The Impact of Integrating Oral Health Education into a Medical Curriculum

Assessment of oral manifestations of systemic health related knowledge of medical students pursuing internship programme at a tertiary health care centre

Aim

Clinicians across the entire medical profession are responsible for detection, prevention and imparting importance of oral health to the patients. However, many studies conducted so far show lack of knowledge of medical students regarding dental conditions. The present observational study was undertaken to evaluate the knowledge of oral manifestations of systemic diseases amongst medical students undergoing Internship program at a tertiary centre.

Materials & method

A self-structured Questionnaire comprising of 20 questions was used as a survey tool to assess the understanding of 100 medical students undergoing internship program. They were explained about the purpose of the study. The questionnaire consisted of an objective part Yes/No (7 questions) and subjective part designed on likert scale(13 questions). There were questions on their view on current curriculum for dentistry in medical undergraduate training and possible enhancement in teaching modalities. The subjective part had five options to choose from, Strongly agree, Agree, Neutral, Disagree And Strongly Disagree.

Statistical analysis

The responses of objective questions was recorded and percentage calculated for both options. The total score was obtained for each participant based on their reponses to the subjective questions based on the Likert scale. Student t-test was applied to calculate means between male and female students.

Results

For all objective questions, percentage was calculated for affirmative and negative responses. The responses were calculated on scale5-1 for the subjective questions. Reverse scoring was done for questions 10,11,12 i. e scale 1-5. The maximum achievable score in this category was 65 which was further divided into three category as Excellent score range 55-65, Good score range 45-54, Unsatisfactory score range 35-44. The number of students in excellent category were 11, Good 66, unsatisfactory 23. The average score obtained was 48.175. The mean scores for males was 48.0161 and for females it was 48.142. The scores were slightly better for females but the difference was statistically insignificant as (p-value = 0.455056).

Conclusion

The present study showed good level of Knowledge on oral manifestations of systemic diseases among medical students as compared to other studies which forms an integral part of medical curriculum. The students responses on enhancing dental curriculum and teaching aids for improved education tools can help the faculty provide a better teaching learning experience.

Oral Health Knowledge, Attitudes, and Clinical Practices of Pediatricians and Pediatric Residents: A Cross-Sectional Study

Background Pediatricians are the first line in the provision of healthcare for children. They can make an important contribution to the oral health of their patients because they usually see children and parents early and frequently in life. This study aims to assess the pediatricians' and pediatric residents' oral health knowledge, attitudes, and practices with patients. Methods A structured English survey was developed based on previous surveys in the literature. It collected data on oral health knowledge, attitudes, and practices. Pediatricians were visited and invited to take the survey. A link to the survey was sent via email to all pediatric residents. An oral health practice score was created based on participants' responses to the practice questions, and a linear regression assessed its predictors. Frequencies of oral health knowledge, attitudes, and practices were presented and compared between both groups by the chi-square test. Results A total of 218 pediatricians and residents were surveyed. The oral health knowledge was low overall, but it was higher among pediatricians, 10.0±1.9, compared to the residents, 8.2±2.5 (P<0.001). The attitude ranged from 66.3% agreeing with the statement "Limited time with patients makes it difficult to integrate oral health into primary care practice" to 87.4% agreeing with the statement "Primary healthcare physicians should know their local dentists to facilitate dental referral and treatment." Overall, pediatricians practice positive oral health behaviors more than pediatric residents, and higher knowledge levels predicted more positive oral health practices. Conclusion Despite acknowledging their important role in promoting oral health, pediatricians' and future pediatricians' knowledge is poor, and their participation in oral health continues to be limited. The potential for the non-dental workforce to greatly improve children's oral health is underexploited. The healthcare system should seek to integrate medical and dental practices better. Incorporating oral health into residency programs and providing continuous education courses are strongly encouraged.

Special care in dental curriculum: A transversal axis for integrating oral health with systemic health

AIMS

Distance between dentistry and medicine is a traditional and historical obstacle that affects multiple levels of the health system, especially the health policies to improve health service quality. Changes in dental education, especially involving the adoption of integrative health models in professional development, are considered essential for reducing this gap. We aimed to show a dental curriculum focused on special care as a tool for medicine-dentistry integration.

METHODS

In this study, we present a new proposal for an undergraduate dental curriculum in which topics related to special care are addressed transversally and are the core for interdisciplinary integration of oral health with systemic health. We also describe how themes related to dental home care and hospital dentistry were included in this course as basic professional competencies.

RESULTS AND CONCLUSION

This initiative is aligned with the global trend to adopt educational systems that contribute to the reduction of health care inequalities and improve health service quality.

The implication of integrating pediatric education into a pediatric dentistry course for undergraduate dental students

Background/purpose

The separation of dentistry and medicine was initiated as a historical root. The purpose of this study was to evaluate the implication of integrating pediatric education into a pediatric dentistry course (so-called the integrated pediatric dentistry course in this study) for undergraduate dental students through students' perspectives.

