Variation in assessing the need for change of snacking habits in schoolchildren's oral health counselling

A review of approaches for dental practice teams for promoting oral health

To determine the circumstances in which oral health promotion (OHP) in General Dental Practice is at its most effective, a systematic review was conducted to identify, critically appraise and synthesize the available evidence. The research question was: Is oral health promotion within dental practice effective and how can its effects be optimized? Systematic searches of 20 online resources (including Ovid Medline and Embase) were conducted. A call for evidence was also issued, and citation lists of other relevant systematic reviews were included. All studies published since 1994 which were set in the context of general dental practice and investigated promoting good oral health in adult or child patients were considered. 44 studies reported in 52 papers were included in the review. The evidence was heterogeneous and the quality of reporting was variable. Results showed that oral health promotion based on behavioural and psychological models was effective for improving oral health. Verbal advice affected knowledge and reported behaviour, written advice promoted oral health knowledge. There was moderate evidence that the attributes of the 'sender' of an oral health promotion message influenced its effectiveness. Many barriers and facilitators were shown to influence the effectiveness of OHP in dental practice. The results of this review suggest that the psychology of behaviour change is the key to oral health promotion and greater emphasis on teaching oral health professionals about health psychology would make oral health promotion in the dental surgery more effective.

Timing of first dental visits for newly Medicaid-enrolled children with an intellectual or developmental disability in Iowa, 2005-2007

OBJECTIVES

We evaluated the relationship between having an intellectual or developmental disability (IDD) and the timing of the first dental visit for children who were newly enrolled in Medicaid in Iowa.

METHODS

We identified children aged 3 to 8 years with and without IDD who were newly enrolled in the Iowa Medicaid program in 2005 (N = 5391). We gathered data on presence of IDD, health status, age at baseline, gender, length of Medicaid enrollment, medical care visits, household Medicaid enrollment, urbanization, residence in a federally designated Health Professional Shortage Area (HPSA), and time of first dental visit through 2007.

RESULTS

About 32% of children had a first dental visit within 6 months of enrollment; this proportion increased to 49%, 64%, and 74% by years 1, 2, and 3, respectively. In the unadjusted models, there was no significant difference between children with and without IDD in time to first dental visit (P = .22). After adjusting for model covariates, however, children with IDD were 31% more likely to have a delayed first dental visit (P = .04).

CONCLUSIONS

Newly Medicaid-enrolled children aged 3 to 8 years with IDD in Iowa were significantly more likely to have a later first dental visit. Future interventions should focus on ensuring timely access to first dental visits for all Medicaid-enrolled children, with an emphasis on those with IDD.