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Wolf E, Ziesemer K, Van der Hijden E. Policy interventions to improve the accessibility and affordability of Dutch dental care. A scoping review of effective interventions. Heliyon 2024; 10:e28886. [PMID: 38707350 PMCID: PMC11066141 DOI: 10.1016/j.heliyon.2024.e28886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/26/2024] [Accepted: 03/26/2024] [Indexed: 05/07/2024] Open
Abstract
Caries and periodontitis remain prevalent in the Netherlands. Given the assumption that increasing the accessibility and affordability of dental care can improve oral health outcomes, policy interventions aimed at improving these aspects may contribute to better oral health. To identify possible solutions, this scoping review firstly identifies policy interventions from around the world that have effectively improved the accessibility or affordability of dental care. Secondly, this review discusses the potential of the policy interventions identified that are applicable to the Dutch healthcare sector specifically. A literature search was performed in four databases. Two reviewers independently screened all potentially relevant titles and abstracts before doing the same for the full texts. Only studies that had quantitatively evaluated the effectiveness of policy interventions aimed at improving the accessibility or affordability of dental care were included. 61 of the 1288 retrieved studies were included. Interventions were grouped into four categories. Capacity interventions (n = 5) mainly focused on task delegation. Coverage interventions (n = 25) involved the expansion of covered dental treatments or the group eligible for coverage. Managed care interventions (n = 20) were frequently implemented in school or community settings. Payment model interventions (n = 11) focused on dental reimbursement rates or capitation. 199 indicators were identified throughout the 61 included studies. Indicators were grouped into three categories: accessibility (n = 137), affordability (n = 21), and oral health status (n = 41). Based on the included studies, increasing managed care interventions for children and adding dental coverage to the basic health insurance plan for adults could improve access to dental care in the Netherlands. Due to possible spillover effects, it is advisable to investigate a combination of these policy interventions. Further research will be necessary for the development of effective policy interventions in practice.
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Affiliation(s)
- E.H. Wolf
- Talma Instituut, Vrije Universiteit Amsterdam, Faculty of Social Sciences, De Boelelaan 1105, 1081, HV Amsterdam, Noord-Holland, the Netherlands
| | - K.A. Ziesemer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Library, De Boelelaan 1117, 1081, HV Amsterdam, Noord-Holland, the Netherlands
| | - E.J.E. Van der Hijden
- Talma Instituut, Vrije Universiteit Amsterdam, Faculty of Social Sciences, De Boelelaan 1105, 1081, HV Amsterdam, Noord-Holland, the Netherlands
- Zilveren Kruis Health Insurance, Handelsweg 2, 3707 NH Zeist, Utrecht, the Netherlands
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Ramos-Gomez F, Parkinson S, Garcia de Jesus V, Rios JA, Kinsler JJ. Pediatric Oral Health Online Education for Rural and Migrant Head Start Programs in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:544. [PMID: 38791758 PMCID: PMC11121221 DOI: 10.3390/ijerph21050544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/16/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024]
Abstract
Children living in rural and migrant areas in the United States disproportionately suffer from poor oral health. Additionally, there continues to be a shortage of pediatric dentists practicing in rural/migrant areas. The purpose of this formative research study was to assess whether staff, teachers and families from rural/migrant Head Start/Early Head Start (HS/EHS) programs in California were receptive to oral health online education workshops conducted by pediatric dental residents who were assisted by bilingual (English and Spanish) community oral health workers (COHWs). Our findings suggest that partnering pediatric dental residents with bilingual COHWs to educate HS/EHS teachers, staff and parents on oral health care in rural/migrant areas could result in a rewarding experience for pediatric dentists that might lead them to practice in these communities upon graduation from their residency program. Furthermore, the positive feedback received from the teachers, staff and parents who participated in the workshops indicates they were receptive to receiving oral health information related to oral health literacy from the dental providers and COHWs. COHWs can help increase access to oral health care by serving as a bridge between families and providers by relaying information in a cultural, linguistic and sensitive manner.
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Affiliation(s)
- Francisco Ramos-Gomez
- Section of Pediatric Dentistry, Division of Growth & Development, Los Angeles (UCLA) School of Dentistry, University of California, Los Angeles, CA 90095, USA; (S.P.); (V.G.d.J.); (J.A.R.); (J.J.K.)
| | - Stephanie Parkinson
- Section of Pediatric Dentistry, Division of Growth & Development, Los Angeles (UCLA) School of Dentistry, University of California, Los Angeles, CA 90095, USA; (S.P.); (V.G.d.J.); (J.A.R.); (J.J.K.)
| | - Victor Garcia de Jesus
- Section of Pediatric Dentistry, Division of Growth & Development, Los Angeles (UCLA) School of Dentistry, University of California, Los Angeles, CA 90095, USA; (S.P.); (V.G.d.J.); (J.A.R.); (J.J.K.)
| | - Jose A. Rios
- Section of Pediatric Dentistry, Division of Growth & Development, Los Angeles (UCLA) School of Dentistry, University of California, Los Angeles, CA 90095, USA; (S.P.); (V.G.d.J.); (J.A.R.); (J.J.K.)
- Venice Family Clinic, Los Angeles, CA 90291, USA
| | - Janni J. Kinsler
- Section of Pediatric Dentistry, Division of Growth & Development, Los Angeles (UCLA) School of Dentistry, University of California, Los Angeles, CA 90095, USA; (S.P.); (V.G.d.J.); (J.A.R.); (J.J.K.)
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3
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Christian B, George A, Veginadu P, Villarosa A, Makino Y, Kim WJ, Masood M, Martin R, Harada Y, Mijares-Majini MC. Strategies to integrate oral health into primary care: a systematic review. BMJ Open 2023; 13:e070622. [PMID: 37407034 PMCID: PMC10367016 DOI: 10.1136/bmjopen-2022-070622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/04/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Integration of oral health into primary care has been proposed as a primary healthcare approach for efficient and sustainable delivery of oral health services, and the effective management of oral diseases. This paper aimed to synthesise evidence on the effectiveness of strategies to integrate oral health into primary care. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, Embase, Scopus, ProQuest, Cochrane and Google Scholar were searched without date limits until the third week of June 2022. Reference lists of eligible studies were also searched. Experts in the field and existing professional networks were consulted. ELIGIBILITY CRITERIA Only studies that evaluated integration strategies were included in the review. Eligibility was restricted to English language studies published in academic peer-reviewed journals. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and performed the risk of bias assessments. A narrative synthesis approach was used to report review findings. Heterogeneity among included studies precluded a meta-analysis. RESULTS The search identified 8731 unique articles, of which 49 were included in the review. Majority of the studies explored provision of oral healthcare by primary care professionals in primary care settings, where integration was primarily via training/education and/or policy changes. Most studies reported results favouring the integration strategy, such as improvements in referral pathways, documentation processes, operating efficiencies, number of available health staff, number of visits to non-dental primary care professionals for oral health issues, proportion of children receiving fluoride varnish applications/other preventive treatment, proportion of visits to an oral health professional and dental caries estimates. CONCLUSION The findings from this review demonstrate that the majority of identified strategies were associated with improved outcomes and can be used to inform decision-making on strategy selection. However, more research and evaluation are required to identify best practice models of service integration. PROSPERO REGISTRATION NUMBER CRD42020203111.
