diet advice compared with standard care: We are very uncertain about the effect on the risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). dmfs and dmft were not reported. Oral hygiene, child diet and feeding practice advice versus standard care: The evidence is very uncertain about the effect on the risk of caries presence in primary teeth (RR 0.73, 95% CI 0.50 to 1.07; 5 trials; 1326 participants; very low-certainty evidence) and there maybe little to no difference in mean dmfs (MD -0.87, 95% CI -2.18 to 0.43; 2 trials; 657 participants; low-certainty evidence) and mean dmft (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; low-certainty evidence). High-dose versus low-dose vitamin D supplementation during pregnancy: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.99, 95% CI 0.70 to 1.41; 1 trial; 496 participants; very low-certainty evidence). dmfs and dmft were not reported. Clinical interventions (for mother dentition) Chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo: We are very uncertain regarding the difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment for mother dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trial reported dmfs or dmft. Xylitol compared with CHX antimicrobial treatment: We are very uncertain about the effect on caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence), but we observed there may be a lower mean dmft with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence). No trial reported dmfs. Oral health education/promotion plus clinical interventions (for mother dentition) Diet and feeding practice advice for infants and young children plus basic dental care for mothers compared with standard care: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.44, 95% CI 0.05 to 3.95; 2 trials, 324 participants; very low-certainty evidence) or on mean dmft (1 study, not estimable). No trial reported dmfs. No trials evaluated policy or health service interventions. AUTHORS' CONCLUSIONS There is moderate-certainty evidence that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very-low certainty and is insufficient for determining which, if any, other intervention types and features may be effective for preventing ECC, and in which settings. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine the effects and relative effects of different interventions and inform practice. We have identified 13 ongoing studies. Future studies should consider if and how effects are modified by intervention features and participant characteristics (including socioeconomic status).
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Affiliation(s)
- Judith C Gomersall
- Life Course and Intergenerational Health Research Group, Robinson Research Institute and School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Nicky Kilpatrick
- Vascular Biology, Murdoch Children's Research Institute, Melbourne, Australia
- Plastic and Maxillofacial Surgery, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Carlton, Australia
| | - M S Muthu
- Centre for Early Childhood Caries Research, Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Australia
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Wang K, Lee GHM, Liu P, Gao X, Wong SYS, Wong MCM. Health belief model for empowering parental toothbrushing and sugar intake control in reducing early childhood caries among young children-study protocol for a cluster randomized controlled trial. Trials 2022; 23:298. [PMID: 35413872 PMCID: PMC9003160 DOI: 10.1186/s13063-022-06208-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 03/26/2022] [Indexed: 12/02/2022] Open
Abstract
Background It has been recognized that oral health education for parents is critical for preventing early childhood caries (ECC). Few parents practiced caries prevention procedures for their children in daily life, though. A novel intervention scheme using mobile messages will be developed in this study under the framework of the health belief model (HBM). The objective of the present randomized clinical trial (RCT) is to evaluate the effectiveness of the new scheme in promoting oral health of young children by reducing dental caries. Methods This RCT will involve 26–36 child care centers or kindergartens with nursery classes (clusters) located in Hong Kong. A total of 518–628 child-parent dyads (child age 18–30 months) will be recruited and randomly allocated at the cluster level into the test or control group with a 1:1 ratio. For parents in the test group, the intervention will consist of a set of HBM-based text messages sent regularly in 48 weeks. A standard text message will be sent to the parents in the control group in the first week. The primary outcome will be dental caries measured by dmft/dmfs of the children after 2 years (around 4 years of age). The secondary outcomes will be toothbtushing and sugar intake. Discussion HBM-based intervention via a low-cost text messaging vehicle may serve as a viable way to empower parents to establish proper oral health behaviors for their children and safeguard the oral health of children in Hong Kong. Trial registration ClinicalTrials.govNCT04665219. Registered on 11 December 2020. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06208-w.
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Affiliation(s)
- Ketian Wang
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Gillian Hiu Man Lee
- Division of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Pei Liu
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Xiaoli Gao
- Faculty of Dentistry, National University of Singapore and Saw Swee Hock School of Public Health, National University of Singapore, Queenstown, Singapore
| | - Samuel Yeung Shan Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Pok Fu Lam, Hong Kong
| | - May Chun Mei Wong
- Division of Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong.
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Verlinden DA, Schuller AA, Verrips GHW, Reijneveld SA. Effectiveness of a short web-based film targeting parental oral health knowledge in a well-child care setting. Eur J Oral Sci 2020; 128:226-232. [PMID: 32396668 PMCID: PMC7317767 DOI: 10.1111/eos.12700] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2020] [Indexed: 12/01/2022]
Abstract
Young children rely on their parents with respect to oral health routines. However, parental knowledge on this topic is often insufficient. Well‐child care may be an excellent route to reach parents because almost all of them attend. To evaluate the effectiveness of an 8.5 min web‐based film about oral health, provided by well‐child care, a non‐blinded quasi‐experimental study was performed. Parents attending well‐child care clinics in the Netherlands were assigned to an intervention (n = 88) or control group (n = 41). The control group received care as usual. We measured parental knowledge of oral health with a questionnaire (range of scores 1–12) before and directly after the intervention, and 6 months later, and assessed differences between the intervention and the control group. Parental oral health knowledge improved after watching the film: the intervention group’s mean score of 11.1 (SD 1.3) was greater than the mean score of 7.1 (SD 2.0) of the control group (Cohen's d = 2.64). Scores remained higher in the intervention group 6 months after watching the film (mean 9.1, SD 1.3) than before (Cohen's d = 1.25). A web‐based educational film delivered in a well‐child care setting can be an effective way to address oral health and to improve parental knowledge.
