National survey of Korean dentists' knowledge and opinions: dental caries etiology and prevention

Reduction of Dental Caries Among Children and Adolescents From a 15-Year Community Water Fluoridation Program in a Township Area, Korea

Since 2000, a community water fluoridation program (CWFP) has been implemented in Hapcheon for over 15 years. We aimed to evaluate the caries-reducing effect on permanent teeth after this implementation. In 2015, evaluation surveys were conducted by our study group, 498 subjects aged 8, 10, 12, and 15 years. As the control, 952 similarly aged subjects were selected from the Sixth Korean National Health and Nutrition Examination Survey (2013-2015 KNHANES). Data of a prospective cohort of 671 8-,10- and 12-year-olds, collected when CWFP started, were used for the evaluation. Caries-reducing effects were estimated by decayed, missing and filled teeth (DMFT) scores between CWFP and control groups, pre- and post-program. Confounders including the mean number of sealant teeth and gender were adjusted for. The mean adjusted DMFT scores of 10-, 12- and 15-year-olds in Hapcheon were significantly lower compared to KNHANES DMFT scores; in addition, those of 8-, 10- and 12-year-olds after the 15-year CWFP were significantly lower than in 2000. The caries-reducing effect among 12-year-olds was 37.6% compared to those recorded in KNHANES, and 67.4% compared to those in 2000. In conclusion, the caries-reducing effect was so high that health policy makers should consider CWFP as a priority policy for caries-reducing in Korean children and adolescents.

Knowledge about preventive dentistry versus self-reported competence in providing preventive oral healthcare - a study among Nepalese dentists

BACKGROUND

Dentists' and dental healthcare providers' professional knowledge and attitude towards the prevention of oral diseases may have an impact on the oral health of the general population. The aim of this study was to describe Nepalese dentists' competency in giving preventive education and treatment to their patients, and to assess their level of knowledge about preventive dental health.

METHODS

This was a cross-sectional study of 195 dentists (71 males and 124 females). Knowledge of preventive oral healthcare and self-reported aspects of preventive oral healthcare were assessed using a close-ended multiple-choice questionnaire. Statistical evaluation was done using chi-squared test, independent sample t-test and factor analysis as appropriate.

RESULTS

More than 90% of dentists self-reported to be competent in providing preventive treatment and oral hygiene education to their patients. Female dentists reported being more competent in giving oral hygiene education than their male counterparts (p = 0.045). Dentists scored a mean of 24.06 ± 3.8 [range (15-33)] out of 56 on knowledge based on self-reported awareness of seven different aspects of preventive dentistry. More than 70% of the dentists had relatively good knowledge regarding the use of fluoride, whereas the preventive knowledge in other aspects of dental health such as frequency of sugar consumption, xylitol use, dental visits, sealant, gingival health, dental and general health was found to be limited.

CONCLUSIONS

The majority of participating dentists reported a high level of general competency in providing preventive treatment and oral health education to their patients, whereas their knowledge was found to be limited in some aspects of preventive dentistry.

Factors that drive dentists towards or away from dental caries preventive measures: systematic review and metasummary

BACKGROUND

Dental caries is a serious public health concern. The high cost of dental treatment can be avoided by effective preventive measures, which are dependent on dentists' adherence. This study aimed to evaluate the factors that drive dentists towards or away from dental caries preventive measures.

METHODS AND FINDINGS

This systematic review was registered in PROSPERO (CRD42012002235). Several databases as well as the reference lists and citations of the included publications were searched according to PRISMA guidelines, yielding 18,276 titles and abstracts, which were assessed to determine study eligibility. Seven qualitative studies and 41 surveys (36,501 participants) remained after data extraction and interpretation. A total of 43 findings were abstracted from the reports and were grouped together into 6 categories that were judged to be topically similar: education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. The main findings for adherence based on their calculated frequency effect sizes (ES) were teamwork (21%) and post-graduation (12%), while for non-adherence were biologicism (27%), and remuneration for preventive procedures (25%). Intensity ES were also calculated and demonstrated low prevalence of the findings. Quality assessment of the studies demonstrated that the methodological quality, particularly of surveys, varied widely among studies.

CONCLUSIONS

Despite the questionable quality of the included reports, the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favor of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general.

Do dentists have better oral health compared to general population: a study on oral health status and oral health behavior in Kathmandu, Nepal

Background

Dentists are considered role models by the general population in regards to oral hygiene and oral health behavior. This study aimed to access the oral health status of dentists and laypersons, and compare the dentists’ practice of preventive dentistry and oral self-care behaviors to that of the laypersons.

Methods

This cross-sectional study recruited 472 participants (195 dentists and 277 laypersons from the general population). Their oral health/hygiene behavior was assessed using a standardized close-ended multiple choice questionnaire. Oral examination was performed to assess caries using Decayed Missed Filled teeth (DMFT) index and periodontal status using Community Periodontal Index of Treatment Needs (CPITN).