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Affiliation(s)
- Bradley Christian
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
| | - Ajesh George
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Prabhakar Veginadu
- Menzies School of Health Research, Alice Springs, Northern Territory, Australia
| | - Amy Villarosa
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Yuka Makino
- Noncommunicable Diseases Team, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Warrick Junsuk Kim
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Mohd Masood
- Department of Rural Clinical Sciences, La Trobe University - Bendigo Campus, Bendigo, Victoria, Australia
| | - Rachel Martin
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yuriko Harada
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
- Oral Health Programme, Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
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Geurs NC, Jeffcoat MK, Tanna N, Geisinger ML, Parry S, Biggio JR, Doyle MJ, Grender JM, Gerlach RW, Reddy MS. A Randomized Controlled Clinical Trial of Prenatal Oral Hygiene Education in Pregnancy-Associated Gingivitis. J Midwifery Womens Health 2023; 68:507-516. [PMID: 37026567 DOI: 10.1111/jmwh.13486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/18/2023] [Accepted: 02/02/2023] [Indexed: 04/08/2023]
Abstract
INTRODUCTION Research shows there is a significant increase in gingival inflammation during pregnancy. This study was conducted to determine if an oral health intervention (OHI), including oral hygiene education delivered by nurse-led staff and an advanced over-the-counter (OTC) oral home care regimen, improved gingival inflammation in pregnant women with moderate-to-severe gingivitis compared with a standard oral hygiene control group. METHODS This was a multicenter, randomized, controlled, single-masked, parallel group clinical trial conducted in obstetrics clinics of 2 medical centers. A total of 750 pregnant women between 8 and 24 weeks of pregnancy with at least 20 natural teeth and moderate-to-severe gingivitis (>30 intraoral bleeding sites) were enrolled. Participants were randomized to either the OHI group, which included oral hygiene instructions supplemented with an educational video and advanced OTC antibacterial/mechanical oral hygiene products, or the control group receiving oral hygiene instructions and standard products. Both groups received oral hygiene instructions from nurse-led staff. Experienced, masked examiners measured whole mouth gingival index (GI) and periodontal probing depths (PDs) at baseline and months 1, 2, and 3. RESULTS Participants enrolled in this study presented with moderate-to-severe gingivitis at baseline. Both the OHI and control groups exhibited significant reductions in GI (P < .001) and PD (P < .03) from baseline that persisted throughout the study period. The OHI group exhibited modest, yet statistically greater, reductions in GI (P ≤ .044) compared with the control at all time points. The reduction in PD directionally favored the OHI group, but between-group differences were small (<0.03 mm) and not statistically significant (P > .18). DISCUSSION Significant gingivitis was prevalent among participants in this study and identifies an opportunity to improve gingival health during pregnancy by providing oral health education during the course of prenatal care when coupled with an advanced OTC oral hygiene regimen.
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Affiliation(s)
- Nicolaas C Geurs
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Marjorie K Jeffcoat
- Department of Periodontics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nipul Tanna
- Department of Periodontics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Maria L Geisinger
- Department of Periodontology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Samuel Parry
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph R Biggio
- Department of Obstetrics and Gynecology, Ochsner Baptist, New Orleans, Louisiana
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Matthew J Doyle
- Research & Development, The Procter & Gamble Company, Cincinnati, Ohio
| | - Julie M Grender
- Research & Development, The Procter & Gamble Company, Cincinnati, Ohio
| | - Robert W Gerlach
- Research & Development, The Procter & Gamble Company, Cincinnati, Ohio
| | - Michael S Reddy
- School of Dentistry, University of California San Francisco, San Francisco, California
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Bashirian S, Barati M, Barati M, Shirahmadi S, Khazaei S, Jenabi E, Gholami L. Promoting Oral Health Behavior During Pregnancy: A Randomized Controlled Trial. J Res Health Sci 2023; 23:e00584. [PMID: 37571955 PMCID: PMC10422136 DOI: 10.34172/jrhs.2023.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/27/2023] [Accepted: 06/18/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Pregnant women are vulnerable to oral disease due to physiological, hormonal, and dietary alterations. The aim of the present study was to evaluate the impact of the educational program according to the Health Promotion Model (HPM) on the oral health prevention behavior of pregnant women. STUDY DESIGN A randomized controlled trial. METHODS This study was performed on 105 pregnant women visiting health centers located in Arak from February to November 2022. The subjects were randomly assigned to intervention (n=54) and control (n=51) groups. A reliable and valid questionnaire according to HPM constructs was used to collect the data. The pre-test was conducted in the groups. The intervention group received the educational program in 9 educational sessions (from 12 to 24 weeks of pregnancy). Then, the post-test was conducted in the 36th week of pregnancy in the groups. Finally, the data were analyzed by SPSS software (version 18) and using independent t-test, paired t-test, and Chi-square test. RESULTS There were statistically significant differences between the intervention and control groups regarding perceived benefits (24.68±3.63 vs. 26.57±3.67, P=0.009), perceived barriers (7.31±3.14 vs. 5.81±3.59, P=0.025), positive affect (10.50±1.66 vs. 11.29±1.34, P=0.009), negative affect (1.59±0.223 vs. 1.40±1.51, P=0.006), commitment to the action plan (4.05±1.92 vs. 4.77±1.50, P=0.034), and tooth brushing time (2.29±0.72 vs. 2.74±0.48, P<0.001). However, no significant difference was observed regarding the tooth brushing frequency (2.05±0.58 vs. 2.07±0.66, P=0.901) after the intervention. The brushing time for 2-3 minutes in the intervention group increased from 51.85% to 75.92% after the intervention. CONCLUSION HPM-based education was effective in promoting the duration of tooth brushing in pregnant women. However, it had no effect on the tooth brushing frequency.