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Affiliation(s)
- Deborah Ashley Verlinden
- Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Child Health, Netherlands Organization for Applied Scientific Research TNO, Leiden, the Netherlands
| | - Annemarie A Schuller
- Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Child Health, Netherlands Organization for Applied Scientific Research TNO, Leiden, the Netherlands
| | - Gijsbert H W Verrips
- Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.,Department of Child Health, Netherlands Organization for Applied Scientific Research TNO, Leiden, the Netherlands
| | - Sijmen A Reijneveld
- Department of Child Health, Netherlands Organization for Applied Scientific Research TNO, Leiden, the Netherlands.,Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Chattopadhyay A, Christian B, Masood M, Calache H, Carpenter L, Gibbs L, Gussy M. Natural history of dental caries: Baseline characteristics of the VicGen birth cohort study. Int J Paediatr Dent 2020; 30:334-341. [PMID: 31850608 PMCID: PMC9292657 DOI: 10.1111/ipd.12609] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 10/04/2019] [Accepted: 12/12/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early-life dental caries is a major global health problem. Children's first dental visit is recommended at 2 years age. The VicGeneration (VicGen) oral health birth cohort study aims to understand the multifactorial nature of early childhood caries. This report describes the baseline characteristics of children in the VicGen study. METHODS We merged data between the first (at birth) and fourth waves (18 month age) to assess dental caries among children (primary outcome) and other oral diseases (secondary outcomes) employing t tests, chi-square tests, Fisher's exact tests, and Cochran-Mantel-Haenszel tests using IBM-SPSS(v25). RESULTS Most children lived in metros with two-parent families. Most guardians were women graduated from high school. Twenty-seven of 389 (6.94%) 18-month-old children experienced dental caries. More children living in rural areas (vs. urban) experienced caries. Females were more likely to experience caries (OR: 2.16). Several children had other oral health problems. In early life, children's oral examination was conducted by midwives, breastfeeding/lactation consultants, hospital nurses, speech pathologists, and breastfeeding clinic staff. CONCLUSION VicGen baseline characteristics show that almost 7% of the 18-month-old children experienced caries. There is a need to advance children's recommended first dental visit date and to train early-life healthcare professionals about oral diseases.
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Affiliation(s)
- Amit Chattopadhyay
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia,School of Dental MedicineCase Western Reserve UniversityClevelandOhio,Manipal College of Dental SciencesMangaloreIndia,Quest Arete ScienceOklahoma CityOklahoma
| | | | - Mohd. Masood
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia
| | - Hanny Calache
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia,Deakin Health EconomicsCentre for Population Health ResearchFaculty of HealthDeakin UniversityBurwoodVICAustralia
| | - Lauren Carpenter
- Jack Brockhoff Child Health and Wellbeing ProgramCentre for Health EquityThe University of MelbourneMelbourneVICAustralia
| | - Lisa Gibbs
- Jack Brockhoff Child Health and Wellbeing ProgramCentre for Health EquityThe University of MelbourneMelbourneVICAustralia
| | - Mark Gussy
- La Trobe Rural Health SchoolLa Trobe UniversityBendigoVICAustralia
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Hiratsuka VY, Robinson JM, Greenlee R, Refaat A. Oral health beliefs and oral hygiene behaviours among parents of urban Alaska Native children. Int J Circumpolar Health 2019; 78:1586274. [PMID: 30857502 PMCID: PMC6419661 DOI: 10.1080/22423982.2019.1586274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/28/2019] [Accepted: 02/13/2019] [Indexed: 11/06/2022] Open
Abstract
American Indian/Alaska Native (AI/AN) children have a prevalence rate of early childhood caries 5 times that of the overall US population. Oral hygiene and oral health beliefs have not been described among AI/AN parents. This study explored constructs of the health belief model informing oral health beliefs and oral hygiene behaviours of parents of AI/AN children ages 0-6 years. The study aimed to determine the toothbrushing behaviour in parents of AI/AN childrenand the relationship between parent oral health beliefs and toothbrushing frequency. A cross-sectional survey which included the Oral Hygiene Scale, Oral Health Belief Questionnaire and the Early Childhood Oral Health Impact Scale was administered to a convenience sample of parents of AI/AN children 71 months or younger attending outpatient paediatric primary care appointments (N=100). Analyses were conducted to determine parent toothbrushing and the relationship between parent health beliefs and child toothbrushing. The odds of regular child toothbrushing were 49.10 times higher when the parent brushed their own teeth regularly (confidence interval (CI)=11.46-188.14; p<0.001). Parental toothbrushing had a strong positive association with the belief that oral health is as important as physical health. This research endorses parent-focused toothbrushing interventions to reduce AI/AN early childhood caries rates.