Materials and methods

A total of the 34 fifth-year dental students were invited to fill out the questionnaire for the integrated pediatric dentistry course survey after the class of integrated pediatric dentistry course.

Results

Of the 34 dental students, all participated in the survey with a 100% valid response rate. The results showed that most of dental students found this integrated pediatric dentistry course to be helpful in improving their knowledge and clinical skills for pediatric dentistry, and knowledge about pediatrics related to dentistry. However, in comparison, the acquisition of clinical skills was less than that of knowledge for pediatric dentistry.

Conclusion

We conclude that the integrated pediatric dentistry course improves dental students' knowledge and clinical skills about pediatric dentistry, and knowledge about pediatrics related to dentistry. Considering the effectiveness of this integrated pediatric dentistry course on students' knowledge and clinical skills, and positive attitude towards pediatric dentistry, this model shows promising for the further use in the dental education.

Oral healthcare provision at long-term care facilities in eThekwini: Perspectives of coordinators

BACKGROUND

The prevalence and impact of oral disease among long-term institutionalised residents highlight the need for a scale-up of preventive and promotional oral health services that include oral health education and training for caregiving staff. However, opportunities to improve oral healthcare services are met with challenges.

AIM

This study was undertaken to establish coordinator perspectives on oral health provision.

SETTING

Seven long-term care facilities in the eThekwini district, South Africa.

METHODS

An in-depth exploratory study was conducted with 14 purposively selected coordinators (managers and nurses). Semi-structured interviews were conducted and focused on coordinators' experience and perspectives on oral healthcare. Data were analysed using thematic analysis.

RESULTS

The following themes emerged from the study: A lack of comprehensive oral health care practices, inadequate support from the dental sector, insufficient oral health prioritisation, limited funding for oral health, and challenges associated with coronavirus disease (COVID-19). All respondents reported that no oral health initiatives existed. Plans for oral health training workshops presented with coordination and funding challenges. Oral health screening initiatives have ceased since COVID-19.

CONCLUSION

The study findings indicated that prioritisation of oral health services was inadequate. There is a need for continual oral health in-service training for caregivers and support from coordinators in guiding the implementation of oral health training programmes.Contribution: It is envisaged that the findings of this study will bring about greater coordinator involvement and collaboration with the public and private dental sectors to improve oral healthcare at long-term care facilities.

Bridging gaps in oral health education in a medical school in the United States: a pilot study

BACKGROUND

Oral health is an important component of medical education given its connection to overall health and quality of life; however, oral health is infrequently incorporated into medical school curricula in the United States. The aim of this study was to pilot a novel oral health care clerkship for United States medical students that implemented the Smiles for Life (SFL) curriculum, in-person clinical activities, and pre and post curricula assessments to assess knowledge acquisition, attitude change, and clinical skill development.

METHODS

Third year medical students at Albert Einstein College of Medicine, Bronx, New York, volunteered (n = 37) for a clerkship in oral health. Students completed the Smiles For Life National Oral Health Curriculum and participated in three half-day clinical sessions in a hospital-based dental clinic. The participants were evaluated on knowledge acquisition, attitude change, and clinical skill development through a pre and post clerkship assessment in order to assess the efficacy of the intervention.

RESULTS

There was a 23.4% increase in oral health knowledge (p < 0.001) following participation in the online modules and clerkship. Additionally, attitudes in the following domains showed improved familiarity and proficiency: causes and prevention of dental caries (78.4%, p < 0.001) and periodontal disease (83.8%, p < 0.001), provision of oral health information to patients (67.6%, p < 0.001), and ability to conduct an oral examination (62.2%, p < 0.001).

CONCLUSIONS

Third year medical students who participated in a novel oral health clerkship demonstrated significant increases in basic oral health knowledge and reported increased comfort in providing oral examinations and anticipatory guidance to patients. The results support the feasibility of this approach to incorporating oral health education into a medical school curriculum in the United States.

The impact of integrating oral health education into a microbiology curriculum for students of department of life science

Background/purpose

Good oral health is important for general health of the body. This study aimed to evaluate an innovative design incorporating oral health education related to oral pathogenic bacteria into a microbiology laboratory curriculum for students of department of life science by evaluating the students' perspectives on the oral health curriculum.

Materials and methods

Twenty-six students who took the elective course entitled "Microbiology Laboratory" in the National Taiwan Normal University in 2022 were invited to fill out the questionnaire for a presurvey regarding their familiarity with basic oral health concepts, and a postsurvey in which the students answered the same presurvey questions after finishing the class.