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Affiliation(s)
- Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Barati
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Samane Shirahmadi
- Department of Community Oral Health, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Salman Khazaei
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ensiyeh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Gholami
- Department of Periodontology, School of Dentistry, Hamedan Medical Science University, Hamedan, Iran
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Faghihian R, Saied-Moallemi Z, Zakizade M, Faghihian E, George A, Abbasi S. Design, Implementation, and Evaluation of Educational Program in Oral Health for Midwives and Other Antenatal Care Providers in Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:305-311. [PMID: 37575502 PMCID: PMC10412786 DOI: 10.4103/ijnmr.ijnmr_297_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/08/2021] [Accepted: 09/20/2022] [Indexed: 08/15/2023]
Abstract
Background Maintaining oral health during pregnancy has been considered an essential public health issue worldwide. One of the various preventive strategies is to train antenatal care providers to guide pregnant women. This study aimed to design, implement, and evaluate an educational program's effect on the oral health-related knowledge, attitudes, and practice of antenatal care providers in Iran. Materials and Methods All of the antenatal care providers working at Isfahan health centers were invited for this study in April 2019. A total of 340 volunteers (120 midwives and 220 others) finally participated in this interventional study with a pre-test-post-test design. A questionnaire was developed to assess the participants' knowledge, attitudes, and practice before and after the intervention. A lecture-based educational session containing similar issues asked in the questionnaire was held for all the participants. The participant's total knowledge scores before and after the intervention, and their attitudes and practice were evaluated and compared through paired t-test. Results The participants' mean total knowledge scores before and after the intervention were 42.87 and 52.25, respectively. The paired t-test revealed a statistically significant difference between pre- and post-intervention scores (p < 0.001). The frequency of participants' answers to attitude and practice questions was also determined. Conclusions Improving oral health-related knowledge of antenatal care providers can be achieved through a single educational session designed by accurately assessing their needs. The participants' attitudes revealed barriers to seeking dental care by pregnant women; however, the participants' oral health-related practice was acceptable.
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Affiliation(s)
- Reyhaneh Faghihian
- Dental Research Center, Department of Pediatric Dentistry, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Saied-Moallemi
- Dental Research Center, Department of Community Oral Health, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrnaz Zakizade
- Postgraduate Student of Orthodontics, Student Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Faghihian
- Dental Research Center, Department of Oral Medicine, Dental Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ajesh George
- Australian Centre for Integration of Oral Health, School of Nursing and Midwifery, Western Sydney University, Ingham Institute for Applied Medical Research, Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Liverpool, Australia
| | - Somaye Abbasi
- Department of Mathematics, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran
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George A, Kong A, Sousa MS, Villarosa A, Ajwani S, Dahlen HG, Bhole S, Yaacoub A, Srinivas R, Johnson M. Long-term effectiveness of the midwifery initiated oral health-dental service program on maternal oral health knowledge, preventative dental behaviours and the oral health status of children in Australia. Acta Odontol Scand 2023; 81:164-175. [PMID: 36001600 DOI: 10.1080/00016357.2022.2108896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND The Midwifery Initiated Oral Health-Dental Service was developed to train midwives to promote maternal oral health, and a large trial showed it substantially improved the oral health, knowledge and behaviours of pregnant women. AIM Evaluate the long-term effectiveness of the program (post-trial) on maternal oral health knowledge, dental behaviours, and early childhood caries in offspring. METHODS A prospective cohort study involving 204 women and children 3-4 years (followed after trial) was conducted in Sydney, Australia from 2017 to 2019. RESULTS The program did not have a significant impact on the study measures. Mothers who received the program did have comparatively better knowledge around preventative behaviours to reduce early childhood caries and significantly more mothers were engaging in a key behaviour of using a cup to feed their child. Overall maternal oral health knowledge and level of education did have a protective effect on the dental decay of children. Higher knowledge and levels of education reduced the odds of having a dmft of one or more by over half (OR 0.473), and almost 80% (OR 0.212) respectively. CONCLUSIONS Although the MIOH-DS program was not effective, there is still value in exploring other complementary interventions to improve maternal oral health, especially for disadvantaged families. Future research should focus on co-designing an antenatal and postnatal oral health intervention and exploring its long-term impact on the oral health of children.
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Affiliation(s)
- Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,La Trobe Rural Health School, La Trobe University, Bendigo, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | - Ariana Kong
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Mariana S Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,IMPACCT (Improving Palliative, Aged and Chronic Care through Clinical Research and Translation), Faculty of Health, University of Technology Sydney, Broadway, Australia
| | - Amy Villarosa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia
| | - Shilpi Ajwani
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Sydney Dental Hospital, Oral Health Services, Sydney Local Health District, Surry Hills, Australia.,Sydney Institute for Women, Children and Families, Sydney Local Health District, Surry Hills, Australia
| | - Hannah G Dahlen
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Translational Health Research Institute, Western Sydney University, Campbelltown, Australia
| | - Sameer Bhole
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Sydney Dental Hospital, Oral Health Services, Sydney Local Health District, Surry Hills, Australia.,Sydney Institute for Women, Children and Families, Sydney Local Health District, Surry Hills, Australia
| | - Albert Yaacoub
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Oral Health Services, Nepean Blue Mountains Local Health District, Kingswood, Australia
| | - Ravi Srinivas
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, Australia.,Ingham Institute for Applied Medical Research, Liverpool, Australia.,School of Dentistry, Faculty of Medicine and Health, University of Sydney, Surry Hills, Australia.,Oral Health Services, South Western Sydney Local Health District, Liverpool, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, North Sydney, Australia
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Kristensen CB, Ide M, Forbes A, Asimakopoulou K. Psychologically informed oral health interventions in pregnancy and type 2 diabetes: A scoping review. FRONTIERS IN ORAL HEALTH 2022; 3:1068905. [PMID: 36620123 PMCID: PMC9811123 DOI: 10.3389/froh.2022.1068905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Oral health is a critical aspect of gestational diabetes management. Gestational diabetes is high blood glucose levels during pregnancy and is managed like type 2 diabetes with diet and physical activity interventions. This scoping review sets out to discuss why oral health support should also become part of gestational diabetes management. Objectives The primary objective was to synthesise the existing psychologically informed oral health interventions for pregnant women and individuals with type 2 diabetes, and the extent to which these interventions map on to the COM-B Model. No literature exists on oral health interventions in gestational diabetes, why studies with type 2 diabetes populations were selected instead. The secondary objective was to identify the precise outcomes targeted in the interventions. Methodology The Joanna Briggs Institute's Methodology for Scoping Reviews was used to conduct this review. The populations of interest were pregnant women and individuals with type 2 diabetes, and eligible concepts were psychologically informed oral health interventions. Quasi-experimental and experimental designs were considered. The Ovid Interface including Embase, Medline, Global Health, APA PsychInfo, Health Management Information, Maternity, Infant Care Database, the Cochrane Library, and CINAHL was used as information sources. The study selection followed the PRISMA guidelines. The first search was conducted on the week commencing the 25th of July 2022, with a follow-up search conducted on the 10th of October 2022. Results 28 records were included for synthesis. The most frequently assessed psychological outcome was oral health knowledge and the most frequently assessed oral clinical outcome was Plaque Index. All studies used an educational intervention approach, while psychological capability in the COM-B Model was targeted in all interventions by increasing oral health knowledge among the participants. The Health Belief Model was the most frequently used theory in the interventions. Conclusion The results demonstrate that oral health is a recognised aspect of pregnancy and type 2 diabetes. The findings from this review and a qualitative interview study which is under development will inform the first oral health intervention for women with gestational diabetes in the United Kingdom.