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Affiliation(s)
| | | | | | - Amany Refaat
- School of Health Sciences, Walden University, Minneapolis, MN, USA
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Riggs E, Kilpatrick N, Slack‐Smith L, Chadwick B, Yelland J, Muthu MS, Gomersall JC. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2019; 2019:CD012155. [PMID: 31745970 PMCID: PMC6864402 DOI: 10.1002/14651858.cd012155.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dental caries is one of the most common chronic diseases of childhood and is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). OBJECTIVES To assess the effects of interventions with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years of age). SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 14 January 2019), Cochrane Pregnancy and Childbirth Group's Trials Register (to 22 January 2019), Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Register of Studies, to 14 January 2019), MEDLINE Ovid (1946 to 14 January 2019), Embase Ovid (1980 to 14 January 2019) and CINAHL EBSCO (1937 to 14 January 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing one or more interventions with pregnant women, mothers, or other caregivers of infants in the first year of life (intervention types included clinical, oral health education/promotion such as hygiene education, breastfeeding and other dietary advice, and policy or health service), versus standard care or placebo or another intervention. For inclusion, trials had to report at least one caries outcome. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence using the GRADE approach. MAIN RESULTS We included 17 RCTs (4 cluster-randomised), involving 23,732 caregivers (mainly mothers) and their children. Eleven RCTs assessed four oral health education/promotion interventions against standard care: child diet advice, child diet and feeding practice advice, breastfeeding promotion and support, and oral hygiene with child diet and feeding practice advice. Six trials assessed clinical interventions in mother's dentition, four trials chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo, and two trials xylitol against CHX or CHX + xylitol. At most, three trials (maximum of 1148 children and 130 mothers) contributed data to any comparison. For many trials, risk of bias was judged unclear due to lack of methodological details reported, and there was high risk of attrition bias in some trials. None of the included trials indicated receiving funding that is likely to have influenced their results. The trials were performed in high-, middle- and low-income countries. In nine trials, participants were socioeconomically disadvantaged. For child diet and feeding practice advice versus standard care, we observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a lower mean dmfs (decayed, missing, filled primary surfaces) score (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, we are uncertain regarding the difference between the groups in mean dmft (decayed, missing, filled teeth) score (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). For breastfeeding promotion and support versus standard care, we observed that there may be little or no a difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence), or mean dmft score (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). Dmfs was not reported for this comparison. We are uncertain whether child diet advice only compared with standard care reduces risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). Dmfs and dmft were not reported for this comparison. For oral hygiene, child diet and feeding practice advice versus standard care, we observed little or no reduced risk of caries presence in primary teeth (RR 0.91, 95% CI 0.75 to 1.10; 2 trials; 365 participants; low-certainty evidence), and are uncertain regarding difference between the groups in mean dmfs score (MD -0.99, 95% CI -2.45 to 0.47; 1 trial; 187 participants; very low-certainty evidence) and dmft score (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; very low-certainty evidence). We observed there may be little or no difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment in mother's dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trials assessing this comparison reported dmfs or dmft. For xylitol compared with CHX antimicrobial treatment, we observed there may be a lower mean dmft score with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence); however, we are uncertain regarding the difference between groups in caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence). Neither trial evaluating this comparison reported dmfs. No trials assessed a health policy or service intervention. AUTHORS' CONCLUSIONS Moderate-certainty evidence suggests that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very low certainty and is insufficient for determining which, if any, other interventions types and features may be effective for preventing ECC. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine effects and relative effects of different interventions and inform practice. We have identified 12 studies currently in progress. Those designing future studies should describe the intervention components, setting and participants, consider if and how effects are modified by intervention features and participant characteristics, and adopt a consistent approach to measuring and reporting ECC.
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Affiliation(s)
- Elisha Riggs
- Murdoch Children's Research InstituteIntergenerational HealthFlemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of General PracticeBerkeley StreetMelbourneVictoriaAustralia3000
| | - Nicky Kilpatrick
- Murdoch Children's Research InstituteVascular BiologyFlemington RoadParkvilleMelbourneVictoriaAustralia3052
- Royal Children's HospitalPlastic and Maxillofacial Surgery50 Flemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of PaediatricsBerkeley StreetCarltonVictoriaAustralia3010
| | - Linda Slack‐Smith
- The University of Western AustraliaSchool of Population and Global Health35 Sterling Highway, CrawleyPerthWestern AustraliaAustralia6009
| | - Barbara Chadwick
- Cardiff UniversitySchool of DentistryHeath ParkCardiffUKCF14 4XY
| | - Jane Yelland
- Murdoch Children's Research InstituteIntergenerational HealthFlemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of General PracticeBerkeley StreetMelbourneVictoriaAustralia3000
| | - M S Muthu
- Pedo Planet ‐ Children Dental CentersPediatric Dentistry161/62 A Mount Poonamallee RoadPorurChennaiIndia600116
- Sri Ramachandra Institute of Higher Education and ResearchCentre for Early Childhood Caries Research, Department of Pediatric and Preventive DentistryChennaiIndia
| | - Judith C Gomersall
- Women and Kids, South Australian Health and Medical Research InstituteWomen’s and Children’s Hospital7th Floor, 72 King William RoadAdelaideSouth AustraliaAustralia5006
- School of Public Health, University of AdelaideAdelaideAustralia
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Chen Y, Agnello M, Dinis M, Chien KC, Wang J, Hu W, Shi W, He X, Zou J. Lollipop containing Glycyrrhiza uralensis extract reduces Streptococcus mutans colonization and maintains oral microbial diversity in Chinese preschool children. PLoS One 2019; 14:e0221756. [PMID: 31442287 PMCID: PMC6707631 DOI: 10.1371/journal.pone.0221756] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 08/14/2019] [Indexed: 02/05/2023] Open
Abstract
The anticariogenic activity of the extract of Glycyrrhiza uralensis (licorice) has been well documented. We recently developed an herbal lollipop containing licorice extracts with Glycyrrhizol A, the compound displaying strong antimicrobial activity against Streptococcus mutans. Preliminary testing showed that the herbal lollipop reduced salivary S. mutans counts in vivo. In this study, we aimed to further test the efficacy of this herbal lollipop for reducing salivary S. mutans levels, and investigate its impact on salivary microbiome. Using a well-established in vitro oral microbiome model, we showed that licorice extract displays targeted killing against S. mutans without affecting the biodiversity of the community. In vivo study corroborated in vitro findings, showing for high caries-risk children aged 3–6 with salivary S. mutans levels >5x105 cells/ml, daily use of 2 licorice-containing lollipops for 3 weeks significantly reduced salivary S. mutans levels compared to the control group. Salivary microbiome analysis showed either no change or even increase in phylogenetic diversity of the oral community following herbal lollipop usage. Although further study with longer term observation is needed, these results suggest that use of licorice extract-containing lollipops can be as a simple and effective way to reduce the risk of dental caries in children.
