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Marshman Z, Ainsworth H, Fairhurst C, Whiteside K, Sykes D, Keetharuth A, El Yousfi S, Turner E, Day PF, Chestnutt IG, Dixon S, Kellar I, Gilchrist F, Robertson M, Pavitt S, Hewitt C, Dey D, Torgerson D, Pollard L, Manser E, Seifo N, Araujo M, Al-Yaseen W, Jones C, Hicks K, Rowles K, Innes N. Behaviour change intervention (education and text) to prevent dental caries in secondary school pupils: BRIGHT RCT, process and economic evaluation. Health Technol Assess 2024; 28:1-142. [PMID: 39258962 DOI: 10.3310/jqta2103] [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] [Indexed: 09/12/2024] Open
Abstract
Background The presence of dental caries impacts on children's daily lives, particularly among those living in deprived areas. There are successful interventions across the United Kingdom for young children based on toothbrushing with fluoride toothpaste. However, evidence is lacking for oral health improvement programmes in secondary-school pupils to reduce dental caries and its sequelae. Objectives To determine the clinical and cost effectiveness of a behaviour change intervention promoting toothbrushing for preventing dental caries in secondary-school pupils. Design A multicentre, school-based, assessor-blinded, two-arm cluster randomised controlled trial with an internal pilot and embedded health economic and process evaluations. Setting Secondary schools in Scotland, England and Wales with above-average proportion of pupils eligible for free school meals. Randomisation occurred within schools (year-group level), using block randomisation stratified by school. Participants Pupils aged 11-13 years at recruitment, who have their own mobile telephone. Interventions Two-component intervention based on behaviour change theory: (1) 50-minute lesson delivered by teachers, and (2) twice-daily text messages to pupils' mobile phones about toothbrushing, compared with routine education. Main outcome measures Primary outcome: presence of at least one treated or untreated carious lesion using DICDAS4-6MFT (Decayed, Missing and Filled Teeth) in any permanent tooth, measured at pupil level at 2.5 years. Secondary outcomes included: number of DICDAS4-6MFT; presence and number of DICDAS1-6MFT; plaque; bleeding; twice-daily toothbrushing; health-related quality of life (Child Health Utility 9D); and oral health-related quality of life (Caries Impacts and Experiences Questionnaire for Children). Results Four thousand six hundred and eighty pupils (intervention, n = 2262; control, n = 2418) from 42 schools were randomised. The primary analysis on 2383 pupils (50.9%; intervention 1153, 51.0%; control 1230, 50.9%) with valid data at baseline and 2.5 years found 44.6% in the intervention group and 43.0% in control had obvious decay experience in at least one permanent tooth. There was no evidence of a difference (odds ratio 1.04, 95% confidence interval 0.85 to 1.26, p = 0.72) and no statistically significant differences in secondary outcomes except for twice-daily toothbrushing at 6 months (odds ratio 1.30, 95% confidence interval 1.03 to 1.63, p = 0.03) and gingival bleeding score (borderline) at 2.5 years (geometric mean difference 0.92, 95% confidence interval 0.85 to 1.00, p = 0.05). The intervention had higher incremental mean costs (£1.02, 95% confidence interval -1.29 to 3.23) and lower incremental mean quality-adjusted life-years (-0.003, 95% confidence interval -0.009 to 0.002). The probability of the intervention being cost-effective was 7% at 2.5 years. However, in two subgroups, pilot trial schools and schools with higher proportions of pupils eligible for free school meals, there was an 84% and 60% chance of cost effectiveness, respectively, although their incremental costs and quality-adjusted life-years remained small and not statistically significant. The process evaluation revealed that the intervention was generally acceptable, although the implementation of text messages proved challenging. The COVID-19 pandemic hampered data collection. High rates of missing economic data mean findings should be interpreted with caution. Conclusions Engagement with the intervention and evidence of 6-month change in toothbrushing behaviour was positive but did not translate into a reduction of caries. Future work should include work with secondary-school pupils to develop an understanding of the determinants of oral health behaviours, including toothbrushing and sugar consumption, particularly according to free school meal eligibility. Trial registration This trial is registered as ISRCTN12139369. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 15/166/08) and is published in full in Health Technology Assessment; Vol. 28, No. 52. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Hannah Ainsworth
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Caroline Fairhurst
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Katie Whiteside
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Debbie Sykes
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Anju Keetharuth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Sarab El Yousfi
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Emma Turner
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Peter F Day
- School of Dentistry, University of Leeds, Leeds, UK
- Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | | | - Simon Dixon
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ian Kellar
- School of Psychology, University of Leeds, Leeds, UK
| | - Fiona Gilchrist
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Sue Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
| | - Catherine Hewitt
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Donna Dey
- School of Humanities, Social Sciences and Law, University of Dundee, Dundee, UK
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Lesley Pollard
- Children and Young People's Empowerment Project, Sheffield, UK
| | - Emma Manser
- Children and Young People's Empowerment Project, Sheffield, UK
| | - Nassar Seifo
- School of Dentistry, University of Dundee, Dundee, UK
| | | | | | - Claire Jones
- School of Medicine, University of Dundee, Dundee, UK
| | - Kate Hicks
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | - Nicola Innes
- School of Dentistry, Cardiff University, Cardiff, UK
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Alvenfors A, Lingström P, Oskarsson E, Milton C, Bernson J. Finding the person behind caries disease: The dental caregivers' experiences of empowering patients to implement beneficial behavioral changes. J Dent 2024; 145:104990. [PMID: 38583646 DOI: 10.1016/j.jdent.2024.104990] [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: 02/07/2024] [Revised: 04/02/2024] [Accepted: 04/05/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES This study aimed to elucidate dental professionals' experiences of how to empower patients at risk of developing new or additional caries to promote caries-related preventive behavioral changes. METHODS Semi-structured in-depth interviews were conducted, audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. To provide credibility and high-quality data, participant recruitment followed strategic sampling. The 10 participants included nine women and one man; six participants were dentists, and four were dental hygienists. In the data analysis, five descriptive and five strategic themes emerged that formed an overarching theme: Finding the person behind caries disease. RESULTS The results indicated that by initially getting to know the person behind the patient, trusting relationships and knowledge can be generated to successfully influence patients' behaviors related to caries. The five descriptive themes included: Building a treatment alliance, Understanding habitual patterns, Motivating for changes, Implementing new behaviors, and Preserving behavioral improvements. The descriptive themes each revealed a strategy theme containing several strategy proposals for initiating and supporting caries-preventing behavioral changes. CONCLUSIONS This study highlights the importance of establishing a treatment alliance to improve the patient's skills, knowledge, and motivation. It underscores the significance of recognizing the individual behind the patient, to facilitate optimal behavior change at the lowest possible level of treatment. CLINICAL SIGNIFICANCE Our findings could assist in strengthening caries-related health promotion, caries prevention, and understanding of oral health literacy techniques.
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Affiliation(s)
- Adam Alvenfors
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden; Public Dental Service in Region Västra Götaland, Skövde, Sweden.
| | - Peter Lingström
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
| | | | - Cecilia Milton
- Public Dental Service in Region Jönköping, Jönköping, Sweden
| | - Jenny Bernson
- Department of Cariology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, SE-405 30 Gothenburg, Sweden
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Gomersall JC, Slack-Smith L, Kilpatrick N, Muthu MS, Riggs E. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2024; 5:CD012155. [PMID: 38753314 PMCID: PMC11098061 DOI: 10.1002/14651858.cd012155.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Dental caries, a common chronic disease of childhood, 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). This review updates one published in 2019. OBJECTIVES To assess the effects of interventions undertaken 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). SEARCH METHODS We searched Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL EBSCO, the US National Institutes of Health Ongoing Trials Register (clinicaltrials.gov) and WHO International Clinical Trials Registry Platform (apps.who.int/trialsearch). The latest searches were run on 3 January, 2023. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing interventions with pregnant women, or new mothers and other primary caregivers of infants in the first year of life, against standard care, placebo or another intervention, reporting on a primary outcome: caries presence in primary teeth, dmfs (decayed, missing, filled primary surfaces index), or dmft (decayed, missing, filled teeth index), in children up to six years of age. Intervention types include clinical, oral health promotion/education (hygiene education, breastfeeding and other dietary advice) and policy or service. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence (GRADE). MAIN RESULTS We included 23 RCTs (5 cluster-randomised), involving 25,953 caregivers (mainly mothers) and their children. Fifteen trials assessed oral health education/promotion interventions against standard care. Six trials assessed a clinical intervention for mother dentition, against placebo, or a different type of clinical intervention. Two trials assessed oral health/education promotion plus clinical intervention (for mother's dentition) against standard care. At most, five trials (maximum of 1326 children and 130 mothers) contributed data to any comparison. Enamel-only caries were included in the diagnosis of caries in some studies. For many trials, the risk of bias was unclear due to lack of methodological details reported. In thirteen trials, participants were socioeconomically disadvantaged. No trial indicated receiving funding that was likely to have influenced their results. Oral health education/promotion interventions 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 slightly lower mean dmfs (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, the evidence is very uncertain regarding the difference between groups in mean dmft (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). Breastfeeding promotion and support versus standard care: We observed little or no 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) and in mean dmft (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). dmfs was not reported. Child diet advice compared with standard care: We are very uncertain about the effect on the 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. Oral hygiene, child diet and feeding practice advice versus standard care: The evidence is very uncertain about the effect on the risk of caries presence in primary teeth (RR 0.73, 95% CI 0.50 to 1.07; 5 trials; 1326 participants; very low-certainty evidence) and there maybe little to no difference in mean dmfs (MD -0.87, 95% CI -2.18 to 0.43; 2 trials; 657 participants; low-certainty evidence) and mean dmft (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; low-certainty evidence). High-dose versus low-dose vitamin D supplementation during pregnancy: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.99, 95% CI 0.70 to 1.41; 1 trial; 496 participants; very low-certainty evidence). dmfs and dmft were not reported. Clinical interventions (for mother dentition) Chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo: We are very uncertain regarding the difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment for mother dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trial reported dmfs or dmft. Xylitol compared with CHX antimicrobial treatment: We are very uncertain about the effect on caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence), but we observed there may be a lower mean dmft with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence). No trial reported dmfs. Oral health education/promotion plus clinical interventions (for mother dentition) Diet and feeding practice advice for infants and young children plus basic dental care for mothers compared with standard care: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.44, 95% CI 0.05 to 3.95; 2 trials, 324 participants; very low-certainty evidence) or on mean dmft (1 study, not estimable). No trial reported dmfs. No trials evaluated policy or health service interventions. AUTHORS' CONCLUSIONS There is moderate-certainty evidence 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 intervention types and features may be effective for preventing ECC, and in which settings. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine the effects and relative effects of different interventions and inform practice. We have identified 13 ongoing studies. Future studies should consider if and how effects are modified by intervention features and participant characteristics (including socioeconomic status).
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Affiliation(s)
- Judith C Gomersall
- Life Course and Intergenerational Health Research Group, Robinson Research Institute and School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Nicky Kilpatrick
- Vascular Biology, Murdoch Children's Research Institute, Melbourne, Australia
- Plastic and Maxillofacial Surgery, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Carlton, Australia
| | - M S Muthu
- Centre for Early Childhood Caries Research, Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Australia
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Lumsden CL, Edelstein BL, Leu CS, Zhang J, Rubin MS, Andrews H. Change in parental knowledge and beliefs about early childhood dental caries following a pragmatic community-based trial. J Public Health Dent 2024. [PMID: 38684426 DOI: 10.1111/jphd.12620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To evaluate parent knowledge and belief changes following the MySmileBuddy (MSB) early childhood caries (ECC) intervention. METHODS Pre- and post-intervention surveys were completed by 669 parents of children with visually-evident ECC from among 977 participants in a 6-12-month pragmatic community-based caries management trial administered by community health workers (CHWs). Six domains of knowledge about caries and motivating and facilitating determinants were assessed via 26 survey items. Principal components analysis and reliability testing reduced dataset dimensionality. Parent and CHW characteristics were analyzed as potential moderators. Paired T-tests measured pre-to-post-intervention changes. Generalized estimating equations accounted for within-participant correlation with significance set at p < 0.05. RESULTS Twenty items consolidated into five factors (saliva, hygiene, diet, seriousness/susceptibility, and outcome expectations). Six additional items were evaluated individually. Positive post-intervention changes (p < 0.0001) were observed across all factors and all but one individual item (tooth decay is very common). Greatest knowledge increases related to caries as a bacterial disease in two measures, the saliva factor and a single caries belief item tooth decay is an infectious disease (0.59 unit increase, 95% CI [0.55, 0.64] and 0.46 unit increase, 95% CI [0.4, 0.51], respectively), and in the value of fluoridated water over bottled (0.46 unit increase, 95% CI [0.39-0.53]). Most parents improved knowledge of ECC salivary (72%) and dietary risks (57%), and preventative hygiene behaviors (59%). CONCLUSIONS MSB enhanced knowledge and beliefs about caries and confirmed hypothesized mediators of behavior change among parents of high-risk children. Engaging peer-like CHW interventionists may have moderated intervention effects, warranting further exploration.