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Affiliation(s)
- Camilla Böhme Kristensen
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom,Correspondence: Camilla Böhme Kristensen
| | - Mark Ide
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
| | - Angus Forbes
- Care in Long Term Conditions, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, King's College London, London, United Kingdom
| | - Koula Asimakopoulou
- Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, United Kingdom
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Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Effect of oral health promotion interventions on pregnant women dental caries: a field trial. BMC Oral Health 2022; 22:280. [PMID: 35804346 PMCID: PMC9270746 DOI: 10.1186/s12903-022-02292-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background Dental caries is a costly and very common disease, especially in pregnant women. Reasons such as not paying attention to oral health, poor diet and also lack of adequate education in this regard cause this to happen. Performing well-designed educational interventions using primary health system’s forces, can improve oral health of pregnant women and help control this disease. We conducted this study to evaluate the effectiveness of some oral health interventions on pregnant women dental caries. Methods A field trial study was done in comprehensive Health Centers in Varamin, Tehran, Iran to assess 439 mothers’ dental health status from pregnancy up to 2 years after delivery in intervention (n = 239) and control groups (n = 200). Mothers in intervention groups received oral health-related education consisted of nutritional and behavioral messages via either of four methods: A: comprehensive method including all following methods together (n = 74), B: group discussion by dentists (n = 59), C: face to face education by primary health care providers (n = 53), and D: social network applications (n = 53); while those in control group only received routine maternal and oral health care. We used a questionnaire to collect mothers’ demographic, socioeconomic and dental care behavior data and also performed oral examinations to assess their DMFT at baseline and 24 months after delivery to evaluate the effectiveness of these educational oral health interventions. Results From 454 mothers participated the examination session, 18 pregnant women discontinued during the follow-ups and 439 were remained with mean age of 27.47. In the intervention group, the frequency of daily brushing among women increased from 64% at baseline to 85.6% at the last follow-up and the mean D significantly decreased nearly 1unit at same period (P < 0.05). Most and least dental caries changes were in comprehensive intervention group and social network intervention group compared to other intervention groups, respectively. Conclusions Performing educational interventions during and after pregnancy using various message delivery methods and messengers (oral health professionals and trained PHCPs), could improve oral health status and behaviors of pregnant and lactating mothers in a feasible and applicable manner.
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Affiliation(s)
- Marzie Deghatipour
- Department of Community Oral Health, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran.,Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Ghorbani
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Amir Hossein Mokhlesi
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Shahla Ghanbari
- Deputy for Health Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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10
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Raju K, Berens L. Periodontology and pregnancy: An overview of biomedical and epidemiological evidence. Periodontol 2000 2021; 87:132-142. [PMID: 34463990 DOI: 10.1111/prd.12394] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Women are particularly susceptible to developing gingival problems during pregnancy. In addition, periodontal disease in pregnant women may lead to adverse outcomes for both mother and infant, which have serious clinical and public health implications. Both scenarios have been extensively researched, helping to bring attention to pregnant women as an important and vulnerable population as it concerns periodontal health. The increase in gingival inflammation caused by hormonal changes in pregnant women is undisputed and has been studied and documented since the 1960s, although the exact etiology is not fully understood. The relationship between periodontal disease during pregnancy and adverse pregnancy outcomes is less substantiated, because of conflicting evidence. This review of the biomedical and epidemiologic literature provides an overview of both sides of this relationship and examines the potential mechanisms for developing periodontal disease during pregnancy and the proposed mechanisms by which periodontal disease leads to adverse pregnancy outcomes.
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Affiliation(s)
- Karen Raju
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Lisa Berens
- Department of Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, California, USA
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11
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Ahmad MS, Abuzar MA, Razak IA, Rahman SA, Borromeo GL. Oral health education in the undergraduate nursing curriculum of Australian and Malaysian institutions. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:350-359. [PMID: 33021010 DOI: 10.1111/eje.12611] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/23/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION A high degree of training is necessary to prepare student nurses for their roles as oral healthcare partners that can promote a holistic approach to health in the community. This study aims to determine the extent of oral health education in Australian and Malaysian nursing institutions, as well as investigate educators' perceptions of education and practice in this area of care. METHODOLOGY An audio-recorded, semi-structured qualitative phone interview was conducted with the heads of 42 nursing schools across Australia (n = 35) and Malaysia (n = 7) during the 2015 academic year. Qualitative data were analysed via thematic analysis. Quantitative data, wherever appropriate, were measured for frequencies. RESULTS The response rate was 34.2% (n = 12) and 71.4% (n = 5) for the Australian and Malaysian subjects, respectively. Findings revealed that although all the nursing schools measured provided didactic and clinical training in oral health, curriculum content, expected learning outcomes, amount of clinical exposure and assessment approach lacked consistency. Most nursing educators across both countries perceived an overloaded curriculum as a barrier to providing oral health education. Whilst educators demonstrated their support for training in this area of care, they expressed the need for an established national guideline that highlights the educational requirement for future nurses in oral health maintenance and their scope of practice. CONCLUSION This study provides valuable information for further developing oral health education for nurses, to improve their competency and ultimately the health of the communities that they will serve.
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Affiliation(s)
- Mas S Ahmad
- Universiti Teknologi MARA, Selangor Branch, Sungai Buloh Campus, Sungai Buloh, Malaysia
| | | | | | - Sabariah A Rahman
- Universiti Teknologi MARA, Selangor Branch, Sungai Buloh Campus, Sungai Buloh, Malaysia
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12
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Wang L, Ren J, Fiscella KA, Bullock S, Sanders MR, Loomis EL, Eliav E, Mendoza M, Cacciato R, Thomas M, Kopycka-Kedzierawski DT, Billings RJ, Xiao J. Interprofessional collaboration and smartphone use as promising strategies to improve prenatal oral health care utilization among US underserved women: results from a qualitative study. BMC Oral Health 2020; 20:333. [PMID: 33228617 PMCID: PMC7685586 DOI: 10.1186/s12903-020-01327-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 11/12/2020] [Indexed: 12/12/2022] Open
Abstract
Background Data on barriers and facilitators to prenatal oral health care among low-income US women are lacking. The objective of this study was to understand barriers/facilitators and patient-centered mitigation strategies related to the use of prenatal oral health care among underserved US women.
Methods We used community-based participatory research to conduct two focus groups with eight pregnant/parenting women; ten individual in-depth interviews with medical providers, dental providers and community/social workers; and one community engagement studio with five representative community stakeholders in 2018–2019. Using an interpretive description research design, we conducted semi-structured interviews and focus groups which were audio-recorded, transcribed, and analyzed for thematic content. Results We identified individual and systemic barriers/facilitators to the utilization of prenatal oral health care by underserved US women. Strategies reported to improve utilization included healthcare system-wide changes to promote inter-professional collaborations, innovative educational programs to improve dissemination and implementation of prenatal oral health care guidelines, and specialized dental facilities providing prenatal oral health care to underserved women. Moreover, smartphones have the potential to be an innovative entry point to promote utilization of prenatal oral care at the individual level. Conclusions Low-income women face multiple, addressable barriers to obtaining oral health care during pregnancy. Inter-professional collaboration holds strong promise for improving prenatal oral health care utilization.