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Affiliation(s)
- Yandi Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Melissa Agnello
- School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Márcia Dinis
- School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Kenneth C. Chien
- School of Dentistry, University of California, San Francisco, San Francisco, California, United States of America
| | - Jing Wang
- College of Pharmaceutical Science, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Wei Hu
- State Key Lab of Microbial Technology, Microbial Technology Institute, Shandong University, Qingdao, China
| | - Wenyuan Shi
- The Forsyth Institute, Cambridge, Massachusetts, United States of America
| | - Xuesong He
- The Forsyth Institute, Cambridge, Massachusetts, United States of America
- * E-mail: (JZ); (XH)
| | - Jing Zou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- * E-mail: (JZ); (XH)
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8
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Verlinden DA, Reijneveld SA, Lanting CI, van Wouwe JP, Schuller AA. Socio-economic inequality in oral health in childhood to young adulthood, despite full dental coverage. Eur J Oral Sci 2019; 127:248-253. [PMID: 30791128 PMCID: PMC6593773 DOI: 10.1111/eos.12609] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2018] [Indexed: 01/04/2023]
Abstract
The aim of this cross‐sectional study was to assess differences in caries experience according to socio‐economic status (SES) in a health‐care system with full coverage of dental costs for children up to the age of 18 yr. In 2011 and 2014, by performing hurdle negative binomial models, we obtained data on 3,022 children and young adults aged 5, 8, 11, 14, 17, 20, and 23 yr, living in four cities in the Netherlands. At all ages between 5 and 23 yr, the percentages of children with caries‐free dentitions were lower and mean caries experience were higher in low‐SES than in high‐SES participants. In 5‐yr‐old children with dmft > 0, mean caries experience was 3.6 in those with low SES and 2.3 in those with high SES. In 23‐yr‐old participants, these estimates were 6.8 and 4.4, respectively (P < 0.05). Low‐SES children have a greater risk of more caries experience than high‐SES children. Thus, in a system with full free paediatric dental coverage, socio‐economic inequality in caries experience still exists. Dental health professionals, well‐child care doctors and nurses, general practitioners, and elementary school teachers should collaborate to promote oral health at the community level, with specific targeting of low‐SES families. We further need policy measures to curtail, at community level, the increasing availability and consumption of highly processed, carbohydrate‐rich foods, with particular attention for low‐SES families.
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Affiliation(s)
- Deborah A Verlinden
- Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Child Health, the Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Sijmen A Reijneveld
- Department of Child Health, the Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands.,Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Caren I Lanting
- Department of Child Health, the Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Jacobus P van Wouwe
- Department of Child Health, the Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
| | - Annemarie A Schuller
- Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Child Health, the Netherlands Organization for Applied Scientific Research TNO, Leiden, The Netherlands
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Esophageal Atresia with Tracheoesophageal Fistula and Gastroesophageal Reflux in Children: Dental Considerations and Case Report. J Clin Pediatr Dent 2018; 42:256-261. [PMID: 29750630 DOI: 10.17796/1053-4628-42.4.3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Esophageal Atresia (EA) is defined as the congenital interruption of the continuity of the esophagus. Pediatric patients also have other congenital conditions, such as Tracheo-Esophageal Fistula (TEF). CASE REPORT A 7-year-old male with TEF referred by a Pediatric Cardiologist, with the principal complaint of "severe and generalized tooth wearing". Considering that the patient was systemically stable, it was decided to perform the oral procedures under local anesthesia and rubber-dam isolation with an antimicrobial prophylaxis regimen. The treatment consisted of the extraction of all maxillary primary incisors and canines and both first molars; in the mandibular arch, only the lower second right molar was extracted, and a distal shoe was placed. Pulpotomies were performed and preformed metallic crowns were placed on the remaining second primary molars, on both lower first molars, and on lower canines and lateral incisors. Finally, a fixed prosthesis was positioned in the upper arch, and cemented through orthodontic bands adapted to both crowned second molars. The patient has been maintained under close medical and dental control. The child showed satisfactory oral conditions, and the vomiting episodes had decreased significantly. CONCLUSIONS Dentists can learn and then participate in the integral health management of infants and young children affected with EA/TEF, particularly those with dental erosion.
