Peer teaching pilot programme for caries prevention in underprivileged and migrant populations

A systematic review of school-based student peer-led oral health interventions to promote the oral health of school children

BACKGROUND

Poor oral health in children highlights the need for prevention and effective interventions. During late childhood and adolescence, peer relationships can play a vital role in adopting and maintaining positive health behaviours.

AIM

To identify the oral health outcomes of school-based student peer-led delivery of oral health interventions.

METHODS

A search strategy was developed, piloted, and run in four electronic databases: Medline via Ovid, Web of Science, CINAHL via EBSCO, and CENTRAL (Cochrane Central Register of Controlled Trials) using key concepts of peer, oral health and adolescent in the school context. Methodological quality was assessed using QuaDs quality assessment tool. All articles were independently screened by two researchers and data was analysed using narrative data synthesis. The PRISMA checklist complemented by aspects of the Synthesis Without Meta-analysis (SWiM) was used to report this systematic review.

RESULTS

There were 7572 identified, 24 studies progressed to full-text review, ten studies met the eligibility criteria and were included in the review. Only six studies based their interventions on psychological & behavioural theory. Intervention delivered by peers showed improvements in both clinical and self-reported outcomes when compared to other delivery methods (e.g., professionals). Quality of included studies was reported according to QuaDs guidance.

CONCLUSION

Peer-led interventions were more effective in improving oral health status and behaviours when compared to other modes of delivery. Future research should assess if a bi-directional impact of peer-led interventions can be seen. Specifically, if there is added value for school-based student peer-leader's including their own oral health knowledge, skills, attitude and preventative behaviours.

Impact of a Dental Storybook on Parents' Knowledge of Children's Oral Health: A Randomized Controlled Trial

PURPOSE

To evaluate the effectiveness of a dental storybook on parents' knowledge about oral health of their children and to assess their perception of its effect in reducing dental anxiety levels among their children, as well as improving their oral health knowledge.

PATIENTS AND METHODS

This was a two-arm parallel, single-blind, randomized controlled trial (RCT) which was performed at the pediatric dental clinics in the Dental University Hospital, King Saud University, Riyadh, Saudi Arabia. Parents of 88 children (6-8 years old) were included in the present study. Parents and their children were randomly divided into two groups as follows: the intervention group (received the storybook and verbal oral hygiene instructions) and the control group (only received verbal oral hygiene instructions; same information included in the book). Three dental visits, including screening, examination/cleaning and treatment, were provided for each child. In the screening visit, baseline parental oral health knowledge was evaluated for all parents. Afterward, parental oral health knowledge was re-evaluated in the examination visit. In the treatment visit, a parental perception questionnaire was administered to parents following treatment to evaluate their satisfaction regarding the use of the storybook in reducing anxiety levels among their children.

RESULTS

There was a significant improvement in the total knowledge score at the follow-up visit in the intervention group compared to the control group (P<0.0001). Overall, the majority of parents perceived the storybook as a useful source of information, and they found it to be effective in reducing dental anxiety levels among their children.

CONCLUSION

The dental storybook is an effective educational tool that can help parents become more knowledgeable about their children's oral health. Moreover, parents perceived the storybook as an effective tool for enhancing their oral health knowledge and lowering their children's dental anxiety.

Evaluation on the effectiveness of a peer led video on oral hygiene education in young children

This study evaluated the effectiveness of a peer-led oral hygiene education video in improving oral hygiene knowledge and behaviour in year 2 (6- to 7-year-old) and year 3 (7- to 8-year-old) children. A novel peer-led oral hygiene education video was created, in which a group of 6- to 10-year-old children delivered key oral hygiene messages. The video was then shown to children of the same age group, whom oral hygiene knowledge and behaviours were assessed before and after the video. Results found that the video was an effective method of improving overall oral hygiene knowledge. It was effective in improving specific aspects of oral hygiene such as knowledge of the frequency of brushing and toothpaste amount, and in the behaviour of using the toothbrush in a circular motion. It was not an effective method in improving the overall oral hygiene knowledge and behaviour of Year Two children, demonstrating children may develop significantly in just 1 year.

Effectiveness of oral health education intervention among female primary school children in Riyadh, Saudi Arabia

Objective

This study aimed to examine the effectiveness of oral health intervention on the improvement in knowledge and self-reported oral health behavior among 6–8 year old female primary school children in Riyadh, Saudi Arabia.

Materials and methods

The sample consisted of 1661 girls in primary schools who are 6 to 8-year-olds (first, second and third graders). The children’s level of knowledge was assessed by a self-administered questionnaire that was formulated for this specific age and divided into two parts; oral health knowledge and self-reported oral health behavior. There were seven multiple choice questions and one true/false question with five underlying parts in the questionnaire which contained basic information about oral health knowledge, oral hygiene practices and certain habits that affect teeth. The questionnaires were distributed before and six weeks after implementation of the oral health educational program to measure the level improvement of knowledge regarding oral health among these children.

Results

All the questions showed statistically significant improvement in knowledge and self-reported behavior in the post intervention group. There was a significant increase in the level of knowledge by 11.24% and level of self-reported behavior by 25% after intervention (P < 0.001). The highest net change in the knowledge due to intervention was noted among third graders (13.3%), whereas for self-reported oral health behavior, it was noted among first graders (28.3%).

Conclusion

The results of this study showed that an easy-to-organize and inexpensive school-based intervention can, on a short-term basis, be effective in improving the knowledge and self-reported oral health behavior of children.

