Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel

Development and psychometric analysis: Fluoride varnish parent attitude, belief scale

OBJECTIVE

To develop a scale to determine parents' attitudes and beliefs regarding fluoride varnish.

DESIGN AND METHODS

This study had a cross-sectional design and was conducted between 2019 and 2021. A total of 810 parents were included in the study sample. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA), discriminant validity, and convergent validity methods were used to estimate the scale validity. For reliability, the Cronbach alpha coefficient, item-total correlation coefficients, and test-retest method were used.

RESULTS

As a result of psychometric analysis, the scale was found to have a three-factor structure. The factor loads of the items were between 0.838 and 0.715. The three-factor construct showed a good fit in confirmatory factor analysis (X2 (41): 110.06, p <.001; RMSEA: 0.065; RMSR, 0.02; GFI, 0.95; and NFI, 0.94). Cronbach's α coefficient on the scale was 0.85. The item-total correlation of the scale was found to be between 0.355 and 0.626. The test-retest intra-class correlation coefficient of the scale was 0.72.

CONCLUSIONS

This study suggests that the developed scale is a reliable tool to evaluate the attitudes and beliefs of parents toward fluoride varnish. It is thought that the scale will make a contribution to public health.

Health counselling in dental care for expectant parents: A qualitative study

Objectives

Interventions during pregnancy and early childhood have been shown to impact dental health. Thus, Antenatal Care and Dental Care collaborated in an intervention called Health Counselling in Dental Care (HCDC). HCDC was offered free of charge to first‐time expectant parents and was aimed at reducing the frequency of dental caries in children and their parents. However, the intervention reached less than 50% of the parents. The aim of this study was to explore facilitators of, barriers to, and suggestions for increased participation in HCDC.

Methods

Data were collected through semi‐structured, face‐to‐face interviews with expectant parents. Participants were purposively sampled based on having been invited to HCDC and to achieve a variation in socio‐demographics. Interviews were audio recorded, transcribed verbatim and analysed using conventional qualitative content analysis.

Results

In total, 16 interviews were conducted (10 women, 6 men). Six categories representing three facilitators and three barriers for participation emerged. The facilitators were the midwife’s crucial role for disseminating information about HCDC and motivating participation, that the parents perceived HCDC as valuable for themselves and their offspring, and a desire for new or more knowledge. The barriers included a shortage of information regarding the counselling, a perceived lack of value for the parents and offspring, and the timing of the counselling during pregnancy.

Conclusions

The midwives were crucial in providing information and motivation for HCDC participation. To increase attendance, sufficient information regarding the benefits of counselling is required, and the timing needs to be flexible and family‐centred.

Epidemiology and Clinical Management of Early Childhood Caries in Israel

Aim: The aim of the present review is to describe the current status of early childhood caries (ECC) in Israel in aspects of epidemiology, prevention, and management.

Methods: PubMed search was performed using the words caries, children, Israel. Demographic data was collected from the Israeli Central Bureau of Statistics.

Results: The decayed, missing, and filled teeth index was 2.72 in 1992 and 2.56 in 2016. The proportion of restored teeth has increased. A number of preventive programs are ongoing but a general preventive program is lacking at the national level. From 2010, every child in Israel is eligible to receive free dental treatment.

Conclusion: The gaps in understanding of the epidemiological profile of ECC in Israel is a call for more research conduct on ECC in the country.

Efficacy of an adenosine triphosphate meter for evaluating caries risk in clinical dental practice

BACKGROUND

Adenosine triphosphate bioluminescence (ATP-B) readings have been proposed as markers of caries risk. ATP readings may indicate bacteria or oral streptococci activity in microbial plaque. The authors of this study aimed to evaluate whether readings using a commercial ATP meter (CariScreen Testing Meter, Oral BioTech) are significantly different for patients with low, moderate, and high caries risk in the Caries Management by Risk Assessment Practice-Based Research Network study.

METHODS

Twenty practice-based research network dentists enrolled 460 patients; 271 returned for 2 or more semiannual follow-up visits over 2 years. Dentists were trained and calibrated to perform ATP-B testing and caries risk assessment (CRA) using established protocols. ATP-B readings were compared via CRA category (low, moderate, high). Generalized estimating equations were used to compare the risk of experiencing incident clinical outcomes (newly recorded decayed, missing, or restored tooth surfaces and CRA disease indicators) according to ATP-B reading at prior patient visits (≥ 1,500 versus < 1,500 relative light units).

RESULTS

Median ATP-B readings did not differ statistically significantly by clinician-assessed caries risk level (low, 2,323; moderate, 2,940; high, 3,217; P = .65). Adjusted for patient demographics and trial intervention assignment, higher readings were not associated with newly developed decayed, missing, or restored tooth surface (relative risk, 1.57; 95% confidence interval, 0.55 to 4.45) or disease indicators (relative risk, 1.08; 95% confidence interval, 0.85 to 1.37) at the following visit, whereas clinician-assessed caries risk level was strongly associated.

CONCLUSIONS

ATP-B readings poorly predicted caries risk and future clinical outcomes. CRA incorporating multiple risk, protective, and disease indicators has superior predictive performance.

PRACTICAL IMPLICATIONS

The findings of this study do not provide evidence supporting the use of ATP-B to predict caries risk.

Prevention, prevention and prevention

A recent study by Levy et al. presents the dental treatment needs of a large sample of combat soldiers. They found that 80% need some dental care.

It is unfortunate that so many, educated, otherwise healthy young adults are in need of dental care and it indicates that more prevention of dental disease is needed.

In last years, the Ministry of Health started two projects to prevent dental disease among the very young: In Mother and Child Health Centers and in kindergartens. In a couple of years, these projects will be widely implemented. With the School Dental Service, these two projects will cover all ages from birth to 18.

In the future, with these programs implemented, soldiers should need less dental treatment.