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Affiliation(s)
- Lin Wang
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.,Peking University School of Stomatology, Beijing, China
| | - Johana Ren
- University of Rochester River Campus, Rochester, NY, USA
| | - Kevin A Fiscella
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Mechelle R Sanders
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Elizabeth L Loomis
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Eli Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Michael Mendoza
- Department of Family Medicine, University of Rochester Medical Center, Rochester, NY, USA.,Monroe County Department of Public Health, Rochester, NY, USA
| | - Rita Cacciato
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Marie Thomas
- University of Rochester River Campus, Rochester, NY, USA
| | | | - Ronald J Billings
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
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13
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Alvey J, Divaris K, Lytle L, Vann W, Lee J. What Child Oral Health-Related Behaviors Can First-time Mothers Actualize? A Pragmatic Prospective Study. JDR Clin Trans Res 2020; 5:366-375. [PMID: 31835968 PMCID: PMC7495947 DOI: 10.1177/2380084419892554] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION First-time pregnant women are considered to be receptive to health information, rendering the prenatal period an opportune time to provide helpful information on the importance of child-related oral health. However, little is known about pregnant women's knowledge of child oral health-related behaviors (COHBs) during pregnancy and their implementation after birth. We sought to address this knowledge gap by a prospective investigation of intended and actualized oral health behaviors among first-time pregnant women. METHODS We examined relationships between intended and actualized COHBs and their correlations with changes in oral health knowledge, health literacy, general self-efficacy, and dental neglect in a cohort of first-time pregnant clients at Women, Infants, and Children sites in North Carolina-participants of a large community-based study. The COHBs were related to diet (i.e., frequency of fruit juice and sweet snacks consumption and nighttime bottle-feeding) and oral hygiene practices (e.g., performance of daily oral hygiene and use of fluoridated toothpaste). Analyses relied on descriptive statistics and bivariate tests (Student's t and McNemar's). Data were collected from 48 participants (White, 44%; African American, 40%; Native American, 17%) at baseline and again at least 12 months after the birth of their first child. RESULTS On average, most mothers actualized 3 of 5 COHBs (range, 1 to 4). Significant differences between before and after birth were noted for frequency of sweet snacks consumption and putting the baby in bed with a bottle. No correlation was found between knowledge, literacy, self-efficacy, neglect, and sociodemographic characteristics and COHB actualization. CONCLUSION Our findings suggest that first-time mothers in the studied population are likely to implement some but not all positive intended COHBs during pregnancy. Interventions are needed to assist women in implementing these practices. We support that, for prenatal interventional efforts to reap positive benefits, messaging should be personalized and include specific guidance on how to implement these recommendations. KNOWLEDGE TRANSFER STATEMENT A knowledge gap exists in our understanding of the relationship between first-time mothers' intended and actualized child oral health behaviors, with implications in the optimal timing of infant and early childhood oral health messaging. Our findings suggest that first-time mothers are likely to implement some but not all positive behaviors that they intended to adopt during pregnancy. Interventions are needed to assist women in implementing these practices.
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Affiliation(s)
- J. Alvey
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - K. Divaris
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings
School of Global Public Health, University of North Carolina, Chapel Hill, NC,
USA
| | - L. Lytle
- Department of Health Behavior, Gillings
School of Global Public Health, University of North Carolina, Chapel Hill, NC,
USA
| | - W.F. Vann
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - J.Y. Lee
- Division of Pediatric and Public Health,
Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
- Department of Health Policy and
Management, Gillings School of Global Public Health, University of North Carolina,
Chapel Hill, NC, USA
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14
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Adeniyi A, Donnelly L, Janssen P, Jevitt C, von Bergman H, Brondani M. A Qualitative Study of Health Care Providers' Views on Integrating Oral Health into Prenatal Care. JDR Clin Trans Res 2020; 6:409-419. [PMID: 32996370 DOI: 10.1177/2380084420961998] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Providing preventive oral health during prenatal care is a recognized strategy for improving pregnant women's access to oral health care. This study sought to qualitatively explore the views of health care providers in British Columbia (BC), Canada, on strategies for integrating preventive oral health into prenatal care. METHODS Twenty-four purposefully selected health care providers (13 oral health and 11 prenatal care providers) in Vancouver and Surrey BC participated in audio-recorded semistructured interviews. Interviews lasted from 31 to 61 min, were transcribed verbatim, and were analyzed using an inductive thematic analysis with N-Vivo software. Study validity was ensured via memoing, fieldnotes, member checking, and external audit. RESULTS Thematic analysis revealed 5 major themes: perception of integrated care, relevance of integrated prenatal oral health, strategies for achieving integrated prenatal oral health, drivers of the integration process, and barriers to integrating oral health during pregnancy. Interprofessional collaboration based on information sharing and communication was identified as a critical factor for integrated care. Oral health checks should be a component of prenatal assessments for achieving integrated prenatal oral health. Participants recommended that prenatal providers should offer oral health education and use screening questions to identify the pregnant woman's oral health needs. The establishment of referral systems was advocated, while dental assessments and oral prophylaxis via the medical services plan were proposed. The inclusion of dental providers in prenatal teams and educating health care providers on interprofessional collaboration were also supported. CONCLUSION Oral health and prenatal providers in BC are positively disposed to adopting integrated preventive prenatal oral health care based on interprofessional collaborative practices. The inclusion of oral health providers in prenatal teams was suggested. KNOWLEDGE TRANSFER STATEMENT The results of this study can be used by policymakers for advocacy and decision making when planning care delivery programs for women during pregnancy. Including the suggested strategies could lead to increased access to, and utilization of, oral health services among pregnant women.
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Affiliation(s)
- A Adeniyi
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - L Donnelly
- Department of Oral and Biological Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - P Janssen
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - C Jevitt
- Midwifery Program, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - H von Bergman
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - M Brondani
- Dental Public Health, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
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Sociodemographic Differences in Health Awareness and Oral Health in Pregnant Women. Geburtshilfe Frauenheilkd 2020; 80:834-843. [PMID: 32817990 PMCID: PMC7428374 DOI: 10.1055/a-1205-0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 06/22/2020] [Indexed: 10/25/2022] Open
Abstract
Abstract
Objective The aim of this study was to determine the present oral health status of pregnant women depending on selected sociodemographic differences and deduce any resulting consequences for health prevention.
Methods The participantsʼ data of relevance to the study such as age, school leaving qualification, migration background, smoking habits or last dentist visit were recorded using a questionnaire. The subsequent dental check-up concentrated on open carious lesions, any initiated root canal treatments and missing teeth. Finally, the Periodontal Screening Index was recorded to diagnose the presence of any gingivitis or periodontitis. The subsequent biometric evaluation comprised descriptive data analysis, χ2 test and logistical regression.