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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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Shanthini RP, Garla BK, Karuppaiah RM, Taranath M. Effectiveness of Anticipatory Guidance on the Knowledge and Attitude of Pregnant Women Attending Government Hospital, Thirumangalam, Madurai. JOURNAL OF ADVANCED ORAL RESEARCH 2017. [DOI: 10.1177/2229411217729100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims and Objectives: Improving maternal knowledge plays a major role in developing good oral health habits and in preventing diseases like early childhood caries in their children. The present study is aimed to provide pregnant women with the anticipatory guidance and to evaluate its effect on promoting the knowledge and attitude of pregnant mothers regarding infant and toddler’s oral health care. Material and Method: In this interventional study, 600 pregnant women attending government hospital, Madurai, were divided into direct intervention, indirect intervention, and control groups. A self-reported questionnaire was completed before intervention. The anticipatory guidance was presented to the direct intervention group by PowerPoint and to the indirect group by pamphlets. Immediately after the intervention, the questionnaire was completed by intervention groups and two months later by all participants. Chi-square test was used for statistical analysis at a significance level of 0.05. Results: The change of scores in the knowledge and attitude of pregnant women had a significant difference in all the three groups. At the end of the study, a statistically significant difference ( p < 0.05) was noted in the knowledge between the intervention and the control groups. The change in the attitude was not statistically significant. Conclusion: Anticipatory guidance led to change in the score of knowledge about infant and toddler’s oral health in intervention groups compared to control group. The direct presentation had superiority over indirect presentation in increasing knowledge about their oral health care. Dentists should do their utmost to educate parents especially the pregnant mothers on children’s oral health in a culturally and linguistically appropriate manner, as oral health literacy is, ultimately, a pathway to health equity.
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Affiliation(s)
- R. Priya Shanthini
- Department of Public Health Dentistry, Best Dental Science College and Hospital, Madurai, Tamil Nadu, India
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12
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Riggs E, Slack-Smith L, Yelland J, Chadwick B, Robertson L, Kilpatrick N. Interventions with pregnant women and new mothers for preventing caries in children. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Elisha Riggs
- Murdoch Childrens Research Institute; Healthy Mothers Healthy Families Research Group; Flemington Road Parkville Victoria Australia 3052
- University of Melbourne; General Practice and Primary Health Care Academic Centre; Parkville Victoria Australia
| | - Linda Slack-Smith
- University of Western Australia; School of Dentistry; 35 Sterling Highway, Crawley Perth Western Australia Australia 6009
| | - Jane Yelland
- Murdoch Childrens Research Institute; Healthy Mothers Healthy Families Research Group; Flemington Road Parkville Victoria Australia 3052
- University of Melbourne; General Practice and Primary Health Care Academic Centre; Parkville Victoria Australia
| | - Barbara Chadwick
- Cardiff University; School of Dentistry; Heath Park Cardiff UK CF14 4XY
| | - Louise Robertson
- Murdoch Childrens Research Institute; Healthy Mothers Healthy Families Research Group; Flemington Road Parkville Victoria Australia 3052
| | - Nicky Kilpatrick
- Murdoch Childrens Research Institute; Vascular Biology; Flemington Road Parkville Melbourne Victoria Australia 3052
- University of Melbourne; Department of Paediatrics; Parkville Victoria Australia
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Johnson M, George A, Dahlen H, Ajwani S, Bhole S, Blinkhorn A, Ellis S, Yeo A. The midwifery initiated oral health-dental service protocol: an intervention to improve oral health outcomes for pregnant women. BMC Oral Health 2015; 15:2. [PMID: 25588410 PMCID: PMC4324677 DOI: 10.1186/1472-6831-15-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/05/2015] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Evidence is emerging that women's poor oral health and health practices during pregnancy are associated with poor oral health in their children and potentially an increased risk of pre-term or low-birth weight infants. METHODS/DESIGN The Midwifery Initiated Oral Health-Dental Service (MIOH-DS) trial is a three arm multicentre randomised controlled trial which will recruit women from three metropolitan hospitals aimed at improving women's oral health and service access and indirectly reducing perinatal morbidity. All three arms of the trial will deliver oral health promotion material, although a midwife oral assessment and referral to private/public/health fund dental services pathway (Intervention Group 1) and the midwife oral assessment and referral to local free public dental services pathway (Intervention Group 2) will be compared to the control group of oral health promotional material only. Midwives will undergo specific oral health education and competency testing to undertake this novel intervention. DISCUSSION This efficacy trial will promote a new partnership between midwives and dentists focused on enhancing the oral health of women and their infants. Should the intervention be found effective, this intervention, with existing on-line educational program for midwives, can be easily transferred into practice for large metropolitan health services within and beyond Australia. Further cost-benefit analysis is proposed to inform national health policy. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12612001271897.
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Affiliation(s)
- Maree Johnson
- />Faculty of Health Sciences, Australian Catholic University, Ingham Institute Applied Medical Research, Sydney, Australia
| | - Ajesh George
- />Centre for Applied Nursing Research, University of Western Sydney/ South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Liverpool BC, Locked Bag 7103, Sydney, NSW 1871 Australia
| | - Hannah Dahlen
- />School of Nursing & Midwifery, University of Western Sydney, Ingham Institute Applied Medical Research, Sydney, Australia
| | - Shilpi Ajwani
- />Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Sameer Bhole
- />Sydney Local Health District Oral Health Services and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | | | - Sharon Ellis
- />Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Sydney, Australia
| | - Anthony Yeo
- />Centre for Applied Nursing Research, University of Western Sydney, Sydney, Australia
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Jablonski R, Mertz E, Featherstone JDB, Fulmer T. Maintaining oral health across the life span. Nurse Pract 2014; 39:39-48. [PMID: 24841464 DOI: 10.1097/01.npr.0000446872.76779.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Oral health is directly related to systemic health, yet many Americans have limited to no access to dental health professionals. Nurse practitioners are in an excellent position to fill this void by providing caries risk assessments, chemical therapy to prevent progression of caries, and appropriate patient education to prevent caries.