Results

Of the 26 students, 25 (96.15%) participated in both the presurvey and postsurvey. The results showed that the learning unit of oral health education related to oral pathogenic bacteria helped students in raising their concepts of oral health. To the questions asking that I understand the bacteria that cause dental caries and the pathogenic mechanism and I understand the bacteria that cause periodontal diseases and the pathogenic mechanism, the numbers of students who agreed both questions increased from 2 (8%) to 25 (100%), respectively. Moreover, the mean scores increased from 2.64 to 4.32 (P < 0.001) and from 2.68 to 4.32 (P < 0.001) for the two corresponding questions, respectively.

Conclusion

The learning unit of oral health education in the microbiology laboratory curriculum helped the students of department of life science to increase their awareness and understanding of oral health.

The impact of integrating oral health education into a human physiology curriculum for students of early childhood education

Background/purpose

The good oral health plays a pivotal role in improving the general health of the body. The purpose of this study was to evaluate an innovative design incorporating oral health education into a human physiology curriculum for students of early childhood education by evaluating the students' perspectives on the oral health curriculum.

Materials and methods

Forty-two first-year students who took the compulsory course entitled "Introduction to Human Physiology" in National Taiwan Normal University in 2022 were invited to fill out the questionnaire for a presurvey regarding their familiarity with basic oral health concepts, and a postsurvey in which the students answered the same presurvey questions after finishing the class.

Results

Of the 42 students, 41 (97.62%) participated in both the presurvey and postsurvey. The results showed that the learning unit of oral health education helped students in raising their concepts on oral health. To the questions asking that I understand the structure and function of the oral cavity and I understand common oral diseases (dental caries and periodontal diseases), the numbers of students who agreed increased from 12 (29.27%) to 39 (95.12%) and 11 (26.83%) to 36 (87.80%), respectively. Moreover, the mean scores increased from 3.24 to 4.20 (P < 0.001) and from 3.12 to 4.29 (P < 0.001) for the two corresponding questions, respectively.

Conclusion

In this study, the learning unit of oral health education in the human physiology curriculum for students of early childhood education helped the students to increase their awareness and understanding of oral health.

Oral medicine education for medical students - A retrospective evaluation of the course in MacKay Medical College from 2016 to 2021

Background/purpose

The oral medicine education for medical students is very important and a necessary part for the comprehensive medical education. The purpose of this study was to evaluate the oral medicine course for medical students by evaluating students' perspectives and the instructor's observation.

Materials and methods

The medical students who took the compulsory course entitled "Introduction to Oral and Maxillofacial Medicine" in MacKay Medical College from 2016 to 2021 were invited to fill out the questionnaire for course satisfaction survey regarding their satisfied level with the course and their feelings about the instructors or suggestions, and the participatory observation was performed throughout the course activities and instructor-student interactions.

Results

From 2016 to 2021, of a total of 268 medical students, 202 (75%) participated in the surveys. The results of the surveys and the instructor's observation showed that students satisfied with the course, and the course helped them to have a basic understanding of oral medicine. Moreover, all the mean scores and the rates of respondents who answered as agree for each item were 4.22-4.92 and 85%-100%, respectively.

Conclusion

In this study, the oral medicine education for medical students contributed to an increase in students' awareness and understanding of oral health and dentistry. Considering the reported effectiveness of the course, students' satisfaction with the course content and teaching materials, and the instructor's teaching, this model of providing dental and oral health knowledge for the medical students may be a good one for further use in other medical institutions.

Oral Health in America

Background

Important, but insufficient, gains have been achieved in access to and delivery of oral health care since the 2000 US surgeon general’s report on oral health in America. Access to care has increased for children and young adults, but considerable work remains to meet the oral health care needs of all people equitably. The National Institutes of Health report, Oral Health in America: Advances and Challenges, reviews the state of the US oral health care system, achievements made since 2000, and remaining challenges. In this article, the authors highlight key advances and continuing challenges regarding oral health status, access to care and the delivery system, integration of oral and systemic health, financing of oral health care, and the oral health workforce.

Results

Public insurance coverage has increased since 2000 but remains limited for many low-income, minority, and older adult populations. The oral health care workforce has expanded to include new dental specialties and allied professional models, increasing access to health promotion and preventive services. Practice gains made by women and Asian Americans have not extended to other minority demographic groups. Oral health integration models are improving access to and delivery of patient-centered care for some vulnerable populations.

Conclusions and Practical Implications

Coordinated policies and additional resources are needed to further improve access to care, develop dental insurance programs that reduce out-of-pocket costs to lower-income adults, and improve the integration of oral and medical health care delivery targeting a common set of patient-centered outcomes. Dental care professionals need to fully participate in meaningful and system-wide change to meet the needs of the population equitably.