Toothbrushing Systematics Index (TSI) - A new tool for quantifying systematics in toothbrushing behaviour

Systematics is considered important for effective toothbrushing. A theoretical concept of systematics in toothbrushing and a validated index to quantify it using observational data is suggested. The index consists of three components: completeness (all areas of the dentition reached), isochronicity (all areas brushed equally long) and consistency (avoiding frequent alternations between areas). Toothbrushing should take a sufficient length of time; therefore, this parameter is part of the index value calculation. Quantitative data from video observations were used including the number of changes between areas, number of areas reached, absolute brushing time and brushing time per area. These data were fed into two algorithms that converted the behaviour into two index values (each with values between 0 and 1) and were summed as the Toothbrushing Systematics Index (TSI) value; 0 indicates completely unsystematic and 2 indicates perfectly systematic brushing. The index was developed using theoretical data. The data matrices revealed the highest values when all areas are reached and brushed equally long. Few changes occurred between the areas when the brushing duration was ≥90 s; the lowest values occurred under opposite conditions. Clinical applicability was tested with data from re-analysed videos from an earlier intervention study aiming to establish a pre-defined toothbrushing sequence. Subjects who fully adopted this sequence had a baseline TSI of 1.30±0.26, which increased to 1.74±0.09 after the intervention (p≤0.001). When the participants who only partially adopted the sequence were included, the respective values were 1.25±0.27 and 1.69±0.14 (p≤0.001). The suggested new TS-index can cover a variety of clinically meaningful variations of systematic brushing, validly quantifies the changes in toothbrushing systematics and has discriminative power.

Carious lesions of permanent molars and oral health practices of parents and peers in Saudi male adolescents

OBJECTIVES

To assess the association between carious lesions in first and second permanent molars in adolescents and their parents' and peers' oral health practices. Methods: This cross-sectional study of 12-15 year-old male adolescents was conducted in  Dammam, Kingdom of Saudi Arabia, on February 2016. Data collection included dental examination to measure carious lesions and plaque. There was a questionnaire to assess oral health practices such as brushing with fluoridated toothpaste, current daily tobacco use, and daily consumption of sugary food and drinks. Logistic regression models assessed the association between first and second molars carious lesions with adolescents', parents', and peers' oral health practices. Results: Of 302 students, 294 participated. The mother's brushing was significantly associated with a lower odds of carious lesions in the first molar (odds ratio [OR] = 0.17, 95% confidence interval [CI]: 0.04 - 0.77). The mothers' sugary food intake and students' own brushing were significantly associated with carious lesions in the second molar (OR = 1.95 and 0.36, 95% CI: 1.01-9.89 and 0.12-0.89). Friends' intake of sugary drinks had a strong, but non-significant, association with second molar's carious lesions (OR=3.61, 95% CI: 0.35 - 7.44). Conclusion: In Saudi society, mothers have a major influence on their adolescent sons' carious lesions. Adolescents' oral health strategies should involve parents to reduce their risk of caries.

Drawing on healthcare professionals’ ethnicity: lessons learned from a Danish community pharmacy intervention for ethnic minorities

Aims: To present and discuss implementation experiences regarding the involvement of community pharmacists with ethnic minority backgrounds in a medication review intervention for ethnic minority poly-pharmacy patients in Denmark. Methods: Data sources include 1) reflection notes from an introductory seminar with pharmacists and the cross-disciplinary research team and 2) five individual interviews and one focus group interview with pharmacists. Data were thematically coded and synthesised to identify underlying rationales and challenges encountered when involving professionals with ethnic minority backgrounds in interventions for ethnic minorities. Results: Informants perceived the need for interventions targeted at ethnic minority poly-pharmacy patients, and highlighted the potential of involving professionals with diverse ethnic backgrounds in such interventions. However, implementation created challenges, because the professional identity of the pharmacists reduced their options for serving as peers with the same ethnic background. Furthermore, issues related to organisational difficulties and overcoming language barriers in the intervention impacted on the potential of involving professionals with ethnic minority backgrounds. Conclusions: Involving healthcare professionals with ethnic minority backgrounds in encounters with ethnic minorities holds potential for the adaptation of services to ethnically diverse populations, thus improving access to and quality of care. However, it is important to ensure sufficient personal and organisational support and to acknowledge the delicate balance between simultaneously serving as a peer and as a professional.

Effectiveness of oral health education in children - a systematic review of current evidence (2005-2011)

BACKGROUND

So that resources and manpower are allocated in a way of most benefit to the population, systematic review of available evidence on the effectiveness of programmes and interventions is required.

OBJECTIVES

To assess the quality of evidence presented in studies carried out to investigate the effectiveness of oral health education in children.

METHODS

The MEDLINE (PubMed) bibliographic database was searched for English-language articles published from 2005 to 2011. Fifty-five articles were identified by the literature search, and the relevance of each article was determined by examining the title and the abstract. Sixteen original research studies met the inclusion criteria. These articles were read in full and scored independently by two reviewers, with scoring based on predetermined criteria. Articles scoring less than 10 were excluded from the study. For each paper that achieved a validity score of more than 10 (n = 11), data concerning the objectives of the intervention, the types and numbers of participants and the outcomes were extracted from the article. Considering the absence of homogeneity among the articles (as a result of variation in the age of subjects, type of intervention and outcome measures) quantitative analysis was not conducted. The publications were grouped based on their outcome measures: (i) plaque and gingival health; (ii) caries incidence; (iii) knowledge, attitude and oral health-related behaviour; and (iv) toothbrushing skills.

RESULTS

The results of this analysis suggest that further efforts are required to synthesise, systematically, current information about dental health education, along with the maintenance of rigorous scientific standards in research.