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Affiliation(s)
- Rita Jablonski
- Rita Jablonski is an associate professor at the University of Alabama at Birmingham, School of Nursing, Birmingham, Ala. Elizabeth Mertz is an assistant professor at the University of California, San Francisco, Calif. John D.B. Featherstone is a dean and professor at the University of California, School of Dentistry, San Francisco, Calif. Terry Fulmer is a dean and professor at Bouvé College of Health Sciences and professor of Public Policy and Urban Affairs at Northeastern University, Boston, Mass
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15
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George A, Johnson M, Blinkhorn A, Ajwani S, Ellis S, Bhole S. Views of pregnant women in South Western Sydney towards dental care and an oral-health program initiated by midwives. Health Promot J Austr 2014; 24:178-84. [PMID: 24300386 DOI: 10.1071/he13040] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 09/20/2013] [Indexed: 11/23/2022] Open
Abstract
ISSUES ADDRESSED Oral health during pregnancy is important, yet is often neglected by women. A program is currently being developed for midwives in Australia to promote maternal oral health. The aim of this study was to record the views of pregnant women in Australia towards dental care and midwives promoting oral health. METHODS Using convenience sampling, a cross-sectional survey was undertaken of 241 pregnant women attending a metropolitan hospital in South Western Sydney in 2010. RESULTS Only 10% of women received oral-health promotional material during pregnancy. More than 50% reported dental problems, yet only 17% had discussed this with their midwives and less than half (44.6%) had sought dental treatment. The main barriers to obtaining dental care were: lack of awareness, safety concerns about dental treatment and dental costs. Pregnant women were more likely (P<0.05) to see a dentist if they had received information about oral health (odds ratio (OR) 3.25, 95% CI 1.34-7.90) and had private health insurance (OR 2.47, 95% CI 1.26-4.85). Most women (>90%) were receptive to midwives providing oral-health education, assessments and referrals to affordable dental services. CONCLUSION This study has shown that pregnant women are receiving limited dental advice and are concerned about dental costs. It has also confirmed for the first time in Australia that women are very positive about receiving oral-health advice from midwives during their pregnancy. SO WHAT?: Oral-health promotion programs during pregnancy should consider using midwives to increase dental awareness among women and provide pathways to affordable dental services.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research, University of Western Sydney, South Western Sydney Local Health District (SWSLHD) and Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871, Australia
| | - Maree Johnson
- Centre for Applied Nursing Research, University of Western Sydney, South Western Sydney Local Health District (SWSLHD) and Ingham Institute Applied Medical Research, Locked Bag 7103, Liverpool BC, NSW 1871, Australia
| | - Anthony Blinkhorn
- Population Oral Health, Faculty of Dentistry, University of Sydney, 1 Mons Road, Westmead, NSW 2145, Australia
| | - Shilpi Ajwani
- Sydney and South Western Sydney LHD and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Locked Mail Bag 7279, Liverpool BC, NSW 1871, Australia
| | - Sharon Ellis
- Camden and Campbelltown Hospitals, SWSLHD, Therry Road, Campbelltown, NSW 2560, Australia
| | - Sameer Bhole
- Sydney and South Western Sydney LHD and Sydney Dental Hospital, Faculty of Dentistry, University of Sydney, Locked Mail Bag 7279, Liverpool BC, NSW 1871, Australia
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Oredugba F, Agbaje M, Ayedun O, Onajole A. Assessment of Mothers’ Oral Health Knowledge: Towards Oral Health Promotion for Infants and Children. Health (London) 2014. [DOI: 10.4236/health.2014.610114] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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George A, Duff M, Ajwani S, Johnson M, Dahlen H, Blinkhorn A, Ellis S, Bhole S. Development of an online education program for midwives in australia to improve perinatal oral health. J Perinat Educ 2013; 21:112-22. [PMID: 23449750 DOI: 10.1891/1058-1243.21.2.112] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
It is recommended that all pregnant women should receive a comprehensive oral health evaluation because poor maternal oral health may affect pregnancy outcomes and the general health of the woman and her baby. Midwives are well placed to provide dental health advice and referral. However, in Australia, little emphasis has been placed on the educational needs of midwives to undertake this role. This article outlines the development of an online education program designed to improve midwives' dental health knowledge, prepare them to assess the oral health of women, refer when required, and provide appropriate dental education to women and their families. The program consists of reading and visual material to assist with the oral health assessment process and includes competency testing.