Designing and Evaluation of an Elective Oral Health Course for Fifth-Year Medical Students of Tehran University of Medical Sciences

Objectives: This study aimed to evaluate the effect of an educational intervention on oral health-related knowledge, attitude, and practice of medical students. Materials and Methods: This study was performed on the fifth-year medical students attending an elective oral health course at the Faculty of Dentistry of Tehran University (intervention group) and 25 other students attending another elective course (control group) in 2018. A 2-week internship program including 6 sessions of a workshop program plus 2 days of school field and 2 days of attending dental departments was designed for the intervention group. Before and after the intervention, students completed a questionnaire and their simplified debris index was calculated. Statistical analysis was performed using SPSS version 24 by paired-sample t-test and general linear regression. Results: The mean age of the participants was 24.84±1.31 years in the intervention group and 23.64±1.28 years in the control group. There were 14 (56%) males in the intervention group and 16 (64%) males in the control group. At baseline, the mean knowledge, attitude and practice scores of the control and intervention groups were 26.28, 14.20 and 10.88, and 27.84, 15.80, and 9.36, respectively. After the intervention, the knowledge, attitude, debris index and willingness to adhere to oral health measures significantly improved (P<0.05). Conclusion: Oral health-related knowledge, attitude and practice of medical students were not desirable at baseline. The present study showed that even a short-term intervention in this field was effective to improve the oral health concepts in this group.

An approach to developing oral health knowledge for allied health students

BACKGROUND

Oral health competency-based education approaches have been proposed as a mechanism to address oral health outcomes and equity issues. Recommendations for oral health education for allied health professional students include practices to increase team members' knowledge and skills in the integration of oral health and primary care practice (IOHPCP) initiative's oral health clinical competencies for primary care providers.

AIMS

This study aimed to examine changes in self-reported knowledge of occupational students in the topics of oral health, the dental profession, and dental healthcare systems following participation in a series of webinars and a community-engaged learning project.

MATERIALS AND METHODS

This study utilized an oral health education program through webinars and a community-engaged learning project for occupational therapy students. Program evaluation measures were utilized to assess the oral health education activities through self-reported knowledge in oral health topics aligned with IOHPCP domains along with topics identified by the community partner organization.

RESULTS

Findings demonstrate that asynchronous webinars can increase self-reported knowledge in occupational therapy students.

DISCUSSION

Recommendations for inclusion of oral health education for allied health students related to knowledge of oral health, the dental profession, and dental healthcare systems are shared.

CONCLUSIONS

Asynchronous webinars have the potential to increase self-reported oral health knowledge for allied health professionals.

A study to assess the awareness of periodontitis and its relationship with systemic health among undergraduate medical students

Introduction The association between periodontitis and certain systemic diseases is well established; however, there is a distinct lack of research available on its awareness among medical students in the United Kingdom.Aims To determine the awareness of fourth-year undergraduate medical students concerning periodontitis including its risk factors, relationship with systemic health and students' attitudes towards oral diseases and further education.Methods We delivered an online survey via a weekly email news bulletin to 299 fourth-year medical students and received 101 completed responses.Results Medical students were largely aware of the most common features of periodontitis and recognised that systemic diseases may affect the periodontium. There was less awareness of the associations between certain systemic diseases and periodontitis and there appeared to be confusion with tooth decay. Perceived knowledge was generally reported to be poor and most students believed that further teaching would improve their medical practice.Conclusions Increased teaching on periodontitis within the medical curriculum would benefit students. This may be achieved using an integrated teaching approach. Future doctors should graduate with an adequate education on the interdisciplinary links and should be capable of signposting or referring patients early to the appropriate services where indicated to improve patient care.

Knowledgeability, Attitude and Practice Behaviors of Dental Providers Toward Provisions of Integrated Care Delivery for Patients With Prediabetes/Diabetes: Wisconsin Statewide Survey

Introduction: To conduct a statewide survey among Wisconsin-based dental providers evaluating current knowledgeability, attitudes and practice behaviors surrounding management of patients with diabetes/prediabetes in the dental setting. The study explored perceptions on feasibility, value, barriers, and current status of integrated care model (ICM) adoption by dental practices

Materials and Methods: A 32-question paper-based survey was mailed to all licensed dentists and dental hygienists practicing in Wisconsin. The study was conducted over a 4 week period in 2019. The survey instrument was adapted from a previous validated survey and was expanded to include questions on ICM adoption. Content and validity analyses and beta testing were conducted prior to dissemination of the survey. Descriptive statistics and chi-square tests were applied for data analyses. Thematic analyses was performed on open-ended questions.

Results: Survey response rate was 12% (N = 854/7,356) representing 41% dentists and 59% dental hygienists. While 68% reported educating patients on oral health-diabetes association, only 18% reported medical consultations to inform dental treatment, and “frequent” (22%) or “occasional” (40%), medical triage. Knowledge-based questions were correctly answered by &gt;70% of participants. While 50% valued chair-side glycemic screening and 85% supported non-invasive chair-side screening to identify at-risk patients,&gt;88% relied on patient-reported diabetic status. Barriers to ICM adoption included time investment (70%), patient activation/cooperation (62%), cost (50%), insurance coverage (50%), infrequent interdisciplinary communication (46%), lack of equipment (33%) and provider (31%).