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Affiliation(s)
- Christie L Lumsden
- Section of Oral, Diagnostic, and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York, USA
| | - Burton L Edelstein
- Department of Health Policy and Management, Professor Emeritus of Dental Medicine (in Pediatric Dentistry) and Health Policy & Management at Columbia University Irving Medical Center, Columbia University College of Dental Medicine and Mailman School of Public Health, New York, New York, USA
| | - Cheng-Shiun Leu
- Department of Biostatistics, Mailman School of Public Health, New York, New York, USA
| | - Jiaqing Zhang
- Department of Human Development, Teachers College Columbia University, New York, New York, USA
| | - Marcie S Rubin
- Section of Growth and Development, Columbia University College of Dental Medicine, New York, New York, USA
| | - Howard Andrews
- Columbia Data Coordinating Center, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
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Durey A, Ward P, Haynes E, Baker SR, Calache H, Slack-Smith L. Applying Social Practice Theory to Explore Australian Preschool Children's Oral Health. JDR Clin Trans Res 2024:23800844241235615. [PMID: 38623874 DOI: 10.1177/23800844241235615] [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: 04/17/2024] Open
Abstract
INTRODUCTION Despite substantial research and provision of dental care, significant morbidity remains for children's oral health. Guided by social practice theory (SPT), this research moves away from the often-ineffective focus on changing individual behavior to rethinking the centrality of the social world in promoting or undermining oral health outcomes. We define social practice as a routinized relational activity linking and integrating certain elements (competence, materials, and meanings) into the performance of a practice that is reproduced across time and space. OBJECTIVE To investigate oral health in preschool children in Perth, Western Australia, using social practice theory. METHODS With no definitive methodology for investigating SPT, we chose focused ethnography as a problem-focused, context-specific approach using mainly interviews to investigate participants' experience caring for their children's oral health. The focus of analysis was the practice of oral health care, not individual behavior, where themes identified from participants' transcripts were organized into categories of elements and performance. RESULTS Eleven parents, all of whom were married or partnered, were interviewed in 2021. Findings identified social practices relevant to oral health within parenting and family relations linked to routine daily activities, including shopping, consumption of food and beverages, and toothbrushing. Oral health literacy was reflected in integrating competence, materials, and meanings into performing oral health care, notably preferences for children to drink water over sugary beverages and information often being sourced from social media and mothers' groups rather than health providers. CONCLUSION Focusing on social practices as the unit of analysis offers a more layered understanding of elements in young children's oral health care that can indicate where the problem may lie. Findings provide an opportunity to consider future research and policy directions in children's oral health. KNOWLEDGE TRANSFER STATEMENT Examining social practices related to young children's oral health care identifies parents/carers' knowledge about, for example, toothbrushing, the resources required, and why toothbrushing is important. Analyzing these separate elements can reveal both enablers and barriers to oral health care. This provides researchers, clinicians and policymakers an opportunity to focus on not changing individual behavior but understanding how social context impacts parents/carers' capacity to make optimum decisions around young children's oral health.
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Affiliation(s)
- A Durey
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - P Ward
- Research Centre for Public Health, Equity and Human Flourishing, Torrens University, Adelaide, SA, Australia
| | - E Haynes
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - S R Baker
- School of Clinical Dentistry, Sheffield University, Sheffield, UK
| | - H Calache
- La Trobe University, Department of Clinical Sciences, La Trobe Rural Health School, Bendigo, VIC, Australia
| | - L Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
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Lumsden C, Edelstein B, Leu C, Zhang J, Levine J, Andrews H. Behavioral Outcomes of a Pragmatic Early Childhood Caries Management Trial. JDR Clin Trans Res 2024; 9:140-149. [PMID: 37553996 PMCID: PMC11289954 DOI: 10.1177/23800844231189483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES To evaluate a preventative behavioral intervention for managing early childhood caries (ECC) in a cohort of high-risk children. METHODS This pragmatic trial of the MySmileBuddy Program (MSB) evaluated preventive behavioral outcomes in a 1-y community health worker-delivered intervention to prevent ECC progression. Pre-/postintervention surveys assessed parent-reported child engagement in therapeutic toothbrushing (i.e., adult-assisted brushing with fluoridated toothpaste twice daily) and caries-related dietary behaviors and barriers. Generalized linear model with identity link for continuous variables and logit link for dichotomous outcomes evaluated pre-/postintervention comparisons and generalized estimating equations accounted for within-participant correlation (α = 0.05). RESULTS Among 1,130 children with postintervention data, the average age was 3.97 y, 99% were Medicaid insured, and 88% were Hispanic. Most parents (95%) were mothers/grandmothers, married or in a committed partnership (75%), unemployed (62%), and with modest education (80% high school degree or less). The odds of reported therapeutic brushing nearly doubled (n = 864; odds ratio [OR] = 1.79, 95% confidence interval [CI] = 1.46, 2.20, P < 0.001); day and night bottle/sippy cup frequencies dropped 0.29 units (n = 871; 95% CI = -0.37, -0.33, P < 0.001) and 0.22 units (n = 1,130; 95% CI = -0.30, -0.15, P < 0.001); nighttime breastfeeding reduced 0.15 units (n = 870; 95% CI = -0.21, -0.10, P < 0.001); sharing utensils reduced 0.30 units (n = 572; 95% CI = -0.39, -0.21, P < 0.001); not using sugary foods to calm child improved 0.37 units (n = 664; 95% CI = 0.31, 0.44, P < 0.001); odds of eating meals and snacks at a table increased (n = 572; OR = 1.57, 95% CI = 1.28, 1.93, P < 0.001; n = 572; OR = 1.80, 95% CI = 1.50, 2.15, P < 0.001) respectively; and reducing barriers to behaviors improved 0.38 units for toothbrushing (n = 666; 95% CI = 0.31, 0.44, P < 0.001) and 0.33 units for diet (n = 668; 95% CI = 0.29, 0.38, P < 0.001). CONCLUSION Despite limitations inherent to pragmatic trials, significant behavioral changes suggest that MSB yielded an important salutary impact. Forthcoming mediation analyses will explore causal pathways. Findings support integration of MSB's behavior change program in caries management initiatives. KNOWLEDGE TRANSFER STATEMENT The results of this study can be used by clinicians, public health leaders, and researchers to inform the development and implementation of community-based, preventative behaviorally focused early childhood caries prevention programs. Study findings may enhance the understanding of the impact of behavioral interventions that engage parents of young children and could lead to more effective prevention for populations at high-risk of caries.
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Affiliation(s)
- C.L. Lumsden
- Columbia University Irving Medical Center, Columbia University College of Dental Medicine, Section of Oral, Diagnostic, and Rehabilitation Sciences, New York, NY, USA
| | - B.L. Edelstein
- Columbia University Irving Medical Center, Columbia University College of Dental Medicine, and Mailman School of Public Health, Department of Health Policy and Management, New York, NY, USA
| | - C.S. Leu
- Teachers College Columbia University, Department of Human Development, New York, NY, USA
| | - J. Zhang
- Teachers College Columbia University, Department of Human Development, New York, NY, USA
| | - J. Levine
- Columbia University College of Dental Medicine, Section of Oral, Diagnostic, and Rehabilitation Sciences, New York, NY, USA
| | - H. Andrews
- Columbia Data Coordinating Center, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
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Blomma C, Aronsson K, Bågesund M, Risberg MB, Gerdin EW, Davidson T. Evaluation of an early childhood caries preventive programme starting during pregnancy-Results after 3 and 6 years. Int J Paediatr Dent 2024. [PMID: 38462758 DOI: 10.1111/ipd.13174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 02/04/2024] [Accepted: 02/20/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Early childhood caries (ECC) has been found to be up to five times more common among children living in areas of low socio-economic status (SES) than among children in areas of higher SES. AIM To evaluate an ECC prevention programme from pregnancy to 3 and 6 years of age. DESIGN A prospective, controlled, intervention cohort study was initiated in 2013 in a low-SES area in Sweden. The intervention group received an individual interdisciplinary ECC prevention programme starting pre-birth, consisting of supportive oral health-promoting talks using motivational interviewing techniques and individual ECC preventive actions. A control group, consisting of pregnant women living in a comparable area, received ordinary routines. RESULTS Of the 336 pregnant women, 64 mothers (with 64 children) completed the programme, and 394 children were born in the control group. At the sixth year examination, the proportion of children with no caries was similar between the groups (53% resp. 52%, p = .976), whereas the proportion with decayed, missed, filled primary teeth (dmft = 1-5) was slightly lower (23% resp. 36%, p = .063), and the proportion with severe caries disease (dmft > 5) was higher (p = .013) in the intervention group (25%) than in the control group (12%). CONCLUSION No preventive effect regarding caries can be demonstrated at sixth year of age. Maternal behavioural change in dental care was not sufficient to even out inequalities in oral health in children, eventually due to difficulties in reaching the target group and the lack of effects among the families reached.
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Affiliation(s)
- Caroline Blomma
- Östergötland Public Dental Service, Region Östergötland, Linköping, Sweden
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kerstin Aronsson
- Unit for Public Health and Statistics, Region Östergötland, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Centre for Orthodontics and Pediatric Dentistry, Östergötland Public Dental Service, Region Östergötland, Linköping, Sweden
- Division of Pediatrics, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | | | | | - Thomas Davidson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Bakar M, Johnston B, Fitzgerald K, Casby C, Duane B. Environmental impact of the supervised toothbrushing programme amongst children in Scotland. J Dent 2023; 139:104773. [PMID: 37931697 DOI: 10.1016/j.jdent.2023.104773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES To understand the environmental impact of providing a nationwide supervised toothbrushing programme (Childsmile) for 5-year-old children in Scotland. METHODS A life cycle assessment was conducted to assess the annual environmental effects of the supervised toothbrushing programme in early years childcare, as well as each dental procedure (dental restoration under local anaesthesia (LA), single tooth extraction under LA, and multiple teeth extraction under general anaesthesia) spanning from 2001/02 to 2009/10. The expected savings in annual carbon dioxide equivalent (CO2e) emissions for all combined dental treatments in subsequent years were calculated compared to those in 2001/02. RESULTS An overall decrease in CO2e emissions was evident in the Childsmile programme and across all dental procedures. The estimated reduction in emissions across all procedures varied from 102.5 tonnes in 2002/03 to 461.1 tonnes in 2009/10 when compared to 2001/02. Within three years, the expected emissions savings from all combined dental procedures surpassed the emissions generated by implementing the Childsmile programme. CONCLUSIONS Over time, there was a significant reduction in annual CO2e emissions for all combined dental treatments in children. In the eighth year of the Childsmile, emissions savings were more than 4.5 times greater than the emissions generated during its implementation. CLINICAL SIGNIFICANCE The study highlights the importance of educating public by individual dentists about the environmental impact of caries prevention programmes and paediatric dental treatments as this may influence patient choice. It also encourages commissioners of community dental programmes to support the implementation of supervised toothbrushing programmes in early years childcare.
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Affiliation(s)
- Majidi Bakar
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland.
| | - Bridget Johnston
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland
| | - Kirsten Fitzgerald
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland
| | - Caoimhe Casby
- Children's Health Ireland, Crumlin, Dublin D12 N512, Ireland
| | - Brett Duane
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland
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Ugolini A, Porro F, Carli F, Agostino P, Silvestrini-Biavati A, Riccomagno E. Probabilistic graphical modelling of early childhood caries development. PLoS One 2023; 18:e0293221. [PMID: 37903153 PMCID: PMC10615302 DOI: 10.1371/journal.pone.0293221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 09/23/2023] [Indexed: 11/01/2023] Open
Abstract
In order to develop a statistical model for complex interactions among factors affecting early childhood caries development (ECC), 234 children from the "XXXX oral growth longitudinal study" were analysed at ages 3, 4 and 5. A questionnaire for children's parents (clinical history, nutritional and oral hygiene habits) and clinical oral examinations were recorded each year. The probabilistic dependence structure on the most significant factors was modelled with an Undirected Graphical Model (UGM or Markov random fields) which provides a probabilistic reasoning approach for the establishment of multi-way associations. The best fitting UGM was estimated through the maximum likelihood principle and two-way factor associations were verified through Fisher's exact statistical hypothesis tests for count data. The effect of sugar intake on caries incidence is mediated by oral hygiene; for caries incidence, oral hygiene quality is more relevant than toothbrushing time; the effect of pacifier on caries incidence is statistically significant only when considered in combination with breastfeeding time. Among behavioural ECC risk factors, the quality of oral hygiene, and not the toothbrushing frequency, is a primary factor that modulates the sugar intake in his primary role of the ECC developer. School-based oral health programs for ECC prevention should be improved with supervised toothbrushing program. UGM analysis could improve the school-based oral health programs with more effective and efficient prevention strategies based on the hierarchical interactions among the ECC risk factors. Oral hygiene plays a pivotal role in early childhood caries and can modulate positively or negatively their development. Supervised toothbrushing is a crucial intervention to be included in the daily educational and clinical practice and in the school-based oral health promotion programs. Trial registration: Clinical trial registration number: NCT02798809.