Results The higher the school leaving qualification, the lower the probability that a pregnant woman smoked prior to pregnancy (OR 0.291; 95% CI 0.114 – 0.743) and that tartar was diagnosed (OR 0.424; 95% CI 0.185 – 0.973). Regular dentist visits (OR 4.026; 95% CI 1.613 – 10.049) increase with the attained school leaving qualification. There is a greater chance that women born in Germany taking part in the study were aware of dental risks in pregnancy (OR 2.652; 95% CI 1.285 – 5.472) and attended the dentist during pregnancy (OR 2.507; 95% CI 1.281 – 4.907).
Conclusion The rate of awareness of the risks and consequences of pregnancy for oral health must be increased. The main aim for primary prophylaxis should be a reduction in the periodontal bacteria and caries of the mother and father.
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Kong AC, Ramjan L, Sousa MS, Gwynne K, Goulding J, Jones N, Srinivas R, Rambaldini B, Moir R, George A. The oral health of Indigenous pregnant women: A mixed-methods systematic review. Women Birth 2020; 33:311-322. [PMID: 31501053 DOI: 10.1016/j.wombi.2019.08.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/19/2019] [Accepted: 08/19/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Western models of care to improve the oral health of pregnant women have been successfully implemented in the healthcare setting across various developed countries. Even though Indigenous women experience poorer pregnancy and birth outcomes compared to other women, these models have not been developed with Indigenous communities to address the oral health needs of Indigenous pregnant women. This review aimed to understand the oral health knowledge, practices, attitudes and challenges of Indigenous pregnant women globally. METHODS A comprehensive search including six electronic databases and grey literature up to September 2018 was undertaken (PROSPERO Registration Number: 111402). Quantitative and qualitative evidence exploring at least one of the four oral health domains relating to Indigenous pregnant women worldwide, including women pregnant with an Indigenous child, were retrieved. RESULTS Eleven publications related to nine studies were included. Indigenous pregnant women's attitudes, practices and challenges relating to their oral health were influenced by socioeconomic and psychosocial factors, and their healthcare context. Availability of dental services varied depending on the healthcare model, whether services were public or private, and whether services met their needs. Although there was little evidence related to oral health knowledge, the literature suggests some misconceptions within this population. CONCLUSIONS The availability of culturally appropriate dental services that fulfilled the needs of Indigenous pregnant women varied between developed countries. This review highlighted the need for community-tailored dental services and a care coordinator to provide both education and assistance to those navigating services.
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Affiliation(s)
- Ariana C Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Lucie Ramjan
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Mariana S Sousa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia.
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, University of Sydney, Camperdown 2050, Australia.
| | - Joanne Goulding
- Primary and Community Health, South Western Sydney Local Health District, NSW, Australia.
| | - Nathan Jones
- Aboriginal Health Unit, South Western Sydney Local Health District, NSW, Australia.
| | - Ravi Srinivas
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia; Oral Health Services, South Western Sydney Local Health District, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia.
| | - Boe Rambaldini
- Poche Centre for Indigenous Health, University of Sydney, Camperdown 2050, Australia.
| | - Rachael Moir
- Poche Centre for Indigenous Health, University of Sydney, Camperdown 2050, Australia.
| | - Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University/South Western Sydney Local Health District / Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown 2050, Australia; Translational Health Research Institute, Campbelltown, NSW, Australia.
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17
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Abstract
PurposeIntegrating preventive oral care into prenatal care is suggested as a strategy for reducing the burden of oral diseases among pregnant women and their offspring. This scoping review sought to synthesize available information and identify knowledge gaps on integrating oral health into prenatal care.Design/methodology/approachThe scoping review was conducted based on the Joanna Briggs Institute scoping review framework using the following databases: CINAHL, Cochrane Database of Systematic Reviews, Medline, ProQuest Dissertation and theses Global, Psychinfo and Web of Science®. No search limits were used. Content analysis of the included articles was performed to identify conceptual frameworks, types of integration used, study designs, study objectives and outcomes.FindingsOverall, 2,861 references were obtained from the databases search; and based on the inclusion and exclusion criteria 35 references were included in the final analysis. Of these 35 references, one document presented a conceptual model, six documents reviewed guidelines for integrating oral health in prenatal care, two were policy documents aimed at interprofessional collaboration for oral health during pregnancy, eight documents described programs focused on providing oral care during pregnancy, five of the references were literature reviews and the remaining 13 evaluated the impact of integration. Linkages between healthcare professionals were the most common type of integration used.Research limitations/implicationsDespite advances in understanding integrated care concepts for healthcare delivery, there is little evidence available on the impact of the various types of, and strategies for, integrating oral health into prenatal care. Future research to bridge the identified gaps is recommended.Originality/valueThe originality of this study is to provide evidence on integrated oral healthcare during pregnancy.
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18
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George A, Kong AC, Villarosa A, Duff M, Sheehan A, Burns E, Priddis H, Chua C, Dahlen HG. Implementing and evaluating the effectiveness of an oral health module for the bachelor of midwifery program at an Australian university. NURSE EDUCATION TODAY 2020; 90:104457. [PMID: 32388200 DOI: 10.1016/j.nedt.2020.104457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 03/17/2020] [Accepted: 04/26/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Although guidelines recommend antenatal care providers such as midwives promote oral health during pregnancy, oral health training is not routinely provided in undergraduate midwifery curricula. The aim of this study was to implement an oral health module into an Australian undergraduate midwifery program, and evaluate its effectiveness in improving the oral health knowledge and confidence of midwifery students. DESIGN Pre-test post-test study (2015-2017). SETTING An undergraduate midwifery program within an Australian university. PARTICIPANTS All first-year undergraduate midwifery students enrolled in two core units at the above university (N = 56). METHODS Oral health modules were implemented into each of the two core units within the first year of the Bachelor of Midwifery course. Changes in knowledge and confidence were measured using a standardised questionnaire, administered at baseline, immediately following module completion, and at 2 and 3 years following module completion. RESULTS 44 students participated in the baseline survey (79% response rate), of which 41 completed the first post-module questionnaire, 21 completed the second post-questionnaire, and 24 completed the third post-questionnaire. Knowledge scores significantly increased from baseline (mean 13.12) to follow-up (mean 17.78, p < 0.001), with increases being retained through to the 3-year mark (mean 18.29, p < 0.001). Confidence scores also showed a sustained increase following the module, particularly regarding introducing oral health in the first antenatal appointment (62.1% increase, p < 0.001) and referring pregnant women to a dentist (48.2% increase, p < 0.001). However, the 48.2% increase (p < 0.001) in confidence in conducting a visual mouth check on a pregnant woman following the module was not sustained at subsequent time points, reducing to a 31.5% increase (p = 0.118) by the third year post-module. CONCLUSIONS The module is effective in improving and sustaining the knowledge and confidence of midwifery students to promote maternal oral health. Ongoing updates may be required to keep confidence high regarding visual mouth checks.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia; Translational Health Research Institute, Campbelltown, NSW 2560, Australia.
| | - Ariana C Kong
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Amy Villarosa
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia; South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia.
| | - Margaret Duff
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Athena Sheehan
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Elaine Burns
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Holly Priddis
- School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
| | - Clarity Chua
- Centre for Oral Health Outcomes and Research Translation (COHORT), School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Hannah G Dahlen
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Nursing and Midwifery, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751, Australia.