Conclusion: Low rates of ICM adoption, chair-side testing, medical consultation and triage, and need for educational curricula reform were identified.

Medical-Dental Integration-Achieving Equity in Periodontal and General Healthcare in the Indian Scenario

Aims:

Dentistry and medicine have been treated as separate entities by healthcare professionals as well as the populace since a long time. Although dentistry as a standalone entity has achieved considerable progress, there is a significant inequity in the accessibility, affordability, and acceptability of dental care among various socioeconomic strata in the community. Moreover, it is becoming increasingly evident that oral diseases and systemic diseases often share multiple risk factors. Management of oral and systemic diseases as distinct units often results in duplication of care and wastage of resources. This paper gives information on the models of medical-dental integration and possible methods for integrating the same into Indian healthcare scenario.

Materials and Methods:

A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for articles pertaining to medical-dental integration. The data obtained were collated.

Results:

Literatures show that different modalities for medical-dental integration are in practice. However, there is a paucity in conceptual models that may be applied to bring about such an integration into the Indian healthcare system.

Conclusion:

Integration of medical and dental care would pave the way for equity in health care for everyone. Conceptual models for integrating oral disease surveillance into systemic disease have been proposed in this paper.

Oral Health Disorders in Parkinson's Disease: More than Meets the Eye

Despite clinical evidence of poor oral health and hygiene in Parkinson’s disease (PD) patients, the mouth is often overlooked by both patients and the medical community, who generally focus on motor or psychiatric disorders considered more burdensome. Yet, oral health is in a two-way relationship with overall health—a weakened status triggering a decline in the quality of life. Here, we aim at giving a comprehensive overview of oral health disorders in PD, while identifying their etiologies and consequences. The physical (abnormal posture, muscle tone, tremor, and dyskinesia), behavioral (cognitive and neuropsychiatric disorders), and iatrogenic patterns associated with PD have an overall detrimental effect on patients’ oral health, putting them at risk for other disorders (infections, aspiration, pain, malnutrition), reducing their quality of life and increasing their isolation (anxiety, depression, communication issues). Interdisciplinary cooperation for prevention, management and follow-up strategies need to be implemented at an early stage to maintain and improve patients’ overall comfort and condition. Recommendations for practice, including (non-)pharmacological management strategies are discussed, with an emphasis on the neurologists’ role. Of interest, the oral cavity may become a valuable tool for diagnosis and prognosis in the near future (biomarkers). This overlooked but critical issue requires further attention and interdisciplinary research.

Knowledge, attitudes and practices of patients and healthcare professionals regarding oral health and COPD in São Paulo, Brazil: a qualitative study

Poor oral health is associated with worse clinical outcomes in Chronic Obstructive Pulmonary Disease (COPD). This qualitative study aimed to investigate the knowledge, attitudes and practices of COPD patients and primary health care professionals (HCPs) in Brazil - where there are high rates of COPD and periodontal disease. Semi-structured interviews with COPD patients (n = 9) and three semi-structured focus groups with HCPs (n = 25) were conducted in São Paulo. Interviews were thematically analysed using The Framework Method. Despite a high prevalence of edentulism, patients viewed tooth loss and decay as a norm and neglected preventative oral health practices. HCPs blamed patients for avoiding preventative opportunities, whilst patients discussed significant barriers to oral healthcare. Knowledge of the relationship between oral health and COPD was lacking among HCPs and patients, but all participants were receptive to oral health education. Practitioners identified the need for a COPD primary care pathway that integrates oral health protocols. This study indicates that Brazil must incorporate preventative oral health into COPD management and expand public dental services to increase uptake.

Knowledge, Attitude, and Practice of Oral Hygiene Among Students of a Private University

OBJECTIVE

The objective of the study was to evaluate the knowledge, attitude, and practice among pre-final and final year students of pharmacy, medicine, biotechnology, and business faculties about oral hygiene.

MATERIALS AND METHODS

A cross-sectional observational study was conducted to evaluate the knowledge, attitude, and practice of students towards oral hygiene at a private university in Malaysia. Validated questionnaires were distributed to a convenient stratified sample of 324 students studying in the different selected faculties, namely pharmacy, medicine, biotechnology, and business, respectively. The Statistical Package for Social Science (SPSS) Version 24.0 was used to analyze the data.