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Affiliation(s)
- Alessandro Ugolini
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, Genoa, Italy
| | - Francesco Porro
- Department of Mathematics, University of Genova, Genoa, Italy
| | - Federico Carli
- Department of Mathematics, University of Genova, Genoa, Italy
| | - Paola Agostino
- Department of Surgical and Integrated Diagnostic Sciences, University of Genova, Genoa, Italy
| | | | - Eva Riccomagno
- Department of Mathematics, University of Genova, Genoa, Italy
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Lienhart G, Elsa M, Farge P, Schott AM, Thivichon-Prince B, Chanelière M. Factors perceived by health professionals to be barriers or facilitators to caries prevention in children: a systematic review. BMC Oral Health 2023; 23:767. [PMID: 37853400 PMCID: PMC10585780 DOI: 10.1186/s12903-023-03458-1] [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: 03/02/2023] [Accepted: 09/26/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Considered the most prevalent noncommunicable disease in childhood, dental caries is both an individual and a collective burden. While international guidelines highlight prevention as a major strategy for caries management in children, health professionals still struggle to implement prevention into their clinical practice. Further research is needed to understand the gap between the theoretical significance of dental prevention and its lack of implementation in the clinical setting. This systematic review aims to identify and classify factors perceived by health professionals to be barriers or facilitators to caries prevention in children. METHOD A systematic literature search was conducted in three electronic databases (Medline, Web of Science and Cairn). Two researchers independently screened titles, abstracts and texts. To be selected, studies had to focus on barriers or facilitators to caries prevention in children and include health professionals as study participants. Qualitative and quantitative studies were selected. The factors influencing caries prevention in children were sorted into 3 main categories (clinician-related factors, patient-related factors, and organizational-related factors) and then classified according to the 14 domains of the theoretical domains framework (TDF). RESULTS A total of 1771 references were found by combining manual and database searches. Among them, 26 studies met the inclusion criteria, of which half were qualitative and half were quantitative studies. Dentists (n = 12), pediatricians (n = 11), nurses (n = 9), and physicians (n = 5) were the most frequently interviewed health professionals in our analysis. Barriers and facilitators to caries prevention in children were categorized into 12 TDF domains. The most frequently reported domains were Environmental Context and Resources, Knowledge and Professional Role and Identity. CONCLUSION This systematic review found that a wide range of factors influence caries prevention in children. Our analysis showed that barriers to pediatric oral health promotion affect all stages of the health care system. By highlighting the incompatibility between the health care system's organization and the implementation of caries prevention, this study aims to help researchers and policy-makers design new interventions to improve children's access to caries prevention. TRIAL REGISTRATION PROSPERO CRD42022304545.
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Affiliation(s)
- Guillemette Lienhart
- Service d'Odontologie, Hospices Civils de Lyon, 6/8 Place Deperet, 69007, Lyon, France.
| | - Masson Elsa
- Hôpital Femme Mère Enfant, Hospices Civils de Lyon, 59 Boulevard Pinel, 69500, Bron, France
| | - Pierre Farge
- Research On Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Domaine Rockefeller, 8 Avenue Rockefeller, 69373, Lyon 8, France
| | - Anne-Marie Schott
- Research On Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Domaine Rockefeller, 8 Avenue Rockefeller, 69373, Lyon 8, France
| | | | - Marc Chanelière
- Research On Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Domaine Rockefeller, 8 Avenue Rockefeller, 69373, Lyon 8, France
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Sarraf-Shirazi A, Saharkhiz P, Movahhed T, Charmeh A. Evaluation of the Effect of Maternal Education on Toddler Dental Plaque Removal Based on a Health Belief Model. Front Dent 2023; 20:38. [PMID: 38025307 PMCID: PMC10679782 DOI: 10.18502/fid.v20i38.13878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 01/15/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives: The objective of this study was to investigate the impact of an educational intervention, guided by the Health Belief Model (HBM), on promoting preventive behaviors among mothers to combat early childhood caries (ECC) in toddlers aged 12 to 18 months. Materials and Methods: This single-blind interventional study evaluated 92 toddlers between 12 to 18 months and their mothers, who were selected by stratified random sampling. Data regarding demographic and nutritional factors were collected using a questionnaire. The dental status of children was evaluated by clinical examination and measuring the plaque index (PI) of maxillary central incisors and the dmfs index. A pamphlet designed according to the HBM was used for oral hygiene instruction in both the intervention and control groups. All of the mothers in the intervention group received a music file to listen to when brushing their children's teeth. Data were analyzed using chi-square, Fisher exact, Mann-Whitney, and Wilcoxson tests. P<0.05 was considered significant. Results: No significant correlation was noted between the daily frequency of sugary substance intake and primary PI in the intervention or control group with/without dental plaque (P>0.05). In the intervention group, PI significantly decreased after the intervention compared to baseline (P<0.001). However, there was no significant change in PI after the intervention in the control group compared with baseline (P=0.1). Conclusion: The findings indicate that a combination of educational intervention and incentives, such as using age-appropriate music for toddlers, can significantly enhance mothers' effectiveness in removing dental plaque.
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Affiliation(s)
- Alireza Sarraf-Shirazi
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parisa Saharkhiz
- Department of Restorative Dentistry, School of Dentistry, Bojnourd University of Medical Sciences, Bojnourd, Iran
| | - Taraneh Movahhed
- Department of Pediatric Dentistry, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alieh Charmeh
- Department of Pediatric Dentistry, School of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
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12
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Reda M, Sen A, Mustafa M. Prevention of caries and obesity in children with immigrant background in Norway- a study protocol for a cluster randomized controlled trial. BMC Oral Health 2023; 23:620. [PMID: 37658341 PMCID: PMC10474737 DOI: 10.1186/s12903-023-03329-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/18/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND Immigrants are known to experience greater socioeconomic stress and poorer well-being and to suffer more from lifestyle- and diet-related disorders than native populations. There is also evidence that children of immigrant parents are at greater risk of diverse health problems than their host country cohorts. The aim of this study is to apply and evaluate the efficacy of an early life intervention program among parents/children with immigrant background to prevent childhood caries and obesity, thereby improving the children's general health, oral health, and quality of life. METHODS This is a study protocol for a cluster randomized controlled intervention follow-up study. In phase I of the study, the primary care health centers in the municipality of Bergen, Norway were randomly allocated to intervention or control groups. The intervention was carried out using the motivational interviewing technique and the common risk factor approach. The intervention group received guidance on diet/oral hygiene and the control group received standard care information. Parental knowledge and children at age 3 and 5 years old will be assessed in a prospective phase II follow-up study compared to native Norwegian controls. The primary outcome will be evaluation of change on parental oral health related knowledge and attitudes. The secondary outcome will assess the impact of the intervention on children's caries -, body mass index- and oral health related quality of life. DISCUSSION Collaboration between dental public health and primary health care personnel on the common risk approach motivational intervention offers opportunities to address key dietary behaviors that may prevent obesity and dental caries. Providing sustainable preventive measures decreases the burden of diseases and consequently reduces health inequalities, particularly among at-risk children. TRIAL REGISTRATION The study is registered as a clinical trial (ClinicalTrials.gov Identifier: NCT05758454: 7 March 2023). Ethical approval has already been granted by the Regional Ethical Committee (REK) (2015/ 27,639 /REK vest) and Sikt - Norwegian Agency for Shared Services in Education and Research (Reference number 778825).
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Affiliation(s)
- Mariam Reda
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Abhijit Sen
- Center for Oral Health Services and Research (TkMidt), Trondheim, Norway
- Department of Public Health and Nursing, Faculty of Medicine, and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Manal Mustafa
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway.
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Durey A, Naylor N, Slack-Smith L. Inequalities between Aboriginal and non-Aboriginal Australians seen through the lens of oral health: time to change focus. Philos Trans R Soc Lond B Biol Sci 2023; 378:20220294. [PMID: 37381845 DOI: 10.1098/rstb.2022.0294] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/21/2023] [Indexed: 06/30/2023] Open
Abstract
Inequitable social environments can illustrate changes needed in the social structure to generate more equitable social relations and behaviour. In Australia, British colonization left an intergenerational legacy of racism against Aboriginal people, who are disadvantaged across various social indicators including oral health. Aboriginal Australian children have poorer health outcomes with twice the rate of dental caries as non-Aboriginal children. Our research suggests structural factors outside individual control, including access to and cost of dental services and discrimination from service providers, prevent many Aboriginal families from making optimum oral health decisions, including returning to services. Nader's concept of 'studying up' redirects the lens onto powerful institutions and governing bodies to account for their role in undermining good health outcomes, indicating changes needed in the social structure to improve equality. Policymakers and health providers can critically reflect on structural advantages accorded to whiteness in a colonized country, where power and privilege that often go unnoticed and unexamined by those who benefit incur disadvantages to Aboriginal Australians, as reflected in inequitable oral health outcomes. This approach disrupts the discourse placing Aboriginal people at the centre of the problem. Instead, refocusing the lens onto structural factors will show how those factors can compromise rather than improve health outcomes. This article is part of the theme issue 'Evolutionary ecology of inequality'.
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Affiliation(s)
- Angela Durey
- School of Population and Global Health, University of Western Australia, Perth, Western Australia 6009, Australia
| | - Nola Naylor
- Aboriginal Health Strategy, Clinical Service Planning & Population Health, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, University of Western Australia, Perth, Western Australia 6009, Australia
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14
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van Nes KA, van der Ark LA, van Loveren C, Aartman IHA. Construction of a questionnaire based on the Health Action Process Approach for psycho-social cognitive determinants of parents in brushing children's teeth in the Netherlands. PLoS One 2023; 18:e0289337. [PMID: 37535634 PMCID: PMC10399854 DOI: 10.1371/journal.pone.0289337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/18/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The health action process approach (HAPA) model is promising to increase the frequency of brushing children's teeth by parents to improve their children's oral health. A validated HAPA questionnaire is needed as one of the measures of the effects of such an intervention. OBJECTIVES The aim of this study was to evaluate whether our data, based on a translated and adopted version of the Health Action Process Approach (HAPA)-based questionnaire on dental flossing, supported the constructs of the HAPA model. If so, a next aim was to assess whether these constructs could be measured reliably. METHODS In this cross-sectional study, 269 questionnaires filled out in dental offices by parents of children 1-10 years old were analysed. Scale validation was performed according to the 6-step protocol of Dima, including Mokken scale analyses (MSA), graded response model (GRM), factor analyses and reliability measures. Pearson correlation coefficients were calculated to identify divergent validity and test-retest reliability. RESULTS MSA showed a unidimensional, medium total scale. Three items were removed based on this analysis. The total scale with the remaining 26 items did not fit the GRM. Factor analysis extracted five factors and two components for the total scale. The separate subscales, except the 'intention' construct, fitted the MSA and did not fit the GRM. The data fitted a seven-factor model better than a one-factor model. Reliability measures varied from acceptable to excellent, but were poor for 'action control'. Test-retest reliability (r's 0.60-0.83) was questionable to good. CONCLUSION Our results did not fully support the constructs of the HAPA model. To support the HAPA constructs, modification to the subscales risk perceptions, intention, action planning, action control and self-reported behaviour are suggested. With these adjustments, the reliability and validity of the questionnaire could be significantly improved".