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Abstract
In the United States, people are more likely to have poor oral health if they are low-income, uninsured, and/or members of racial/ethnic minority, immigrant, or rural populations who have suboptimal access to quality oral health care. As a result, poor oral health serves as the national symbol of social inequality. There is increasing recognition among those in public health that oral diseases such as dental caries and periodontal disease and general health conditions such as obesity and diabetes are closely linked by sharing common risk factors, including excess sugar consumption and tobacco use, as well as underlying infection and inflammatory pathways. Hence, efforts to integrate oral health and primary health care, incorporate interventions at multiple levels to improve access to and quality of services, and create health care teams that provide patient-centered care in both safety net clinics and community settings may narrow the gaps in access to oral health care across the life course.
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Affiliation(s)
- Mary E Northridge
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
- Hansjörg Wyss Department of Plastic Surgery, NYU School of Medicine, Brooklyn, New York 11220, USA
| | - Anjali Kumar
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, USA; , ,
| | - Raghbir Kaur
- NYU Langone Dental Medicine-Brooklyn, Postdoctoral Residency Program, Brooklyn, New York 11220, 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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Olatosi OO, Oladugba A, Oyapero A, Belie F, Owais AI, Weber-Gasparoni K, Sote EO, Butali A. A Preexperimental Study to Assess the Impact of an Interdisciplinary Educational Intervention on Nurses' Knowledge of Perinatal and Infant Oral Health Care. J Int Soc Prev Community Dent 2019; 9:619-629. [PMID: 32039083 PMCID: PMC6905320 DOI: 10.4103/jispcd.jispcd_144_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/07/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of this study was to assess the impact of an interdisciplinary educational intervention on the knowledge of nursing practitioners regarding perinatal and infant oral health (PIOH) care. MATERIALS AND METHODS This was a preexperimental study conducted among nursing practitioners in Lagos, Nigeria. Participants received hands-on training and didactic lectures, which included dental caries etiology and risk factors; oral hygiene and dietary education; teething and its management; dental trauma and its prevention; nonnutritive habits; screening, referrals, and counseling; and fluoride varnish application. Knowledge of the trainees was assessed using pre- and posttest questionnaires. Level of statistical significance was set at P < 0.05. RESULTS Overall, 110 nurses participated in the study with a mean age of 40.9 ± 10.8 years; 106 (96.4%) were females. Approximately 88% of the participants had not received formal training on PIOH. The baseline mean scores of the participants' knowledge on oral hygiene, teething, trauma, caries, and oral habits were 4.31 ± 1.9, 9.84 ± 2.6, 2.59 ± 1.7, 4.24 ± 1.8, and 1.45 ± 0.6, respectively; this increased significantly (P < 0.001) following the educational intervention with posttest mean scores as 7.58 ± 0.8, 11.79 ± 1.3, 4.34 ± 1.9, 6.19 ± 1.8, and 1.82 ± 0.4 and six-month evaluation scores as 6.21 ± 1.8,7 10.27 ± 3.1, 4.39 ± 1.5, 5.91 ± 1.8, and 1.79 ± 0.5, respectively. Overall posttest (31.4 ± 4.2) and six-month (28.6 ± 6.2) knowledge scores were significantly higher than the pretest values (22.4 ± 4.8, P < 0.001). At the six-month post-intervention survey, 84% of the nurses reported inclusion of PIOH education in their routine general health education sessions. CONCLUSION There was a positive impact of the educational intervention as evidenced by an increase in the knowledge of the nurses on PIOH care and the inclusion of PIOH education in their general health education. A slight decline between posttest and six-month evaluation scores indicates a need for continuous education and evaluation.
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Affiliation(s)
- Olubukola O. Olatosi
- Department of Child Dental Health, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | | | - Afolabi Oyapero
- Department of Preventive Dentistry, Faculty of Dentistry, Lagos State University College of Medicine, Lagos, Nigeria
| | - Funmilola Belie
- Department of Child Dental Health, Lagos University Teaching Hospital, Lagos, Nigeria
| | - Arwa I Owais
- Department of Pediatric Dentistry, University of Iowa, Iowa, USA
| | | | - Elizabeth O. Sote
- Department of Child Dental Health, Faculty of Dental Sciences, University of Lagos, Lagos, Nigeria
| | - Azeez Butali
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa, USA
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22
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Villalta J, Askaryar H, Verzemnieks I, Kinsler J, Kropenske V, Ramos-Gomez F. Developing an Effective Community Oral Health Workers-"Promotoras" Model for Early Head Start. Front Public Health 2019; 7:175. [PMID: 31334211 PMCID: PMC6621922 DOI: 10.3389/fpubh.2019.00175] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 06/11/2019] [Indexed: 11/13/2022] Open
Abstract
Purpose: To determine the effectiveness of a train-the-trainer program for Community Oral Health Workers (COHWs) with the goal of reducing Early Childhood Caries (ECC). Methods: Thirteen Latina caregivers from a local Early Head Start program participated in an 8 h bilingual oral health training program that provided information and hands-on experiences pertaining to prenatal and children's oral health. Once trained, the 13 COHWs conducted a series of bilingual interactive oral health promotion workshops at local community sites. Pre/post-tests were conducted after each workshop with a total of 157 caregivers of young children. Bivariate analyses were used to assess changes in knowledge, attitudes, and practices of the COHWs and caregivers regarding children's oral health. Results: Significant positive changes (p < 0.05) in COHWs' knowledge were observed for age a child can brush his/her teeth alone and what a pregnant woman with morning sickness can do to protect her teeth. Positive trends were observed for knowing that tap water with fluoride prevents cavities and that poor oral health of parents affects their children's dental health. While community caregivers in the workshops reported a high consumption of sweet snacks and beverages, there was a significant positive increase (p < 0.05) in knowledge and attitudes regarding oral health care. Significant increases in knowledge were obtained regarding: when a child can brush his/her teeth well alone, the age when fluoridated toothpaste can be used, ways tooth decay can be prevented, when a child's first dental visit should be, and what a pregnant woman with morning sickness can do to protect her teeth. Significant positive improvements were found regarding caregiver's favorable attitude that fluoridated water can help prevent cavities, disagreeing that tap water is dangerous, and agreeing that a parent's dental health affects their children's dental health. Conclusions: The study showed a targeted and culturally competent oral health program can significantly improve knowledge, attitudes, and self-reported practices of COHWs and the caregivers they trained. Although longitudinal studies are needed to determine if a COHW model can help reduce ECC in underserved communities, preliminary results support the utilization of this model as a viable option that should be expanded.