RESULTS

With regard to knowledge, upon evaluation, it was seen that the students of the Faculty of Pharmacy had the highest percentage of adequate knowledge, which was statistically significant with a P-value of 0.001 and the effect size of 0.246. On the evaluation of attitudes, it was seen that the Faculty of Biotechnology had the highest positive attitudes. According to race, Malay students had the highest positive attitude among all the races that participated in the study, which showed a P-value of 0.037 with the effect size of 0.034. Regarding practice, the Faculty of Pharmacy had the lowest practice compared with the other faculties. This variable had a P-value of 0.001 and showed to have significance against the practice with an effect size of 0.193.

CONCLUSION

Overall, a good attitude was seen amongst the students on their oral hygiene. It was also observed that the attitude, knowledge, and practice of the students in a private university increased with an increasing level of education.

Oral Health Attitudes among Preclinical and Clinical Dental Students: A Pilot Study and Self-Assessment in an Egyptian State-Funded University

Dentists should present to patients as good role models in their oral health behaviour. Previous studies have demonstrated how education can improve dental students’ oral health. This pilot investigation aimed to compare and evaluate the features of the oral health behaviour and attitudes of preclinical and clinical dental students at Ain Shams University, a public Egyptian university. The Hiroshima University-Dental Behaviour Inventory (HU-DBI) survey was provided to 149 (78 female/71 male) dental students. Dichotomised (agree/disagree) answers to 20 HU-DBI items were possible, with a maximum conceivable score of 19. An estimation of oral health behaviour and attitudes was calculated by the sum of correct oral health answers to every item by the study groups and evaluated statistically. The score of oral health-favouring answers was higher in clinical (11.50) than preclinical students (10.63) and was statistically significant (p < 0.05). Single-item evaluations showed no statistical significance, except in one survey item. This survey exhibited weak differences in the improvement of oral hygiene behaviour and attitudes between participating preclinical and clinical students, as well as overall poor oral health behaviour in both groups. This inadequacy of Egyptian public dental education in terms of sufficient student oral health progress emphasises the necessity for supplementary courses and curricular reviews that accentuate the need for future dentists to display the correct oral health behaviour.

Diabetes mellitus and periodontal disease: The call for interprofessional education and interprofessional collaborative care - A systematic review of the literature

Diabetes mellitus and periodontal disease are among the most frequently occurring conditions that have a substantial effect on the global health economy. The literature regarding medical professionals' knowledge of the bidirectional link between diabetes mellitus and periodontal disease has not been analyzed systematically. The review aimed to investigate the knowledge and understanding of physicians and specialists regarding the two-way relationship between diabetes mellitus and periodontal disease and their approach to referring their patients for a dental consultation. An electronic search of PubMed and Google Scholar databases was conducted to review the studies that assessed knowledge and understanding of medical professionals regarding the relationship between diabetes mellitus and periodontal disease. Data from 13 included studies involved 4,027 participants: 3,256 primary care physicians and 771 medical specialists. Just over 50% of the medical professionals had an understanding of oral health and/or periodontal disease. Over one-third of medical professionals were ignorant of the relationship between oral health and diabetes mellitus. Only 30% reported ever referring their patients for an oral health assessment. Another key finding of the investigation was the absence of interprofessional collaborative care between medical and dental professionals while managing patients with diabetes mellitus. Medical professionals with an integrated knowledge of elementary oral health education and training could play a central role in the timely diagnosis and management of periodontal disease in patients living with diabetes mellitus.

Oral Health Attitudes among Preclinical and Clinical Dental Students in Germany

Oral health care providers are expected to show good examples of oral health behaviours and attitudes to their community. Previous studies displayed the constructive effect of dental education on oral hygiene manners of undergraduate students. The aim of this survey was to assess and compare aspects of oral health attitudes and behaviours between preclinical and clinical dental students in German universities. The German-language version of the HU-DBI was distributed to preclinical and clinical students from different German universities. Dichotomized (agree/disagree) responses to 20 HU-DBI items were provided in this study, with a maximum possible score of 19. A quantitative estimate of oral health attitudes and behaviours was provided by the total of appropriate answers given to every statement by each group. Data were analysed statistically. The overall mean score of answers favouring good oral hygiene was marginally higher in preclinical (14.62) than clinical students (14.31) but showed no statistical significance. Similarly, the analysis of each item individually displayed no statistically significant differences between preclinical and clinical participants, except in a single item of the survey. This study showed no effective differences in oral hygiene attitudes and behaviour between preclinical and clinical students in German universities. This reveals a weak effect of dental education on improving students' oral health attitudes in Germany and might demand the introduction of more courses emphasizing the importance of correct oral health behaviour of health care providers.

Knowledge and attitude of male schoolteachers towards primary dental care

Introduction:

Children are the most important natural resources. School is a location which helps to promote the health of staff, families, and community members along with the students. Teachers are the most resourceful manpower available to deliver any healthcare at school setup.

Aims and Objectives:

To assess the knowledge and attitude towards primary dental care among male schoolteachers at Al-Kharj Saudi Arabia.