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Affiliation(s)
- Karin Alexandra van Nes
- Department of Paediatric Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
| | - L Andries van der Ark
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, The Netherlands
| | - Cor van Loveren
- Department of Paediatric Dentistry, Academic Centre for Dentistry (ACTA), University of Amsterdam and VU Amsterdam, Amsterdam, The Netherlands
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Karikoski E, Sarkola T, Blomqvist M. Early Counseling to Improve Oral Health Behavior in Children with Major Congenital Heart Defects: A Randomized Controlled Trial. Caries Res 2023; 57:563-574. [PMID: 37442113 DOI: 10.1159/000531817] [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: 12/30/2022] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Maintaining optimal oral health behavior in children with a congenital heart defect (CHD) is important in managing the risk for caries development and infective endocarditis. The aim of this study was to evaluate the impact of an early and repeat oral health promotion intervention (OHPI) among children with major CHD. Randomized controlled trial including 72 out of 91 children born in Finland April 1, 2017-October 31, 2020 with (a) major CHD potentially included in the criteria of endocarditis prophylaxis or (b) any CHD with surgical repair combined with a chromosomal syndrome. A parallel passive control (C) group of 87 healthy children were recruited at birth. CHD children were randomized 1:1 to intervention (CHD-I) and control (CHD-C) groups. The OHPI included counseling by motivational interviewing, home delivered toothpaste and toothbrushes, and written information, and was provided at baseline, 6, 12, and 18 months of age to CHD-I group. The primary outcome measure at 24 months was child's oral health behavior (toothbrushing, sugar intake, and dental care contact). The secondary outcome measures were parents' awareness of the importance of oral health behavior, and oral health behavior as a predictor for child behavior. At 24 months, toothbrushing was performed twice a day in 20/27 (74%) among CHD-I, in 13/30 (43%) among CHD-C (CHD-I vs. CHD-C p = 0.03), and in 37/50 (74%) among healthy comparisons (CHD-C vs. C p = 0.01). Electric toothbrush use was 12/27 (44%) in CHD-I, 5/30 (17%) in CHD-C (CHD-I vs. CHD-C p = 0.04), and 7/50 (14%) in healthy comparison (CHD-C vs. C p = 0.76) children. Among CHD-I, toothbrushing and use of electric toothbrush improved between 12 months and 24 months. Sugar drink intake was more common among CHD-C (CHD-C vs. C p = 0.02), but comparable to CHD-I children. Parental toothbrushing predicted child toothbrushing twice a day. There were no statistical group differences in dental care contact. Children with CHD are at risk for poor oral health behavior. This could be improved with early and repeat oral health promotion parental counseling.
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Affiliation(s)
- Essi Karikoski
- Department of Children and Adolescents, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
| | - Taisto Sarkola
- Department of Children and Adolescents, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - My Blomqvist
- Department of Children and Adolescents, Children's Hospital, Helsinki University and Helsinki University Hospital, Helsinki, Finland
- Department of Oral and Maxillofacial Diseases, Helsinki University and Helsinki University Hospital, Helsinki, Finland
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Arduim ADS, Gonçalves DP, Scherer MM, Araújo FBD, Lenzi TL, Casagrande L. Effectiveness of non-operative approaches in active enamel carious lesions: a retrospective longitudinal study. Braz Oral Res 2023; 37:e057. [PMID: 37255077 DOI: 10.1590/1807-3107bor-2023.vol37.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 11/03/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.
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Affiliation(s)
- Andressa da Silva Arduim
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Debora Plotnik Gonçalves
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Maitê Munhoz Scherer
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Fernando Borba de Araújo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Luciano Casagrande
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
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17
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Kuppusamy E, Ratnasingam MD, Yazid F, Rosli TI, Ali AM, Sockalingam SNMP, Ashari A, S Bahiar AS. Patterns of Parental Information Seeking Behavior on Early Childhood Caries: A Qualitative Exploration. J Int Soc Prev Community Dent 2023; 13:133-140. [PMID: 37223451 PMCID: PMC10202258 DOI: 10.4103/jispcd.jispcd_213_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/15/2023] [Accepted: 03/08/2023] [Indexed: 05/25/2023] Open
Abstract
Objectives This study aims to explore the information-seeking behavior patterns of parents with children receiving treatment for early childhood caries (ECC). Materials and Methods Semistructured in-depth interviews were conducted with 20 parents of children with ECC. A topic guide was developed, focusing on questions relating to (i) the timing of their seeking information on ECC, (ii) the types of EEC information they seek, and (iii) the resources used to seek information. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was performed, whereby the data were coded and categorized into themes and subthemes. Results Four main themes were identified: the immediacy of seeking information, perceived information need, use of resources, and barriers to seeking information. Parents either sought information immediately after detecting changes to the appearance of their child's teeth, with some being aware of the changes after signs and symptoms developed. The types of information parents usually sought covered the disease, its prevention, and management. Common sources of information were friends, family, the internet, and healthcare professionals. Barriers to seeking information discussed by parents were lack of time as well as insufficiency and inaccuracy of the information they received. Conclusion This study highlighted the need for comprehensive, tailored early education on ECC for parents using reliable information sources. There is also a need to empower other nondental healthcare professionals to provide oral healthcare education for parents.
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Affiliation(s)
- Elavarasi Kuppusamy
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Farinawati Yazid
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Tanti I Rosli
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adliah Mhd Ali
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Asma Ashari
- Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ahmad Shaqir S Bahiar
- Department of Paediatric Dentistry, UKM Children’s Specialist Hospital, Kuala Lumpur, Malaysia
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Arrow P, Raheb J, McInnes R. Motivational Interviewing and Childhood Caries: A Randomised Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4239. [PMID: 36901250 PMCID: PMC10001603 DOI: 10.3390/ijerph20054239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study tested the occurrence of early childhood caries (ECC) and changes in potential mediators of ECC after an early childhood oral health promotion intervention. METHODS Consenting parent/child dyads in Western Australia were randomised into test [motivational interviewing (MI) + anticipatory guidance (AG)] or control (lift the lip assessments by child health nurses). A questionnaire at baseline and follow-ups (at 18, 36 and 60 months) evaluated the parental factors and the children clinically examined. Data were analysed using parametric and non-parametric tests for two groups and paired comparisons. Multivariable analysis used negative binomial regression with robust standard errors for over-dispersed count data and effect estimates presented as incidence rate ratios. RESULTS Nine hundred and seventeen parent/child dyads were randomised (test n = 456; control n = 461). The parental attitude toward a child's oral hygiene needs improved among the test group at the first follow-up (n = 377; baseline 1.8, SD 2.2, follow-up 1.5, SD 1.9, p = 0.005). Living in a non-fluoridated area and parents holding a fatalistic belief increased the risk of caries (IRR = 4.2, 95% CI 1.8-10.2 and IRR = 3.5, 95% CI 1.7-7.3), respectively, but MI/AG did not reduce the incidence of dental caries. CONCLUSION The brief MI/AG oral health promotion intervention improved parental attitude but did not reduce ECC.
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Affiliation(s)
- Peter Arrow
- Dental Health Services, Department of Health, Perth, WA 6152, Australia
- Dental School, University of Western Australia, Crawley, WA 6009, Australia
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA 5005, Australia
| | - Joseph Raheb
- Faculty of Health Sciences, Curtin University, Bentley, WA 6102, Australia
| | - Rowena McInnes
- Dental Health Services, Department of Health, Perth, WA 6152, Australia
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Riddle M, Rice E. Rigorous theory-based intervention research is the bold action needed to address oral health disparities and inequities. Community Dent Oral Epidemiol 2023; 51:43-45. [PMID: 36779641 DOI: 10.1111/cdoe.12814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 02/14/2023]
Abstract
The Consensus Statement about behavioral and social sciences in oral health encourages future research to draw on testable theories that specify causal pathways that reflect the complex nature of oral health. In this commentary, we amplify the importance of explicit and well-specified theory in oral health intervention research, acknowledging that problematic use of theory has limited its utility in developing effective public health interventions. Also, we affirm the need to focus on determinants of oral health-and health inequities-most likely to drive meaningful change, and to understand the causal pathways that connect drivers of change from the individual to the global level. We view theory-based, causal mechanisms research as a powerful approach to building successful public health interventions, and suggest resources to inspire such research, including exemplary studies, methodologies, and collaborative initiatives that facilitate strong theory-based public health research.
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Affiliation(s)
- Melissa Riddle
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Elise Rice
- National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA
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Ainsworth H, Marshman Z, Whiteside K, Sykes D, Fairhurst C, Turner E, Chestnutt I, Day P, Dey D, Elliott L, El-Yousfi S, Hewitt C, Jones C, Pavitt S, Robertson M, Torgerson D, Innes N. Set up and assessment of progression criteria for internal pilots: the Brushing RemInder 4 Good oral HealTh (BRIGHT) trial example. Pilot Feasibility Stud 2023; 9:17. [PMID: 36707907 PMCID: PMC9881267 DOI: 10.1186/s40814-023-01243-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/06/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Dental caries is common in young people and has wide-ranging ramifications for health and quality of life. Text messaging interventions show promise as a means to promote oral health behaviour change among young people. This paper reports the internal pilot of the Brushing RemInder 4 Good oral HealTh (BRIGHT) trial, which is evaluating an intervention comprising an oral health classroom lesson and text messages about toothbrushing, on caries in young people. Pilot trial objectives were to evaluate the feasibility and appropriateness of recruitment and data collection methods, the randomisation strategy, and intervention delivery against progression criteria for the main trial. METHODS This is an internal pilot trial embedded within an assessor-blinded, two-arm, cluster randomised controlled trial. Participants were pupils aged 11-13 years (in year 7/S1 or year 8/S2) in secondary schools in England, Scotland, and Wales with above average pupil eligibility for free school meals. Following completion of pupil baseline questionnaires and dental assessments, year groups within schools were randomised to the intervention or control arm. Approximately 12 weeks later, participants completed a follow-up questionnaire, which included questions about sources of oral health advice to assess intervention contamination between year groups. At the end of the pilot phase, trial conduct was reviewed against pre-specified progression criteria. RESULTS Ten schools were recruited for the pilot, with 20 year groups and 1073 pupils randomised (average of 54 pupils per year group). Data collection methods and intervention delivery were considered feasible, the response rate to the follow-up questionnaire was over 80%, there was an indication of a positive effect on self-reported toothbrushing, and interest was obtained from 80% of the schools required for the main trial. Despite partial intervention contamination between year groups, within-school randomisation at the level of the year-group was considered appropriate for the main trial, and the sample size was revised to account for partial contamination. Facilitators and barriers to recruitment and data collection were identified and strategies refined for the main trial. CONCLUSIONS Progression to the main trial of BRIGHT, with some design refinements, was concluded. The internal pilot was an efficient way to determine trial feasibility and optimise trial processes. TRIAL REGISTRATION ISRCTN registry, ISRCTN12139369 , registered 10/05/2017.
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Affiliation(s)
- Hannah Ainsworth
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Zoe Marshman
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - Katie Whiteside
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Debbie Sykes
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Caroline Fairhurst
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Emma Turner
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Ivor Chestnutt
- grid.5600.30000 0001 0807 5670School of Dentistry, Cardiff University, Heath Park, Cardiff, UK ,grid.273109.e0000 0001 0111 258XCardiff and Vale University Health Board, Cardiff, UK
| | - Peter Day
- grid.9909.90000 0004 1936 8403School of Dentistry, University of Leeds, Leeds, UK ,grid.498142.2Bradford Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| | - Donna Dey
- grid.8241.f0000 0004 0397 2876School of Education and Social Work, University of Dundee, Nethergate, Dundee, UK
| | - Louise Elliott
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sarab El-Yousfi
- grid.11835.3e0000 0004 1936 9262School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, UK
| | - Catherine Hewitt
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Claire Jones
- grid.8241.f0000 0004 0397 2876Health Informatics Centre, University of Dundee, Dundee, UK
| | - Sue Pavitt
- grid.9909.90000 0004 1936 8403School of Dentistry, University of Leeds, Leeds, UK
| | - Mark Robertson
- grid.8241.f0000 0004 0397 2876School of Dentistry, University of Dundee, Park Place, Dundee, UK
| | - David Torgerson
- grid.5685.e0000 0004 1936 9668York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Nicola Innes
- grid.5600.30000 0001 0807 5670School of Dentistry, Cardiff University, Heath Park, Cardiff, UK
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Lienhart G, Thivichon-Prince B, Farge P, Schott-Pethelaz AM, Chaneliere M. What are health professionals' perceptions and attitudes regarding children with early childhood caries and their families? A qualitative research protocol to assess oral health stigma in the medical setting. BMJ Open 2022; 12:e066680. [PMID: 36455999 PMCID: PMC9716888 DOI: 10.1136/bmjopen-2022-066680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Dental caries is one of the most common non-communicable diseases in children. The disease management of caries relies on both a preventive individual approach (fluoridation, risk evaluation) and the surgical treatment of established carious lesions. Similar to other non-communicable diseases (obesity, mental diseases, etc), health professionals' negative perceptions of patients have been shown to affect the quality of disease management. Regarding dental caries in children, some data have indicated the presence of discriminating beliefs and behaviours towards these children and their families in the medical setting. However, oral health stigma related to dental care remains a largely unexplored issue. METHODS AND ANALYSIS This study presents an exploratory research protocol focusing on the perceptions and attitudes of health professionals towards children with early childhood caries (ECC) and their parents. Semistructured interviews will be conducted among medical and dental health professionals, and verbatim quotations obtained from audio transcriptions will be analysed to identify health professionals' perceptions of ECC and the influence of these perceptions on clinical care for these children. ETHICS AND DISSEMINATION The research ethics committee of the Department of Family Medicine at University Lyon 1 approved this protocol. The results will be published in peer-reviewed journals and presented at scientific meetings. TRIAL REGISTRATION NUMBER NCT05284279.