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Affiliation(s)
- Jennifer Villalta
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Hamida Askaryar
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Inese Verzemnieks
- School of Nursing, University of California, Los Angeles, Los Angeles, CA, United States
| | - Janni Kinsler
- Section of Pediatric Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
| | - Vickie Kropenske
- School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States
| | - Francisco Ramos-Gomez
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, United States
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23
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Herval ÁM, Oliveira DPD, Gomes VE, Vargas AMD. Health education strategies targeting maternal and child health: A scoping review of educational methodologies. Medicine (Baltimore) 2019; 98:e16174. [PMID: 31261550 PMCID: PMC6616517 DOI: 10.1097/md.0000000000016174] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 04/26/2019] [Accepted: 06/03/2019] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Health education during pregnancy is important to improve maternal and children outcomes. However, the strategies must be specifically designed for each context and demographic characteristics. Our objective was identify health education strategies targeting pregnant women with the intention of improving results of pregnancy at an urban level. METHODS We conducted a scoping review of the literature to answer the question: "what health education strategies targeting pregnant women were reported by primary healthcare teams or the community promoting health in pregnancy, childbirth, postpartum and childhood?" Potential eligible studies were selected using PubMed, Web of Science, LILACS and SciELO by 2 reviewers. RESULTS From a total of 3105 articles, 23 were deemed eligible. We identified 9 educational methodologies focusing on different outcomes of pregnancy, birth or maternal wellbeing. CONCLUSIONS It is important that health education strategies continue after childbirth, independent of the strategy. All the strategies presented in this review are suitable for transfer with a moderate chance of success of implementation or improvement of current education methodologies. Further research is required on health education, including a higher number of patients.
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Affiliation(s)
- Álex Moreira Herval
- Department of Social and Preventive Dentistry, School of Dentistry. Federal University of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
| | | | - Viviane Elisângela Gomes
- Department of Social and Preventive Dentistry, School of Dentistry. Federal University of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
| | - Andrea Maria Duarte Vargas
- Department of Social and Preventive Dentistry, School of Dentistry. Federal University of Minas Gerais, Belo Horizonte, Minas Gerais State, Brazil
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24
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Haber J, Dolce MC, Hartnett E, Savageau JA, Altman S, Lange‐Kessler J, Silk H. Integrating Oral Health Curricula into Midwifery Graduate Programs: Results of a US Survey. J Midwifery Womens Health 2019; 64:462-471. [DOI: 10.1111/jmwh.12974] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 01/22/2019] [Accepted: 02/21/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Judith Haber
- Rory Meyers College of NursingNew York University New York New York
| | - Maria C. Dolce
- School of NursingStony Brook University Stony Brook New York
| | - Erin Hartnett
- Rory Meyers College of NursingNew York University New York New York
| | | | - Susan Altman
- Rory Meyers College of NursingNew York University New York New York
- School of Dental MedicineHarvard University Boston Massachusetts
| | - Julia Lange‐Kessler
- School of Nursing and Health StudiesGeorgetown University Washington District of Columbia
| | - Hugh Silk
- Medical SchoolUniversity of Massachusetts Worcester Massachusetts
- School of Dental MedicineHarvard University Boston Massachusetts
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25
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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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26
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George A, Dahlen HG, Blinkhorn A, Ajwani S, Bhole S, Ellis S, Yeo A, Elcombe E, Johnson M. Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A multi-centre randomised controlled trial. Int J Nurs Stud 2018; 82:49-57. [PMID: 29605753 DOI: 10.1016/j.ijnurstu.2018.03.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 01/19/2018] [Accepted: 03/05/2018] [Indexed: 12/28/2022]
Abstract
BACKGROUND Oral health care during pregnancy is important for the health of the mother and child. However, pregnant women have limited knowledge about maternal oral health and seldom seek dental care. Further, due to limited training antenatal care providers like midwives rarely discuss oral health with pregnant women. The Midwifery-Initiated Oral Health Dental Service program was developed to address current gaps in oral promotional interventions during pregnancy. OBJECTIVES To assess the effectiveness of a Midwifery-Initiated Oral Health Dental Service program in improving uptake of dental services, oral health knowledge, quality of oral health, oral health status and birth outcomes of pregnant women. DESIGN Multi-centre randomised controlled trial. SETTING Three large metropolitan public hospitals in Sydney, Australia. PARTICIPANTS Pregnant women attending their first antenatal appointment who were at least 18 years old and had a single low risk pregnancy between 12 and 20 weeks gestation. METHODS 638 pregnant women were allocated to three groups using block randomisation (n = 211) control group, intervention group 1 (n = 215), intervention group 2 (n = 212) and followed up till birth. Study investigators and data collectors were blinded to group allocation. Intervention group 1 received a midwifery intervention from trained midwives involving oral health education, screening and referrals to existing dental pathways. Intervention group 2 received the midwifery intervention and a dental intervention involving assessment/treatment from cost free local dental services. The control group received oral health information at recruitment. Primary outcome was uptake of dental services. Secondary outcomes included oral health knowledge, quality of oral health, oral health status and birth outcomes. RESULTS Substantial improvements in the use of dental services (20.2% Control Group; 28.3% Intervention group 1; 87.2% Intervention group 2; Odds Ratio Intervention group 2 vs Control Group = 29.72, 95% CI 15.02-58.53, p < 0.001), women's oral health knowledge (p = 0.03); quality of oral health (p < 0.001) and oral health outcomes (sulcus bleeding, dental plaque, clinical attachment loss, decayed/filled teeth- p < 0.001) were found in Intervention group 2. No difference in the rate of preterm or low-birth weight was found. CONCLUSIONS The Midwifery-Initiated Oral Health Dental Service program (Intervention group 2) improved the uptake of dental services and oral health of pregnant women and is recommended during antenatal care. A cause and effect relationship between this intervention and improved birth outcomes was not supported.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes, Research Translation and Evaluation (COHORTE), Western Sydney University, South Western Sydney Local Health District Oral Health Services, University of Sydney, Ingham Institute Applied Medical Research, Liverpool 1871, Australia.
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, Ingham Institute Applied Medical Research, Parramatta 2150, Australia
| | | | - Shilpi Ajwani
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney 2010, Australia; Sydney Research, Sydney 2010, Australia
| | - Sameer Bhole
- Sydney Local Health District Oral Health Services, Sydney Dental Hospital, University of Sydney, Sydney 2010, Australia; Sydney Research, Sydney 2010, Australia
| | - Sharon Ellis
- Camden and Campbelltown Hospitals, South Western Sydney Local Health District, Campbelltown 2170, Australia
| | - Anthony Yeo
- School of Nursing & Midwifery, University of Western Sydney, Liverpool, 1871, Australia
| | - Emma Elcombe
- Western Sydney University, University of New South Wales, Ingham Institute Applied Medical Research, Liverpool 1871, Australia
| | - Maree Johnson
- Faculty of Health Sciences, Australian Catholic University, Sydney 2060, Australia; Ingham Institute Applied Medical Research, Liverpool 1871, Australia
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