Methodology:

A descriptive cross-sectional questionnaire survey was carried out involving male teachers working in primary schools at Al-Kharj KSA. A total of 350 teachers were included in this study. The data were collected using a self-administered questionnaire survey consisting of 17 questions related to knowledge and attitude towards dental care and oral hygiene practices.

Results:

The overall knowledge was fair among the schoolteachers (65.4%). Al-Kharj male schoolteachers were having a positive attitude. Teaching experience and knowledge showed a statistically significant relation (P < 0.05.

Conclusion:

Although primary schoolteachers had a fair knowledge and good attitudes towards dental care, there is a need to conduct training programs about oral health education in schools and check how teachers educate their children to maintain dental care.

Oral health care in the 21st century: It is time for the integration of dental and medical education

Major issues exist in the provision of oral health care in America, especially to underserved populations. Access to care, health disparities, an aging population with higher chronic disease burden, and rising healthcare costs continue to impact health outcomes for millions. The marginalization of oral health care, like that of behavioral health care, is a contributor. This perspective presents an idea whose time has come: putting the mouth back in the body. Several national reports stress the imperative to better integrate the practice of medicine and dentistry, including the first-ever Surgeon General's Report on Oral Health in 2000. A plan to lead a multifaceted integration of oral health into overall health is proposed. Leaders will come from new educational and practice models stressing teamwork, interprofessional education, innovative residency training programs and even dual degree options.

An evaluation of the effectiveness of dental health training administered at a health services school

ISSUE ADDRESSED

The aim of this study was to determine the knowledge and behaviour of health technician students to determine their oral health (OH) status, and to evaluate the effectiveness of a structured education administered for increasing OH awareness.

METHODS

Interventional research was performed between December 2018 and March 2019 on 445 Vocational School of Health Services students in … University. Questionnaires were conducted under observation. The first questionnaire (Q1) included socio-demographic characteristics, OH knowledge level, attitudes and behaviours. One month after the OH training was given to the students, the same questions in Q1 were asked again in the second questionnaire (Q2). Dental caries and Simplified Oral Hygiene Index (OHI-S) status were determined by a dentist via a clinical oral examination.

RESULTS

Of the 445 students, 416 (93.5%) participated in the study and completed the Q1 and Q2 questionnaires. A total of 277 (66.6%) students were female and 139 (33.4%) were male, with the age range being 17-33 years (average: 19.2 ± 1.86 years). Of the 416 students who answered the Q1 and Q2 questionnaires, 385 received oral examinations. While the Q1 knowledge score was 7.06 ± 2.08, the Q2 was found to be 12.36 ± 2.90 (P < .001). It was seen that 119 (30.9%) students who had poor OHI-S and 120 (31.2%), had a mean number of decayed, missing and filled teeth (DMFT) value of 6 and above. It was found that the females had better OH values ​​than males (P < .001) and smokers had worse OH values overall (P < .016).

CONCLUSION

It was observed that the health technician students had a low level of knowledge about OH before the training but after receiving the training, their knowledge, attitude and behaviour changed positively. SO WHAT?: It was concluded that the OH education given to students caused a positive change in their behaviour, attitude and knowledge.

Oral Health Awareness among International Dental and Medical Students at Lithuanian University of Health Sciences: a Cross-Sectional Study

Objectives

To evaluate the self-reported oral health awareness, knowledge and attitude among international dental and medical students at the Lithuanian University of Health Sciences (Kaunas, Lithuania).

Material and Methods

A cross-sectional study was conducted among international medical and dental students at the Lithuanian University of Health Sciences in 2016 - 2017. The students were invited to participate in the survey before the beginning of a lecture, and they were informed that participation was voluntary and anonymous. In total, 282 students participated in the study, with a response rate of 92.1%. A self-administered English questionnaire consisting of 25 items with options on a Likert scale (agree, neither agree nor disagree and disagree) about oral health problems and their relation to general health status was used to assess a student’s oral health awareness, attitude and knowledge. The level of significance was set at P < 0.05.

Results

Overall good, fair and poor oral health awareness was reported by 71.3%, 24.1% and 4.6%, respectively, of the international dental and medical students (P < 0.05). The mean score of oral health awareness was 18.2 (standard deviation [SD 3.27]), showing overall good oral health awareness. Moreover, the international dental students reported higher oral health awareness than medical students (19.14 [SD 3.25] vs 17.44 [SD 3.1]) (P < 0.001). Comparing this mean score by gender, no statistically significant difference was found (18.33 [SD 3.39] vs 18.05 [SD 3.16]) (P = 0.371).

Conclusions

Overall oral health awareness among international dental and medical students was high. Meanwhile, international dental students reported higher oral health awareness than international medical students.