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Affiliation(s)
- Guillemette Lienhart
- Paediatric Dentistry Department, Hospices Civils de Lyon, Lyon, France
- Health Services and Performance Research (HESPER-EA7425), Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
| | - Beatrice Thivichon-Prince
- Paediatric Dentistry Department, Hospices Civils de Lyon, Lyon, France
- Paediatric Dentistry Department, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Farge
- Health Services and Performance Research (HESPER-EA7425), Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
- Restorative Dentistry Department, Hospices Civils de Lyon, Lyon, France
| | - Anne-Marie Schott-Pethelaz
- Health Services and Performance Research (HESPER-EA7425), Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
- Public Health Department, Hospices Civils de Lyon, Lyon, France
| | - Marc Chaneliere
- Health Services and Performance Research (HESPER-EA7425), Université Lyon 1 Faculté de Médecine Lyon-Est, Lyon, France
- Family Practice Department, Université de Lyon, Lyon, France
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Balasooriyan A, Dedding C, Bonifácio CC, van der Veen MH. Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands. BMC Oral Health 2022; 22:488. [DOI: 10.1186/s12903-022-02510-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Background
Oral health promotion interventions have had limited success in reaching families in disadvantaged neighbourhoods resulting in persistent oral health inequality. This qualitative study provides insight into professionals’ perspectives on children’s poor oral health (≤ 4 years), their perceptions of the roles and responsibilities, and opportunities for child oral health promotion strategies.
Methods
Thirty-Eight professionals from different domains (community, social welfare, general health, dental care, public health, private sector) working in a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated through 24 semi-structured (group) interviews. Transcripts and notes were analysed through thematic analysis.
Results
Professionals indicate that unhealthy diet, children’s non-compliance, poor parental coping, parental low oral health literacy, parent’s negative attitude, family’s daily struggles, and insufficient emphasis on childhood caries prevention in dental practices, general healthcare and social welfare organisations, underlie poor oral health. They hold parents most responsible for improving young children’s oral health, but recognise that families’ vulnerable living circumstances and lack of social support are important barriers. Interestingly, non-dental professionals acknowledge their beneficial role in child oral health promotion, and dental professionals stress the need for more collaboration.
Conclusion
A broad child-, parental-, and societal-centred educational communication strategy is perceived as promising. Professionals working within and outside the dental sector acknowledge that local and collective action is needed. This involves a better understanding of family’s complex daily reality. Furthermore, intensifying child oral health knowledge in dental practices is essential in collaboration with families, general health and social welfare organisations.
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Folayan MO, Adeniyi AA, Arowolo O, Maureen CN, Alade MA, Tantawi ME. Risk indicators for dental caries, and gingivitis among 6-11-year-old children in Nigeria: a household-based survey. BMC Oral Health 2022; 22:465. [PMID: 36329457 PMCID: PMC9635134 DOI: 10.1186/s12903-022-02470-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
Background There is little is known about the factors associated with caries experience and gingivitis among 6–11-year-old children in Nigeria. The aim of the study was to determine the prevalence and preventive oral health behaviors associated with caries and gingivitis among 6–11-year-old children in Nigeria. Methods A cross-sectional questionnaire-based survey was conducted in Ile-Ife, Nigeria. The dependent variables were caries and gingivitis. The dmft/DMFT index was used to assess dental caries experience (present or absent) and caries severity. The gingival index was used to assess the prevalence (present or absent) and severity of gingivitis (healthy gingiva/mild gingivitis versus moderate/severe gingivitis). The independent variables were preventive oral health behaviors (frequency of daily tooth brushing, frequency of consumption of refined carbohydrates in-between-meals, use of fluoridated toothpaste, and use of dental floss, history of dental service utilization). A series of logistic regression analysis models were constructed to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, and socioeconomic status). Results There were 69 (5.2%) children with caries. The mean (standard deviation) dmft was 0.08 (0.457) and the mean DMFT was 0.02 (0.159). There were 839 (63.3%) children with gingivitis with a mean (SD) gingival index score of 0.503 (0.453). Children who seldom or never used fluoride toothpaste had significantly higher odds of developing moderate to severe gingivitis (AOR; 1.671; 95% CI: 1.003–2.786; p = 0.049). Children with middle socio-economic status had significantly lower odds of developing moderate to severe gingivitis (AOR: 0.573; 95%CI: 0.330–0.994; p = 0.048). There were no risk indicators identified for caries. Conclusion The prevalence of dental caries was low while the prevalence of gingivitis was high in the study population. The daily used of fluoridated toothpaste seem to reduce the risk for moderate/severe gingivitis. Further studies are needed to understand these findings.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- grid.10824.3f0000 0001 2183 9444Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria ,grid.416197.c0000 0001 0247 1197Nigeria Institute of Medical Research, Yaba, Lagos State Nigeria ,grid.411705.60000 0001 0166 0922Community Oral Health Department, Tehran University of Medical Sciences, Tehran, Iran ,grid.11205.370000 0001 2152 8769Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Abiola Adetokunbo Adeniyi
- grid.17091.3e0000 0001 2288 9830Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - Olaniyi Arowolo
- grid.459853.60000 0000 9364 4761Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife, Nigeria
| | - Chukwumah Nneka Maureen
- grid.413068.80000 0001 2218 219XDepartment of Preventive Dentistry, School of Dentistry, College of Medical Sciences, University of Benin, Benin, Nigeria
| | - Micheal Abimbola Alade
- grid.459853.60000 0000 9364 4761Obafemi Awolowo University Teaching Hospitals Complex, Ile‑Ife, Nigeria
| | - Maha El Tantawi
- grid.7155.60000 0001 2260 6941Department of Preventive Dentistry, Alexandria University, Alexandria, Egypt
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Saikia A, Aarthi J, Muthu MS, Patil SS, Anthonappa RP, Walia T, Shahwan M, Mossey P, Dominguez M. Sustainable development goals and ending ECC as a public health crisis. Front Public Health 2022; 10:931243. [PMID: 36330110 PMCID: PMC9624450 DOI: 10.3389/fpubh.2022.931243] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/20/2022] [Indexed: 01/24/2023] Open
Abstract
Early Childhood Caries (ECC) remains a global issue despite numerous advancements in research and interventional approaches. Nearly, 530 million children suffer from untreated dental caries of primary teeth. The consequences of such untreated dental caries not only limit the child's chewing and eating abilities but also, significantly impact the child's overall growth. Research has demonstrated that ECC is associated with nearly 123 risk factors. ECC has also been associated with local pain, infections, abscesses, and sleep pattern. Furthermore, it can affect the child's emotional status and decrease their ability to learn or perform their usual activities. In high-income countries, dental care continues to endorse a "current treatment-based approach" that involves high-technology, interventionist, and specialized approaches. While such approaches provide immediate benefit at an individual level, it fails to intercept the underlying causes of the disease at large. In low-income and middle-income countries (LMICs), the "current treatment approach" often remains limited, unaffordable, and unsuitable for the majority of the population. Rather, dentistry needs to focus on "sustainable goals" and integrate dental care with the mainstream healthcare system and primary care services. Dental care systems should promote "early first dental visits," when the child is 1 year of age or when the first tooth arrives. The serious shortages of appropriately trained oral healthcare personnel in certain regions of the world, lack of appropriate technologies and isolation of oral health services from the health system, and limited adoption of prevention and oral health promotion can pose as critical barriers. The oral health care systems must focus on three major keystones to combat the burden of ECC-1. Essential oral health services are integrated into healthcare in every country ensuring the availability of appropriate healthcare accessible and available globally, 2. Integrating oral and general healthcare to effectively prevent and manage oral disease and improve oral health, 3. Collaborating with a wide range of health workers to deliver sustainable oral health care tailored to cater to the oral health care needs of local communities.
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Affiliation(s)
- Ankita Saikia
- Department of Pediatric Dentistry, Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Jagadeesan Aarthi
- Department of Pediatric and Preventive Dentistry, Madha Dental College and Hospital, Chennai, India
| | - MS Muthu
- Department of Pediatric Dentistry, Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Sneha S. Patil
- Department of Pediatric Dentistry, Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Robert Prashanth Anthonappa
- Dental School, Oral Developmental and Behavioural Sciences, University of Western Australia, Perth, WA, Australia
| | - Tarun Walia
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Moayad Shahwan
- Centre of Medical and Bio allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Peter Mossey
- Dundee Dental School, University of Dundee, Dundee, United Kingdom
| | - Monica Dominguez
- Global Oral Health Programs, Smile Train Head Office, New York, NY, United States
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Tadakamadla SK, Rathore V, Mitchell AE, Johnson N, Morawska A. Protocol of a cluster randomised controlled trial evaluating the effectiveness of an online parenting intervention for promoting oral health of 2-6 years old Australian children. BMJ Open 2022; 12:e056269. [PMID: 36229155 PMCID: PMC9562284 DOI: 10.1136/bmjopen-2021-056269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Dental decay is a major problem among Australian children. It can be prevented through good self-care and limiting sugar intake, but many parents/caregivers lack the skills and confidence to help their children adopt these practices. This trial will evaluate the efficacy of Healthy Habits Triple P - Oral health, a web-based online programme, in improving children's oral health-related behaviours (toothbrushing, snacking practices and dental visits) and related parenting practices, thereby preventing dental caries. METHODS AND ANALYSIS This is a cluster, parallel-group, single-blinded, randomised controlled trial of an online intervention for parents/caregivers of children aged 2-6 years. From the City of Gold Coast (Australia), 18 childcare centres will be randomly selected, with equal numbers randomised into intervention and control arms. Intervention arm parents/caregivers will receive access to a web-based parenting intervention while those in the control arm will be directed to oral health-related information published by Australian oral health agencies. After the completion of the study, the Healthy Habits Triple P - Oral health intervention will be offered to parents/caregivers in the control arm. The primary outcome of this trial is toothbrushing frequency, which will be assessed via Bluetooth supported smart toothbrushes and parent/caregiver report. Data on other outcomes: parenting practices and child behaviour during toothbrushing, consumption of sugar rich foods and parents' confidence in dealing with children's demands for sugar rich food, and dental visiting practices, will be collected through a self-administered questionnaire at baseline (before randomisation), and 6 weeks (primary endpoint), 6 months and 12 months after randomisation. Data on dental caries will be collected at baseline, 12 and 18 months post-randomisation. ETHICS AND DISSEMINATION Ethical approval has been obtained from Human Research Ethics Committees of Griffith University (2020/700) and the University of Queensland (2020002839). Findings will be submitted for publication in leading international peer-reviewed journals. TRIAL REGISTRATION NUMBER ACTRN12621000566831.
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Affiliation(s)
- Santosh Kumar Tadakamadla
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
- Violet Vines Marshman Centre for Rural Health Research, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Vatsna Rathore
- Dentistry and Oral Health, Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Amy E Mitchell
- School of Nursing and Midwifery & Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Newell Johnson
- School of Medicine and Dentistry & Menzies Health Institute Queensland, Griffith University - Gold Coast Campus, Gold Coast, Queensland, Australia
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
| | - Alina Morawska
- Parenting and Family Support Centre, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
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What Do Mothers (or Caregivers) Know about Their Children’s Oral Hygiene? An Update of the Current Evidence. CHILDREN 2022; 9:children9081215. [PMID: 36010105 PMCID: PMC9406871 DOI: 10.3390/children9081215] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/08/2022] [Accepted: 08/09/2022] [Indexed: 11/17/2022]
Abstract
Tooth decay remains one of the most common diseases in children, although it is a preventable injury and despite significant advances that has been made in terms of attention and care for oral hygiene. Several studies have shown the association between prevalence of tooth decay in children and parents’ incorrect oral care habits, with a low educational level and a low socioeconomic background. The question that arises concerns the actual oral hygiene knowledge of mothers, fathers, family members or caregivers of young patients; therefore, the aim of this review is to investigate the genesis of gaps in the topic. A literature search was conducted through the Scopus and PubMed search engine and ended in May 2022; only studies from the past 20 years were included. Current evidence suggests that parents and caregivers still have little knowledge about their children’s oral health: there is not enough awareness about the importance of preventing oral diseases, due to poor attention to good oral hygiene but also lack of information from health professionals and institutions. In the future, all the professionals involved in the pregnant woman’s care should increase parents’ knowledge, solve their doubts, collect and compare data in order to design effective intervention programs.