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George A, Johnson M, Blinkhorn A, Ajwani S, Bhole S, Yeo AE, Ellis S. The oral health status, practices and knowledge of pregnant women in south-western Sydney. Aust Dent J 2013; 58:26-33. [PMID: 23441789 DOI: 10.1111/adj.12024] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2012] [Indexed: 12/01/2022]
Abstract
BACKGROUND Current evidence highlights the importance of oral health during pregnancy. However, little is known about the oral health of pregnant women in Australia. The aim of this study was to report the oral health status, knowledge and practices of pregnant women in south-western Sydney. METHODS A cross-sectional survey of 241 pregnant women attending a large hospital in south-western Sydney. RESULTS More than half (59.3%) reported dental problems during pregnancy, less than a third (30.5%) saw a dentist in the last six months, only 10% had received any information about perinatal oral health and many (>50%) were unaware of the potential impact of poor maternal oral health on pregnancy and infant outcomes. Analysis revealed a significant difference (<0.05) in the uptake of dental services among pregnant women who had higher household incomes, private health insurance, received information about perinatal oral health and knowledge about maternal oral health. CONCLUSIONS The participants reported significant barriers to obtaining dental care including limited access to affordable dental services and lack of awareness about the importance of maternal oral health. The findings suggest the need for preventive strategies involving dentists and antenatal providers to improve maternal oral health in Australia.
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Affiliation(s)
- A George
- Centre for Applied Nursing Research, The University of Western Sydney, Ingham Institute for Applied Medical Research/South Western Sydney Local Health District, New South Wales, Australia.
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George A, Shamim S, Johnson M, Dahlen H, Ajwani S, Bhole S, Yeo AE. How do dental and prenatal care practitioners perceive dental care during pregnancy? Current evidence and implications. Birth 2012; 39:238-47. [PMID: 23281906 DOI: 10.1111/j.1523-536x.2012.00553.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Poor maternal oral health may be associated with adverse pregnancy and infant outcomes. However, women seldom seek dental care during pregnancy, and misconceptions by prenatal care practitioners about oral health care during pregnancy may contribute to the problem. The aim of this study was to review current knowledge, attitudes, and behavior of dental and prenatal care practitioners about oral health care during pregnancy. METHODS This review examined all studies published in English that explored the knowledge, attitude, behavior, and barriers faced by dentists, general practitioners, midwives, and obstetricians/gynecologists with respect to oral health care during pregnancy. RESULTS Despite acknowledging the importance of maternal oral health, many dentists are uncertain about the safety of dental procedures and are hesitant in treating pregnant women. General practitioners and midwives are poorly informed about the impact of poor maternal oral health and rarely initiate this topic during prenatal care. Many general practitioners also believe that dental procedures are unsafe during pregnancy. Obstetricians/gynecologists are well informed about perinatal oral health and are supportive of dental procedures, but because of lack of training in this area and competing health demands they seldom focus on oral health care during their prenatal care. CONCLUSION No real consensus exists among dentists and prenatal care practitioners with respect to oral health care during pregnancy. This issue poses a significant deterrent for pregnant women seeking dental care. Practice guidelines in perinatal oral health are needed for health professionals to emphasize this important aspect of prenatal care.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research (CANR), South Western Sydney Local Health District (SWSLHD)/University of Western Sydney, Sydney, New South Wales, Australia
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Arora A, Bedros D, Bhole S, Do LG, Scott J, Blinkhorn A, Schwarz E. Child and family health nurses' experiences of oral health of preschool children: a qualitative approach. J Public Health Dent 2012; 72:149-55. [PMID: 22316083 DOI: 10.1111/j.1752-7325.2011.00295.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The objective of this study was to explore Child and Family Health Nurses' work-related experiences of dental disease in young children. METHODS Child and Family Health Nurses (n = 21) who recruited new mothers to an ongoing birth cohort study that began in South Western Sydney, Australia were invited to take part in a qualitative study. A semi-structured, in-depth interview technique was used to explore their experiences of preschool child oral health and how this affects their working lives. Interviews were audio-recorded, transcribed verbatim, and analyzed using a thematic analysis. RESULTS The nurses considered dental caries to be a significant health issue for young children and their families. They thought that the burden of dental disease in preschool children was underestimated in disadvantaged and multicultural populations. In addition, they reported that parents were often unaware of the disease process and were ignorant of the relationship between bottle feeding and dental caries. Once the parents were informed about their child's poor oral health, they had feelings of anger, despair, and guilt. CONCLUSIONS This study highlights that oral health problems are a significant segment of the child health problems identified by nurses in their daily work. The nurses perceived the problem of dental caries to be one of a lack of parental knowledge, and families should be educated not only on "what" but also on "how" to feed their children. The primary healthcare team should work collaboratively to educate families in a culturally appropriate way.
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Affiliation(s)
- Amit Arora
- Department of Population Oral Health, The University of Sydney, Sydney, Australia.