Knowledgeability, attitude, and practice behaviors of primary care providers toward managing patients' oral health care in medical practice: Wisconsin statewide survey

BACKGROUND

In this study, the authors sought to explore the receptivity, preparedness, and rates of adoption of integrated medical-dental models of care (MOCs) in the practice setting among primary care providers (PCPs) treating patients with diabetes mellitus (DM).

METHODS

The authors conducted an anonymous statewide survey targeting PCPs across a range of Wisconsin-based practice settings to evaluate knowledgeability, attitude, practice behaviors, and perceived barriers to oral health screening in a medical setting. Qualitative analytical approaches included thematic analyses applied to evaluate the status of and barriers to integrated medical-dental MOC adoption.

RESULTS

The integrated medical-dental MOC adoption rate was 34%. Top perceived barriers to integrated medical-dental MOC adoption included insurance coverage (71%) and care access (70%). A total of 39% indicated competency for educating patients about the association between DM and periodontitis. Although 72% of PCPs indicated optimal periodicity for oral health assessment as frequent, 39% reported frequently conducting such assessments.

CONCLUSIONS

Although PCPs indicate receptivity to integrated medical-dental MOCs, PCPs identify suboptimal education, lack of adequate training in oral-systemic disease assessment, and barriers to oral health care access as barriers to integrated medical-dental MOC adoption.

PRACTICAL IMPLICATIONS

Integrated medical-dental MOC adoption in care delivery to patients with DM remains below average. Interdisciplinary efforts and education are needed to address identified barriers to care integration.

Estimating the costs of the national basic public health services in Zhuhai, China, through activity-based costing: a cross-sectional study

OBJECTIVE

Our research aims to estimate the per capita cost of 13 items in the basic public health service (BPHS) project in Zhuhai, China, and provide an economical basis for the improvement of the cost compensation mechanism used by the government.

DESIGN

This research is a cross-sectional study.

SETTING

A total of 19 primary healthcare facilities (PHFs) in Zhuhai, China, are involved in this research.

PARTICIPANTS

A total of 152 participants (114 personnel engaged in BPHS, 19 financial personnel and 19 PHF heads) were included in this study, which was conducted from May 2017 to July 2017.

PRIMARY AND SECONDARY OUTCOME MEASURES

We used the activity-based costing model to calculate the cost of providing BPHS in Zhuhai. An analytical hierarchy process was used to determine the difficulty dimension and workload coefficient.

RESULTS

The weights of the difficulty dimensions in the provision of BPHS in Zhuhai were 35.04% (coordination of residents), 24.03% (staff workload), 21.36% (complexity of work-related skills) and 19.59% (basic qualities of staff). The average difficulty coefficient of each subproject was 5.28. The actual per capita cost of BPHS provision in 2016 was 97.48 RMB (12.76 EUR), which was higher than the actual standard compensation of 55 RMB (7.2 EUR) in Zhuhai. Immunisation was the most costly among the 13 service items (17.82 RMB or 2.33 EUR per person), whereas the management of tuberculosis was the least costly item (0.57 RMB or 0.07 EUR per person).

CONCLUSIONS

Government funds for basic public health services cannot compensate for the actual costs. Accordingly, subsidies should be increased based on the actual per capita cost for sustainable BPHS development. The government should improve the methods used in cost estimation and measures used as the basis for awarding performance incentives.

Orthodontically Relevant Manifestations in People with Rare Diseases

BACKGROUND

Approximately 15% of all rare diseases occur with orofacial manifestations. Symptoms and manifestations of relevance to orthodontists represent a considerable proportion of these diseases and require appropriate strategies for their treatment. This article provides an overview of the orthodontically relevant manifestations of rare diseases.

MATERIAL AND METHODS

Overall, 3,639 rare diseases listed at the Orphanet, OMIM or Pubmed database were evaluated for orofacial manifestations. All rare diseases which were indicated with at least one orofacial manifestation were recorded in a database for rare diseases with orofacial manifestations called "ROMSE," which was developed by the authors. All the rare diseases were analysed with regard to orthodontically relevant orofacial manifestations, such as dysgnathia, changes in the number of teeth, failures of eruption, pathologies of bone metabolism or orofacial clefts. For all rare diseases with orthodontic relevance, an exact analysis was undertaken.

RESULTS

The orthodontically relevant orofacial manifestation termed dysgnathia is described in 151 of 535 identified rare diseases (28.2%). In these 151 rare diseases, 15 different subforms of dysgnathia, in the sense of skeletal misdevelopments of the jaws but without dental abnormalities, were described. Also changes in the number of teeth (17.9%), orofacial clefts (27.6%), failures of eruption (8.4%) and pathologies of the bone (2.1%) were described.

CONCLUSIONS

Orthodontics play an important role in the diagnosis and treatment of orofacial manifestations in rare diseases. Databases such as ROMSE are a first step toward providing valid information in publicly accessible databases.