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Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127114. [PMID: 35742362 PMCID: PMC9222700 DOI: 10.3390/ijerph19127114] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/02/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023]
Abstract
Introduction: Collective evidence on risk factors for dental caries remains elusive in low- and middle-income countries (LMICs). The objective was to conduct a systematic review and meta-analysis on risk factors for dental caries in deciduous or permanent teeth in LMICs. Methods: Studies were identified electronically through databases, including Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, PubMed/MEDLINE, and CINAHL, using “prevalence, dental caries, child, family, socioeconomic, and LMIC” as the keywords. A total of 11 studies fit the inclusion criteria. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale (NOS). The MedCalc software and Review Manager 5.4.1 were used. Results: From 11,115 participants, 38.7% (95% CI: 28.4−49.5%) had caries and 49.68% were female. Among those with caries, 69.74% consumed sugary drinks/sweets (95% CI: 47.84−87.73%) and 56.87% (95% CI: 35.39−77.08%) had good brushing habits. Sugary drinks had a two times higher likelihood of leading to caries (OR: 2.04, p < 0.001). Good oral hygiene reduced the risk of caries by 35% (OR: 0.65, p < 0.001). Concerning maternal education, only secondary education reduced the likelihood of caries (OR: 0.96), but primary education incurred 25% higher risks (OR: 1.25, p = 0.03). A 65% reduction was computed when caregivers helped children with tooth brushing (OR: 0.35, p = 0.04). Most families had a low socioeconomic status (SES) (35.9%, 95% CI: 16.73−57.79), which increased the odds of caries by 52% (OR: 1.52, p < 0.001); a high SES had a 3% higher chance of caries. In the entire sample, 44.44% (95% CI: 27.73−61.82%) of individuals had access to dental services or had visited a dental service provider. Conclusion: Our findings demonstrate that high sugar consumption, low maternal education, and low and high socioeconomic status (SES) increased the risk of dental caries in LMICs. Good brushing habits, higher maternal education, help with tooth brushing, and middle SES provided protection against caries across LMIC children. Limiting sugars, improving oral health education, incorporating national fluoride exposure programs, and accounting for sociodemographic limitations are essential for reducing the prevalence of dental caries in these settings.
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Cunha SR, Fátima Bizarra MD. Oral health and knowledge of sighted children and children with visual impairment and their parents’ role in it: A comparative study. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2022. [DOI: 10.1177/02646196221099152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Aim: The present study aims to evaluate oral health knowledge and habits of children with visual impairment by comparison with their sighted counterparts and also evaluates parental knowledge and involvement in children’s oral hygiene routines. Methods: This observational and transversal study included the participation of 68 children (34 were visually impaired and 34 were sighted), from seven schools from Lisbon. The participants with visual impairment were age and gender-matched with their sighted counterparts to minimize variations in the analysis. In all, 52.9% of children were male, with average age of 11.15 (±3.413) years [6; 18]. The children and parents completed one survey each. Children were submitted to an oral examination to evaluate oral health. Results: Participants with visual impairment showed a non-significant increase in the decayed, missing, and filled teeth index (dmft), gingival, and oral hygiene indexes. Both groups’ gingival state was mostly classified as excellent, and oral hygiene was mainly classified as excellent/good. More children with visual impairment (85.7%) needed help with teeth brushing ( p = .046) and were more likely to miss dentist check-ups more often ( p = .025). Also, sighted children and their parents demonstrated more knowledge about oral health. Conclusion: Children with visual impairment and their parents showed less favorable results, justifying the need to promote oral health education to this demographic.
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Aldhuwayhi S, Bhardwaj A, Deeban YAM, Bhardwaj SS, Alammari RB, Alzunaydi A. A Narrative Review on Current Diagnostic Imaging Tools for Dentomaxillofacial Abnormalities in Children. CHILDREN 2022; 9:children9050621. [PMID: 35626798 PMCID: PMC9139436 DOI: 10.3390/children9050621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/16/2022]
Abstract
The current review narrates the findings and discusses the available diagnostic tools for detecting structural abnormalities. The review discusses several diagnostic tools, such as magnetic resonance imaging, cone beam computed tomography, multi detector row CT and positron emission tomography. The vital findings and comparative analysis of different diagnostic tools are presented in this review. The present review also discusses the advent of newer technologies, such as the HyperionX9 scanner with less field of view and 18F-FDG PET/CT (positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose, integrated with computed tomography), which can give more efficient imaging of dentomaxillofacial structures. The discussion of effective comparative points enables this review to reveal the available diagnostic tools that can be used in the detection of dentomaxillofacial abnormalities in the pediatric population. The advantages and disadvantages of each tool are discussed, and the findings of past publications are also presented. Overall, this review discusses the technical details and provides a comparative analysis of updated diagnostic techniques for dentomaxillofacial diagnosis.
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Affiliation(s)
- Sami Aldhuwayhi
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.A.); (Y.A.M.D.); (R.B.A.)
| | - Atul Bhardwaj
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.A.); (Y.A.M.D.); (R.B.A.)
- Correspondence:
| | - Yahya Ahmed M. Deeban
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.A.); (Y.A.M.D.); (R.B.A.)
| | - Smita Singh Bhardwaj
- Pediatric Dentistry, Department of Preventive Dental Sciences, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia;
| | - Rawan Bakr Alammari
- Department of Prosthodontics, College of Dentistry, Majmaah University, Al Majmaah 11952, Saudi Arabia; (S.A.); (Y.A.M.D.); (R.B.A.)
| | - Ayoub Alzunaydi
- General Dentist, Ministry of Health, Al Artawiyah General Hospital, Al Artawiyah 15719, Saudi Arabia;
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Nembhwani HV, Varkey I. Caries Experience and Its Relationship with Mother\'s Educational Level and Occupational Status: A Cross-sectional Survey. Int J Clin Pediatr Dent 2022; 15:S226-S229. [PMID: 35645509 PMCID: PMC9108831 DOI: 10.5005/jp-journals-10005-2163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aim Most studies have investigated established risk factors contributing to dental caries in children, however, with the growing incidence of caries in children more risk factors are being included in literature. Thus, this cross-sectional study was conducted to assess the relationship between mother's educational level and occupational status with the caries experience of the child. Materials and method About 120 mother–child pairs participated in the study. Children below 12 years were screened for their dental caries status using DMFT index. The pairs were equally divided into three groups according to the mother's education and occupational status as: Group I–Mothers who did not receive any formal education, Group II–Educated mothers but unemployed, and Group III–Educated employed mothers. Mother's knowledge and attitude regarding the child's oral health was recorded analyzed using Chi-square test with statistical significance set at p < 0.05. Results In the present study, the lower DMFT score has been significantly related to higher levels of education and occupation of the mother. It was also observed that the knowledge and attitude of the mother related to the child's oral health is directly proportional to the education and occupational status. Conclusion The findings of our study suggest that mother's level of education increases the awareness of the child's oral health. Therefore, it is utmost important to educate a mother to help the child maintain his oral health and reduce the caries prevalence. Clinical significance The results of the present study conducted will help the clinician to keep in sight the relationship of mother's education and occupational level and its impact on their child's teeth, which will in turn help them for creating further dental awareness in the society. How to cite this article Nembhwani HV, Varkey I. Caries Experience and Its Relationship with Mother's Educational Level and Occupational Status: A Cross-sectional Survey. Int J Clin Pediatr Dent 2022;15(S-2):S226–S229.
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Affiliation(s)
- Harsha V Nembhwani
- Department of Pedodontics and Preventive Dentistry, Dr DY Patil University, Navi Mumbai, Maharashtra, India
- Harsha V Nembhwani, Department of Pedodontics and Preventive Dentistry, Dr DY Patil University, Navi Mumbai, Maharashtra, India, Phone +91 9075020750, e-mail:
| | - Indu Varkey
- Department of Pedodontics and Preventive Dentistry, Dr DY Patil University, Navi Mumbai, Maharashtra, India
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Choi SE, Kalenderian E, Normand S. Measuring the quality of dental care among privately insured children in the United States. Health Serv Res 2022; 57:137-144. [PMID: 34327703 PMCID: PMC8763286 DOI: 10.1111/1475-6773.13713] [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: 03/25/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To examine whether quality of dental care varies by age and over time and whether community-level characteristics explain these patterns. DATA SOURCE Deidentified medical and dental claims from a commercial insurer from January 2015 to December 2019. STUDY DESIGN A retrospective cohort study. The primary outcome was a composite quality score, derived from seven dental quality measures (DQMs), with higher values corresponding to better quality. Hierarchical regression models identified person- and zip code-level factors associated with the quality. DATA COLLECTION/EXTRACTION METHODS Continuously enrolled US dental insurance beneficiaries younger than 21 years of age. PRINCIPAL FINDINGS Quality was assessed for 4.88 million person-years covering 1.31 million persons. Overall quality slightly improved over time, mostly driven by substantial improvements among children aged 0-5 years by 0.153 points/year (95% confidence interval [CI]:0.151, 0.156). Quality was poorest and declined over time among adolescents with only 20.5% of DQMs met as compared to 42.6% among aged 0-5 years in 2019. Dental professional shortage, median household income, percentages of African Americans, unemployed, and less-educated populations at the zip code level were associated with the composite score. CONCLUSION Quality of dental care among adolescents remains low, and place of residence influenced the quality. Increasing the supply of dentists and oral health promotion strategies targeting adolescents and low-performing localities should be explored.
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Affiliation(s)
- Sung Eun Choi
- Department of Oral Health Policy and EpidemiologyHarvard School of Dental MedicineBostonMassachusettsUSA
| | - Elsbeth Kalenderian
- Department of Oral Health Policy and EpidemiologyHarvard School of Dental MedicineBostonMassachusettsUSA
- Department of Preventive and Restorative Dental SciencesUniversity of California at San Francisco, School of DentistrySan FranciscoCaliforniaUSA
- Department of Dental Management Sciences School of DentistryUniversity of PretoriaPretoriaSouth Africa
| | - Sharon‐Lise Normand
- Department of Health Care PolicyHarvard Medical SchoolBostonMassachusettsUSA
- Department of BiostatisticsHarvard T.H. Chan School of Public HealthBostonMassachusettsUSA
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Faisal MR, Mishu MP, Jahangir F, Younes S, Dogar O, Siddiqi K, Torgerson DJ. The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children’s oral health: A systematic review and meta-analysis. PLoS One 2022; 17:e0262118. [PMID: 35015771 PMCID: PMC8751985 DOI: 10.1371/journal.pone.0262118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 12/17/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives
Dental caries is the most common preventable childhood condition. Non-dental professionals and health workers are often well placed to support parents in adopting positive oral health behaviours for their children. The aim of this study was to determine the effectiveness of behaviour change interventions and their individual component behaviour change techniques (BCTs), that were delivered by non-dental professionals and health workers.
Methods
A systematic search of Ovid MEDLINE, PubMed, CINAHL, Cochrane Library, Web of Science, TRoPHI and PROQUEST from inception until March 2021 was conducted. Randomised controlled trials and quasi-experimental studies for improving oral health outcomes in children were included. Quality assessment was carried out using Cochrane Risk of Bias tool and ROBINS-I tool. Publication bias was assessed using funnel plots and Egger’s regression intercept. Effect sizes were estimated as standardised mean difference (SMD) and odds ratio/risk ratio for proportions. Meta-analyses were performed for studies reporting mean decayed, missing, filled surfaces (dmfs) and mean decayed, missing, filled, teeth (dmft) indices. Behaviour change technique coding was performed using behaviour change technique taxonomy v1 (BCTTv1).
Results
Out of the 9,101 records retrieved, 36 studies were included with 28 showing a significant effect either in clinical and/or behavioural/knowledge outcomes. Most studies (n = 21) were of poor methodological quality. The pooled SMD for caries experience showed statistically significant result for caries prevention at surface level -0.15 (95% CI -0.25, -0.04) and at the tooth level -0.24 (95% CI -0.42, -0.07). In 28 effective interventions, 27 individual BCTs were identified and the most frequently used were: “Instructions on how to perform the behaviour” and “Information about health consequences”.
Conclusion
There is low quality of evidence suggesting non-dental professionals and health workers may help improve oral health outcomes for children. To confirm these findings, further high-quality studies incorporating a variety of BCTs in their interventions for adoption of good oral health behaviours are needed.