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George A, Johnson M, Duff M, Ajwani S, Bhole S, Blinkhorn A, Ellis S. Midwives and oral health care during pregnancy: perceptions of pregnant women in south-western Sydney, Australia. J Clin Nurs 2011; 21:1087-96. [DOI: 10.1111/j.1365-2702.2011.03870.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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George A, Shamim S, Johnson M, Ajwani S, Bhole S, Blinkhorn A, Ellis S, Andrews K. Periodontal treatment during pregnancy and birth outcomes: a meta-analysis of randomised trials. INT J EVID-BASED HEA 2011; 9:122-47. [PMID: 21599842 DOI: 10.1111/j.1744-1609.2011.00210.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The objective of this review was to conduct a meta-analysis of all up-to-date randomised control trials to determine whether periodontal treatment during pregnancy has the potential of reducing preterm birth and low birth weight incidence. METHODS Bibliographic databases MEDLINE (1966-present), EMBASE (1980-present), CINAHL (1982-present) and the Cochrane library up to and including 2010 Issue 10 were searched. The reference list of included studies and reviews were also searched for additional literature. Eligible studies were, published and ongoing randomised control trials that compared pregnancy outcomes for pregnant women who received periodontal treatment during the prenatal period. Two of the investigators independently assessed the studies and then extracted and summarised data from eligible trials. Extracted data were entered into Review Manager software and analysed. RESULTS A total of 5645 pregnant women participated in the 10 eligible trials. Meta-analysis found that periodontal treatment significantly lowered preterm birth (odd ratio 0.65; 95% confidence interval, 0.45-0.93; P = 0.02) and low birth weight (odd ratio 0.53; 95% confidence interval, 0.31-0.92; P = 0.02) rates while no significant difference was found for spontaneous abortion/stillbirth (odd ratio 0.71; 95% confidence interval, 0.43-1.16; P = 0.17). Moderate heterogeneity was observed among the studies for preterm birth and low birth weight. Subgroup analysis showed significant effect of periodontal treatment in pregnant women with low rate of previous preterm birth/low birth weight (odd ratio 0.35; 95% confidence interval, 017-0.70; P = 0.003) and less severe periodontal disease (odd ratio 0.49; confidence interval, 028-0.87; P = 0.01) as defined by probing depth. CONCLUSION The cumulative evidence suggests that periodontal treatment during pregnancy may reduce preterm birth and low birth weight incidence. However, these findings need to be further validated through larger more targeted randomised control trials.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research, South Western Sydney Local Health Network/University of Western Sydney, Australia.
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Do public health nurses in Norway promote information on oral health? BMC Oral Health 2011; 11:23. [PMID: 21923940 PMCID: PMC3189905 DOI: 10.1186/1472-6831-11-23] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 09/18/2011] [Indexed: 11/10/2022] Open
Abstract
Background (i) to describe oral health counselling in Norway to parents with infants and toddlers, ii) to assess existing collaboration and routines in oral health matters between nurses and personnel in the PDS, iii) to evaluate to what extent oral health was integrated in the basic educational curriculum of public health nurses. Methods This study was based on two separate surveys: the sample of Study I was 98 randomly selected child health clinics. A questionnaire covering oral health promotion counselling of parents with young children was returned by 259 nurses. Study II was a telephone survey addressing teachers of public health nurses at the eight educational institutions in Norway. Results The response rate in Study I was 45%. Nutrition (breast feeding, diet) was the health subject most often prioritized in the counselling targeting parents of young children (by 60% of the nurses). Oral health was not among the first priority counselling subjects. The subject was seldom spontaneously mentioned by parents. Seventy percent of respondents reported (agreed or totally agreed) that they managed to provide information parents needed and 72% believed that the information they gave influenced parents' health behaviours. Seven nurses (5.2%) responded that they agreed with the statement that the information they gave only slightly influenced parents' health behaviour. Lack of time was mentioned as being a problem. Approximately half of the nurses (48%) had regular contact with the PDS for the 0-3 year-old children, but only a quarter of the nurses claimed that children's teeth were routinely examined at the child clinics. Some forms of previously established contact with the PDS enhanced the likelihood of nurses' referrals. Oral health was a minor part of the educational curriculum for public health nurses; at three institutions, the subject was totally absent. Conclusion Collaboration between nurses and the PDS in Norway could be improved. Oral health should have a bigger place in the basic educational curriculum.
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George A, Johnson M, Duff M, Blinkhorn A, Ajwani S, Bhole S, Ellis S. Maintaining oral health during pregnancy: Perceptions of midwives in Southwest Sydney. Collegian 2011; 18:71-9. [DOI: 10.1016/j.colegn.2010.10.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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George A, Johnson M, Blinkhorn A, Ellis S, Bhole S, Ajwani S. Promoting oral health during pregnancy: current evidence and implications for Australian midwives. J Clin Nurs 2010; 19:3324-33. [PMID: 20955483 DOI: 10.1111/j.1365-2702.2010.03426.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES The aim of this paper is to examine current evidence supporting the promotion of oral health during pregnancy and proffer aspects of a potential role for Australian midwives. BACKGROUND Research continues to show that poor oral health during pregnancy can have an impact on the health outcomes of the mother and baby. Poor maternal oral health increases the chances of infants developing early caries and is strongly associated with adverse pregnancy outcomes such as preterm and low birth-weight babies. Unfortunately in Australia, no preventive strategies exist to maintain the oral health of pregnant women. DESIGN Systematic review. METHOD This review examines all literature on oral health during pregnancy published to date in the English language and focuses on whether preventive oral health strategies during the prenatal period are warranted in Australia and if so, how they could be provided. RESULTS Maintaining oral health is important during pregnancy and many developed countries have implemented preventive strategies to address this issue using non-dental professionals such as prenatal care providers. However, despite the positive international evidence, limited importance is being given to the oral health of pregnant women in Australia. It is also evident that the unique potential of prenatal care providers such as midwives to assess and improve maternal oral heath is not being thoroughly utilised. Compounding the issue in Australia, especially for pregnant women from socioeconomically disadvantaged backgrounds, is the limited access to public dental services and the high cost of private dental treatment. CONCLUSION Promoting and maintaining oral health during pregnancy is crucial, and preventive prenatal oral health services are needed in Australia to achieve this. RELEVANCE TO CLINICAL PRACTICE Midwives have an excellent opportunity to offer preventive oral health services by providing oral health assessments, education and referrals for pregnant women attending antenatal clinics.
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Affiliation(s)
- Ajesh George
- Centre for Applied Nursing Research, Sydney South West Area Health Service, University of Western Sydney, Liverpool, NSW, Australia.
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