Results

Ninety-six percent of dentists brushed their teeth at least once daily, using fluoridated toothpaste and 80.5% twice daily. Although 94% of laypersons brushed their teeth once daily, they seldom used fluoridated toothpaste. Ten percent of participants in each group were caries free. The mean number of teeth present in the oral cavity (27.4 versus 25.4), mean number of teeth with caries (1.8 versus 3.7) and fillings (2.5 versus 0.4) were significantly different (p < 0.0001) between dentists and laypersons, respectively. Regarding the periodontal status, 82% of dentists had CPITN score of 0 whereas 71% of laypersons had the highest score 3 (p = 0.007), and 81% of the laypersons reported tooth mobility compared to 1% of dentists (p < 0.0001).

Conclusions

The participating dentists had better periodontal status and better self-reported oral health behaviors than the laypersons. Despite similar prevalence of caries in the two groups, the prevalence of decayed and unfilled teeth was lower among the dentists.

Determinants of preventive dental practice for children among final-year dental students in Nigeria

BACKGROUND

This study aims to identify the determinants of caries prevention-oriented practice for children among final-year dental students in Nigeria.

METHOD

A questionnaire was distributed to 179 final-year dental students in six dental schools in Nigeria. It requested information on age, gender, knowledge of caries prevention measures, self-perceived competency in providing caries-preventive care for children, and caries prevention-oriented practice for two hypothetical cases with high and low risk of caries. Chi-squares tests and logistic regression analysis were done.

RESULTS

Between 24% and 41% of the respondents indicated their inability to determine the appropriate treatment modality for children with high and low caries risk. Majority of the students failed to differentiate between the caries-preventive practice for children with high and low risk of caries: preventive strategies for children with high caries risk were also used for those with low caries risk. Age, gender, knowledge of caries prevention measures, and self-perceived competency in providing caries-preventive care were not associated with student's capacity to provide caries-preventive practice for children.

CONCLUSION

Caries-preventive practice among dental students in Nigeria could be improved. It may be important to explore the possible role of problem-based learning approach in addressing this challenge.

Determinants of preventive oral health behaviour among senior dental students in Nigeria

BACKGROUND

To study the association between oral health behaviour of senior dental students in Nigeria and their gender, age, knowledge of preventive care, and attitudes towards preventive dentistry.

METHODS

Questionnaires were administered to 179 senior dental students in the six dental schools in Nigeria. The questionnaire obtained information on age, gender, oral self-care, knowledge of preventive dental care and attitudes towards preventive dentistry. Attending a dental clinic for check-up by a dentist or a classmate within the last year was defined as preventive care use. Students who performed oral self-care and attended dental clinic for check-ups were noted to have complied with recommended oral self-care. Chi-square test and binary logistic regression models were used for statistical analyses.

RESULTS

More male respondents agreed that the use of fluoride toothpaste was more important than the tooth brushing technique for caries prevention (P < 0.001). While the use of dental floss was very low (7.3%), more females were more likely to report using dental floss (p=0.03). Older students were also more likely to comply with recommended oral self-care (p<0.001). In binary regression models, respondents who were younger (p=0.04) and those with higher knowledge of preventive dental care (p=0.008) were more likely to consume sugary snacks less than once a day.

CONCLUSION

Gender differences in the awareness of the superiority of using fluoridated toothpaste over brushing in caries prevention; and in the use of dental floss were observed. While older students were more likely to comply with recommended oral self-care measures, younger students with good knowledge of preventive dental care were more likely to consume sugary snacks less than once a day.

Prevention-oriented practice of Iranian senior dental students

OBJECTIVES

To investigate self-reported preventive practice of Iranian senior dental students in dental caries management.

SUBJECTS AND METHODS

To obtain an estimated sample size of 250 subjects, seven state dental schools were selected based on a stratified random sampling approach. All the senior dental students (n = 327) were asked to voluntarily fill in a self-administered pre-tested questionnaire during the spring term in 2005. In the questionnaire two hypothetical patient cases (a high-risk and a low-risk patient) were presented and the students were asked to express their conceptions on a five-point Likert scale about including each of nine given alternatives in the patients' treatment plans. The respondents' self-reported oral self-care (OSC), preventive knowledge, attitude towards prevention and self-perceived competency in giving preventive care were also assessed. Chi-squared test and logistic regression model served for statistical analyses.

RESULTS

A total of 270 students filled in the questionnaire (response rate = 82%). Acquiring high scores of preventive practice as assessed by patient cases was found to be more frequent among those reporting recommended OSC (P = 0.007) and those with higher attitude scores (P < 0.001). Also, those reporting being competent in giving preventive care had higher scores of preventive practice compared with the others (P = 0.02). In the regression model, recommended OSC (P = 0.05, OR = 1.9) and positive attitudes towards preventive dentistry (P = 0.001, OR = 3.3) showed significant association with acquiring highest scores of preventive practice.

CONCLUSION

To improve their preventive practice in the future, more emphasis should be placed on the dental students' own oral health behaviour and attitudes related to it.