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Affiliation(s)
- Mehreen Riaz Faisal
- Department of Health Sciences, University of York, York, United Kingdom
- * E-mail:
| | | | - Faisal Jahangir
- Department of Oral Medicine, Margalla Institute of Health Sciences, Rawalpindi, Pakistan
| | - Sabahat Younes
- Department of Community Health & Wellbeing, University of Central Lancashire, Preston, United Kingdom
| | - Omara Dogar
- Department of Health Sciences, University of York, York, United Kingdom
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, United Kingdom
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Hegde V, Kodali P, Minhaz R, Mithra PP, Alva S, Joseph J, Roshni RS. Cost-Effective analysis of silver diamine fluoride in comparison to glass ionomer cement along with fluoride varnish in the management of early childhood caries in anganwadi centers of Mangalore: A randomized control trail. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2022. [DOI: 10.4103/jiaphd.jiaphd_221_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Huang YZ, Jin Z, Wang ZM, Qi LB, Song S, Zhu BW, Dong XP. Marine Bioactive Compounds as Nutraceutical and Functional Food Ingredients for Potential Oral Health. Front Nutr 2021; 8:686663. [PMID: 34926539 PMCID: PMC8675007 DOI: 10.3389/fnut.2021.686663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 11/08/2021] [Indexed: 12/13/2022] Open
Abstract
Oral diseases have received considerable attention worldwide as one of the major global public health problems. The development of oral diseases is influenced by socioeconomic, physiological, traumatic, biological, dietary and hygienic practices factors. Currently, the main prevention strategy for oral diseases is to inhibit the growth of biofilm-producing plaque bacteria. Tooth brushing is the most common method of cleaning plaque, aided by mouthwash and sugar-free chewing gum in the daily routine. As the global nutraceutical market grows, marine bioactive compounds are becoming increasingly popular among consumers for their antibacterial, anti-inflammatory and antitumor properties. However, to date, few systematic summaries and studies on the application of marine bioactive compounds in oral health exist. This review provides a comprehensive overview of different marine-sourced bioactive compounds and their health benefits in dental caries, gingivitis, periodontitis, halitosis, oral cancer, and their potential use as functional food ingredients for oral health. In addition, limitations and challenges of the application of these active ingredients are discussed and some observations on current work and future trends are presented in the conclusion section.
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Affiliation(s)
- Yi-Zhen Huang
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
| | - Zheng Jin
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
| | - Zhe-Ming Wang
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
| | - Li-Bo Qi
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
| | - Shuang Song
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
| | - Bei-Wei Zhu
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
| | - Xiu-Ping Dong
- School of Food Science and Technology, Academy of Food Interdisciplinary Science, Dalian Polytechnic University, Dalian, China
- National Engineering Research Center of Seafood, Collaborative Innovation Center of Seafood Deep Processing, Liaoning Province Collaborative Innovation Center for Marine Food Deep Processing, School of Food Science and Technology, Dalian Polytechnic University, Dalian, China
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Poirier BF, Hedges J, Smithers LG, Moskos M, Jamieson LM. Aspirations and Worries: The Role of Parental Intrinsic Motivation in Establishing Oral Health Practices for Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111695. [PMID: 34770211 PMCID: PMC8582669 DOI: 10.3390/ijerph182111695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 11/26/2022]
Abstract
Aboriginal and Torres Strait Islander (respectfully, subsequently referred to as Indigenous) children in Australia experience oral disease at a higher rate than non-Indigenous children. A history of colonisation, government-enforced assimilation, racism, and cultural annihilation has had profound impacts on Indigenous health, reflected in oral health inequities sustained by Indigenous communities. Motivational interviewing was one of four components utilised in this project, which aimed to identify factors related to the increased occurrence of early childhood caries in Indigenous children. This qualitative analysis represents motivational interviews with 226 participants and explores parents’ motivations for establishing oral health and nutrition practices for their children. Findings suggest that parental aspirations and worries underscored motivations to establish oral health and nutrition behaviours for children in this project. Within aspirations, parents desired for children to ‘keep their teeth’ and avoid false teeth, have a positive appearance, and preserve self-esteem. Parental worries related to child pain, negative appearance, sugar consumption, poor community oral health and rotten teeth. A discussion of findings results in the following recommendations: (1) consideration of the whole self, including mental health, in future oral health programming and research; (2) implementation of community-wide oral health programming, beyond parent-child dyads; and (3) prioritisation of community knowledge and traditions in oral health programming.
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Affiliation(s)
- Brianna F. Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
- Correspondence: ; Tel.: +61-8-8313-5208
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
| | - Lisa G. Smithers
- School of Public Health and the Robinson Research Institute, University of Adelaide, Adelaide 5000, Australia;
- School of Health and Society, University of Wollongong, Wollongong 2522, Australia
| | - Megan Moskos
- Future of Employment and Skills Research Centre, School of Economic and Public Policy, Faculty of the Professions, University of Adelaide, Adelaide 5000, Australia;
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
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Lumsden CL, Edelstein BL, Basch CE, Wolf RL, Koch PA, McKeague I, Leu CS, Andrews H. Protocol for a family-centered behavioral intervention to reduce early childhood caries: the MySmileBuddy program efficacy trial. BMC Oral Health 2021; 21:246. [PMID: 33962602 PMCID: PMC8103669 DOI: 10.1186/s12903-021-01582-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Although largely preventable through diet management and topical fluoride use, early childhood caries (ECC) often progresses to severity that necessitates surgical repair. Yet repair often fails to mitigate caries progression. Needed is an effective behavioral intervention to address underlying behavioral causes. METHODS This randomized controlled trial will evaluate the efficacy of a behaviorally focused, family-centered intervention, the MySmileBuddy Program (MSB Program), to reduce ECC progression in high-risk preschoolers in New York City. Recruitment will target 858 children ages 24-71 months with ECC and their parents from primary care medical and dental clinics. The study aims to assess the MSB Program's efficacy to: (1) decrease ECC progression measured 12-months post-randomization; and (2) enhance adoption of a low cariogenic diet and twice-daily fluoridated toothpaste use compared to control group. Potential causal pathways (mediators and moderators) will be explored. The MSB Program equips community health workers (CHWs) with an app that facilitates multilevel risk assessment and provides motivational interviewing-based counseling to inform parents about the caries process, develop personalized goals, and create family-level action plans to achieve targeted behaviors. Social support from CHWs (4 interactions during the 6-month intervention, supplemented by up to 4 in-person/remote contacts throughout the 12-month study period, based on need) is bolstered by automated text messages. Participants will be randomized to a Control Group (paper-based educational handout plus toothbrushes and fluoridated toothpaste for the child) or Intervention Group (MSB Program, two tooth-brushing observations with feedback and instruction, and toothbrushes and toothpaste for the entire family). All children will receive visual ICDAS dental examinations and parents will complete study measures at baseline and 12-months. An incentive up to $150 plus round-trip transit cards ($5.50 value) will be provided. DISCUSSION This study hypothesizes that the MSB Program can reduce ECC progression in a high-risk population. Sufficient incentives and a focus on establishing rapport between participants and CHWs are anticipated to mitigate recruitment and retention challenges. If successful, this study will advance the long-term goal of reducing pediatric oral health disparities by demonstrating the efficacy of an acceptable and feasible intervention that shifts attention from dental repair to behavioral risk mitigation. TRIAL REGISTRATION Trial registration was completed on 4/13/2021 through the U.S. National Library of Medicine ClinicalTrials.gov website (Identifier: NCT04845594).
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Affiliation(s)
- Christie L. Lumsden
- Columbia University College of Dental Medicine, Section of Oral, Diagnostic, and Rehabilitation Sciences, 622 West 168th Street, PH7-322, New York, NY 10032 USA
| | - Burton L. Edelstein
- Dental Medicine and Health Policy & Management at Columbia University Irving Medical Center, Columbia University College of Dental Medicine, 622 West 168th Street, PH7-322, New York, NY 10032 USA
| | - Charles E. Basch
- Department of Health and Behavior Studies, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10027 USA
| | - Randi L. Wolf
- Department of Health and Behavior Studies, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10027 USA
| | - Pamela A. Koch
- Department of Health and Behavior Studies, Teachers College Columbia University, 525 West 120th Street, Box 137, New York, NY 10027 USA
| | - Ian McKeague
- Mailman School of Public Health, Department of Biostatistics, Columbia University Irving Medical Center, 722 West 168th Street, 6th Fl, Rm 639, New York, NY 10032 USA
| | - Cheng-Shiun Leu
- Mailman School of Public Health, Department of Biostatistics, Columbia University Irving Medical Center, 722 West 168th Street, 6th Fl, Rm 639, New York, NY 10032 USA
| | - Howard Andrews
- Mailman School of Public Health, Columbia University Irving Medical Center, 1051 Riverside Drive, Unit 47, New York, NY 10032 USA
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Pereira MBB, Pereira VBP, Pereira VBP, Pereira VGF, Paula VMB, Caetano APF, Amaral WN. Randomized trial of a photography-aided behavioural intervention to reduce risk factors for caries and malocclusion in high-risk infants. Int J Dent Hyg 2021; 20:471-478. [PMID: 33908167 DOI: 10.1111/idh.12507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 03/10/2021] [Accepted: 04/14/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the efficacy of a photography-aided behavioural intervention in reducing risk factors for dental caries and malocclusion in high-risk infants. MATERIALS AND METHODS In this randomized trial conducted in a maternity hospital, 55 mothers of recently born infants at high risk of developing oral diseases were allocated to either the intervention (n = 28) or usual care (n = 27). The intervention arm received the same usual care plus an enhanced, behaviour-oriented, photography-aided, two-stage (0 and +6 months) educational programme addressing nutritional, behavioural, lifestyle and familial factors that affect child's oral health. The primary outcome was the proportion of children classified as being at a 'low risk' of developing dental caries at the age of 12 months using a modified score based on the Caries-risk Assessment Form of the American Academy of Pediatric Dentistry. Secondary outcomes included risk factors for malocclusion, such as duration of exclusive breastfeeding, pacifier use and bottle-feeding and/or sippy cup usage. RESULTS At 12 months, the proportion of children considered at low risk for dental caries was significantly higher in the intervention group compared to usual care (71% vs 15%, respectively, relative risk = 4.82, 95% confidence interval = 1.89-12.3, p < 0.001). The median duration of exclusive breastfeeding in the intervention group was 1.7 times higher than in the control arm (5 months vs 3 months, p = 0.03). CONCLUSION Altogether, our findings provide evidence that a low-cost, two-stage preventive strategy using photographs to deliver a stronger visual impact might significantly reduce the incidence of risk factors for dental caries and malocclusion in 12-month-old children.
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Affiliation(s)
- Marina B B Pereira
- Serviço de Odontologia Neonatal, Hospital e Maternidade Dona Iris, Goiânia, Brazil.,Programa de Pós-graduação em Ciências da Saúde, Hospital das Clínicas, Universidade Federal de Goiás, Goiânia, Brazil
| | - Vinícius B P Pereira
- Departamento de Oftalmologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Vitor B P Pereira
- Departamento de Retina e Vítreo, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Brazil
| | | | - Viviane M B Paula
- Serviço de Odontologia Neonatal, Hospital e Maternidade Dona Iris, Goiânia, Brazil
| | - Aline P F Caetano
- Faculdade de Odontologia, Universidade Federal de Goiás, Goiânia, Brazil
| | - Waldemar N Amaral
- Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina, Universidade Federal de Goiás, Goiânia, Brazil
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Floríndez LI, Como DH, Floríndez DC, Vigen C, Floríndez FM, Cermak SA. Identifying Gaps in Oral Care Knowledge, Attitudes, and Practices of Latinx Parents/Caregivers of Children With and Without Autism Spectrum Disorders. Health Equity 2021; 5:185-193. [PMID: 33937604 PMCID: PMC8080905 DOI: 10.1089/heq.2020.0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose: This pilot study used data from a survey to examine the knowledge, attitudes, and practices about oral care of Latinx parents/caregivers of children with or without autism spectrum disorder (ASD) to identify gaps to focus future intervention. Methods: Sixty English-speaking Latinx parents/caregivers who had a child between 4 and 14 years with or without ASD (n=31 ASD, n=29 typically developing [TD]) completed a questionnaire on oral health knowledge, practices, access to care, and demographics. Caregiver responses were compared, and gaps in knowledge and practices were identified. Results: There were no significant differences in parent age, child age, income, insured status, or overall knowledge scores, only a significant difference in education (p=0.02), with the ASD group reporting less. Scores for knowledge, attitudes, access and practice were all nonsignificantly positively correlated, as was attitudes with access and practice. However, knowledge and attitudes were significantly negatively correlated. Additional significant findings were parents who had lower income and education, had lower oral knowledge scores, decreased frequency of dental visits, increased feelings of being discriminated against, children with increased fear of the dentist, and decreased ease of finding a dentist. Conclusion: Factors such as income, education, ethnicity, and having a child with ASD can influence what Latinx parents and caregivers know about oral health and how their children experience receiving dental care. Latinx parents/caregivers of children with and without ASD report barriers to dental care, including difficulty attending visits or feeling stigmatized by their dental provider due to their ethnicity. Fear of the dentist is significantly correlated with ASD diagnosis and lower social demographics of the parent, and may contribute to a reduction in preventative oral care visits as well. Health care providers should consider these perspectives when providing care to this population to mitigate further oral health inequities.
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Affiliation(s)
- Lucía I Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Dominique H Como
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Daniella C Floríndez
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Cheryl Vigen
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | | | - Sharon A Cermak
- USC Mrs. T.H. Chan Division of Occupational Science and Occupational Therapy in the Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
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Rasmus K, Toratti A, Karki S, Pesonen P, Laitala ML, Anttonen V. Acceptability of a Mobile Application in Children's Oral Health Promotion-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063256. [PMID: 33809845 PMCID: PMC8004230 DOI: 10.3390/ijerph18063256] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 11/25/2022]
Abstract
The aim of this pilot study was to investigate the acceptability of an oral health-related mobile application developed for young children based on the feedback given by the children and their parents. Another aim was to evaluate the self-reported change in children’s oral health behaviors during a short test period. The application—a virtual pet integrated into a child’s daily routines—aimed to promote oral hygiene and dietary behaviors in children. A total of 36 4–12-year-old voluntary children were given a mobile phone with the installed application. After the 5-week testing period, the feasibility of the application and possible changes in the children’s oral health behaviors were asked using an electronic questionnaire. Most of the children considered the application clear (n = 34), amusing (n = 31), and useful (n = 29). The children’s tooth brushing manners improved both qualitatively and quantitatively: the time used for tooth brushing increased and the children learned how to brush different tooth surfaces. Mobile applications can be fun and useful in oral health promotion; while playing, children can learn good oral health-related behaviors. Mobile applications integrate oral health promotion into children’s daily environment and routines.
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Affiliation(s)
- Kirsi Rasmus
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland; (K.R.); (A.T.); (M.-L.L.); (V.A.)
| | - Antti Toratti
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland; (K.R.); (A.T.); (M.-L.L.); (V.A.)
| | - Saujanya Karki
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland; (K.R.); (A.T.); (M.-L.L.); (V.A.)
- Correspondence:
| | - Paula Pesonen
- Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland;
| | - Marja-Liisa Laitala
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland; (K.R.); (A.T.); (M.-L.L.); (V.A.)
- Medical Research Center, Oulu University Hospital, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, P.O. Box 5281, 90014 Oulu, Finland; (K.R.); (A.T.); (M.-L.L.); (V.A.)
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Hammersmith KJ, Harlan TA, Fenning RM, Chan J, Stephenson KG, Macklin EA, Casamassimo PS, Townsend JA, Butter EM, Steinberg-Epstein RB. Correlates of oral health fatalism in caregivers of children with autism spectrum disorder. SPECIAL CARE IN DENTISTRY 2021; 41:145-153. [PMID: 33449432 DOI: 10.1111/scd.12564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/18/2020] [Accepted: 12/30/2020] [Indexed: 11/27/2022]
Abstract
AIMS To study correlates of oral health fatalism (OHF) in caregivers of children with autism spectrum disorder (ASD). METHODS AND RESULTS This exploratory analysis used baseline data from 118 Medicaid-eligible families of children with ASD in a multi-site randomized clinical trial of a parent training intervention supporting home oral hygiene and dental visits. About half (46%) of caregivers agreed with the statement "most children eventually develop dental cavities," endorsing OHF. Hispanic caregivers more strongly endorsed OHF than non-Hispanics (cumulative odds ratio = 2.4, 95% confidence interval [CI]: 1.2-4.7, P = .014). Caregivers living alone with children less strongly endorsed OHF than caregivers cohabitating with other adults (cumulative odds ratio = 0.39, 95% CI 0.17-0.86, P = .019). Multivariable analysis maintained significance of ethnicity (P = .030) but not living situation (P = .052). Additional analyses included demographics, parenting beliefs, and children's oral hygiene and oral health status. CONCLUSION About half the caregivers endorsed OHF, with Hispanic caregivers more strongly endorsing OHF. OHF was not significantly associated with oral health behaviors or status, consistent with emerging literature suggesting fatalism is not necessarily linked to health behavior. Further exploration of OHF correlates in families of children with ASD is needed; ethnicity, living situation, child age, and caries status are of interest.
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Affiliation(s)
- Kimberly J Hammersmith
- Division of Pediatric Dentistry, The Ohio State University College of Dentistry and Nationwide Children's Hospital, Columbus, Ohio
| | - Taylor A Harlan
- Division of Pediatric Dentistry, The Ohio State University College of Dentistry and Nationwide Children's Hospital, Columbus, Ohio
| | - Rachel M Fenning
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, California.,The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Irvine, California
| | - James Chan
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts
| | - Kevin G Stephenson
- Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio
| | - Eric A Macklin
- Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts.,Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Paul S Casamassimo
- Division of Pediatric Dentistry, The Ohio State University College of Dentistry and Nationwide Children's Hospital, Columbus, Ohio
| | - Janice A Townsend
- Division of Pediatric Dentistry, The Ohio State University College of Dentistry and Nationwide Children's Hospital, Columbus, Ohio
| | - Eric M Butter
- Department of Pediatrics, The Ohio State University College of Medicine and Nationwide Children's Hospital, Columbus, Ohio
| | - Robin B Steinberg-Epstein
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Irvine, California
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41
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Harrison-Barry L, Elsworthy K, Pukallus M, Leishman SJ, Boocock H, Walsh LJ, Seow WK. The Queensland Birth Cohort Study for Early Childhood Caries: Results at 7 Years. JDR Clin Trans Res 2020; 7:80-89. [PMID: 33331221 DOI: 10.1177/2380084420981882] [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] [Indexed: 11/15/2022] Open
Abstract
AIMS This study investigated caries predictors in 378 children remaining from a birth cohort of 1,052 at 7 y and compared the efficacy of home visits (HVs) and telephone contacts (TCs) for early childhood caries (ECC) prevention. METHODS The HVs or TCs were made at ages 6, 12, 18, 30, and 42 mo with annual dental clinic examinations at ages 2 to 7 y. At every visit, the parents completed validated questionnaires regarding the children's family, medical, dental, and dietary histories. RESULTS The caries prevalence increased from 2% and 6% at ages 2 and 3 y to 15%, 33%, 42%, and 52% at ages 4 to 7 y. The mean caries experience (decayed, missing, and teeth extracted due to caries) of the total cohort increased from 0.1 ± 0.5 at age 2 y to 0.2 ± 1.1 at 3 y, 0.5 ± 1.6 at 4 y, 1.1 ± 2.4 at 5 y, 1.6 ± 2.6 at 6 y, and 2.0 ± 2.7 at 7 y. The prevalence of mutans streptococci (MS) in the total cohort at years 2 to 7 was 22%, 36%, 42%, 42%, 39%, and 44%, respectively. MS was strongly correlated with caries prevalence for all years (all P < 0.001). Statistical modeling employing the generalized estimating equations identified caries predictors as holding a Health Care Card (low socioeconomic status) (P = 0.009; odds ratio [OR] = 2.05; confidence interval [CI]: 1.20-3.52), developmental defects of enamel (DDEs) (P < 0.001; OR = 1.09; CI: 1.05-1.14), and MS counts ≤105/mL (P = 0.001; OR = 1.63; CI: 1.24-2.14). By contrast, HVs were more protective than TCs for caries (P = 0.008; OR = 0.42; CI: 0.22-0.80). CONCLUSIONS This study provides prospective, clinical evidence that MS, DDEs, and low socioeconomic status are strongly correlated with early childhood caries and that HVs are more efficacious than TCs in ECC prevention. KNOWLEDGE TRANSFER STATEMENT This 7-y birth cohort study provides longitudinal clinical evidence that mutans streptococci, developmental defects of enamel, and low socioeconomic status are key risk indicators of early childhood caries.
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Affiliation(s)
- L Harrison-Barry
- The University of Queensland, School of Dentistry, Oral Health Centre, Herston, Queensland, Australia
- Metro South Oral Health, Woolloongabba, Queensland, Australia
| | - K Elsworthy
- The University of Queensland, School of Dentistry, Oral Health Centre, Herston, Queensland, Australia
| | - M Pukallus
- Metro South Oral Health, Woolloongabba, Queensland, Australia
| | - S J Leishman
- The University of Queensland, School of Dentistry, Oral Health Centre, Herston, Queensland, Australia
| | - H Boocock
- Metro South Oral Health, Woolloongabba, Queensland, Australia
| | - L J Walsh
- The University of Queensland, School of Dentistry, Oral Health Centre, Herston, Queensland, Australia
| | - W K Seow
- The University of Queensland, School of Dentistry, Oral Health Centre, Herston, Queensland, Australia
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Basir L, Meshki R, Aghababa H, Rakhshan V. Effects of three commercial toothpastes incorporating "chitosan, casein phosphopeptide-amorphous calcium phosphate, sodium monofluorophosphate, and sodium fluoride" on remineralization of incipient enamel caries in the primary dentition: A preliminary in vitro study. Dent Res J (Isfahan) 2020; 17:433-438. [PMID: 33889348 PMCID: PMC8045520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Given the importance of primary dental caries, assessment of new preventive/therapeutic materials is necessary. In light of the scarcity of such studies on the role of new agents in primary dentition, this study assessed the efficacy of three commercial toothpastes with different ingredients on remineralization of early caries in the primary dentition. MATERIALS AND METHODS Thirty-nine intact primary canines were used in this in vitro experimental study. The baseline microhardness of enamel was measured. Particular demineralizer was used for 96 h and then secondary microhardness was measured. Then, samples were divided into three groups treated by toothpastes with sodium fluoride, chitosan, and casein phosphopeptide-amorphous calcium phosphate and sodium monofluorophosphate (CPP-ACP+SMFP). Each group was incubated and pH-cycled. Subsequently, they were demineralized and remineralized using toothpastes. Eventually, tertiary microhardness was measured. Percent of enamel microhardness recovery (EMHR%) and efficacy of toothpastes in remineralization were established. Data were analyzed using paired t-test, repeated-measures test, Kruskal-Wallis, and Mann-Whitney U-test (α = 0.05, 0.017). RESULTS Demineralization significantly reduced microhardness from 316.2 to 248.5 Vickers hardness number (VHN) (P = 0.000). All toothpastes succeeded to remineralize the enamel significantly (P = 0.000). The efficacies of toothpastes differed significantly (P < 0.05). Mean EMHR percentages of toothpastes incorporating NaF, chitosan, and CPP-ACP+SMFP were 75.1%, 52.5%, and 55.8%, respectively. The highest increases in enamel microhardness were observed after using NaF-containing toothpaste (~53 VHN) which was significantly superior to other toothpastes (P ≤ 0.001). However, there was no statistically significant difference between EMHR percentages of toothpastes including chitosan and CPP-ACP+SMFP (P = 0.739). CONCLUSION Although all three toothpastes could increase the microhardness of primary enamel, NaF toothpaste was superior to others. Toothpastes having chitosan and CPP-ACP+SMFP acted rather similarly.
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Affiliation(s)
- Leila Basir
- Department of Pediatric Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Raziye Meshki
- Department of Pediatric Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hilda Aghababa
- Department of Pediatric Dentistry, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran,Address for correspondence: Dr. Hilda Aghababa, Department of Pediatric Dentistry, School of Dentistry, Ahwaz Jundishapur University of Medical Sciences, Ahwaz, Iran. E-mail:
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Wagner Y, Knaup I, Knaup TJ, Jacobs C, Wolf M. Influence of a programme for prevention of early childhood caries on early orthodontic treatment needs. Clin Oral Investig 2020; 24:4313-4324. [PMID: 32382925 PMCID: PMC7666665 DOI: 10.1007/s00784-020-03295-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/17/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The aim of this prospective birth cohort study was to evaluate the effect of the programme for prevention (PP) of early childhood caries and the resulting need for orthodontic treatment in 8-year-old German children. MATERIAL AND METHODS Children who had been enrolled in a caries-risk-related recall system with continuous dental care starting at the time of birth (prevention group, PG) were compared with children of the same birth cohort whose parents decided not to participate in the programme (control group, CG). All children (n = 289) participating in the last PP evaluation at the age of 5 years were invited again and examined by blinded clinicians. Dental caries was scored using the WHO diagnostic criteria expanded to d1-level without radiography. Impressions were taken of children with premature tooth loss to analyse space conditions. RESULTS Two hundred twenty-seven children (mean age 8.4 ± 0.6 years; 46.7% female) were examined. Children in the PG (n = 127) showed significantly lower caries prevalence and experience (3.1%, 0.4 ± 1.0 d3-4mft) than children in the CG (37.3%, 3.9 ± 3.5 d3-4mft). Orthodontic analysis found a higher prevalence of premature tooth extraction, followed by a greater extent of space loss in the CG (41.0%; 3.3 ± 4.4 mm) vs. PG (7.9%; 0.4 ± 1.9 mm) and an increase in early orthodontic treatment need (KIG P3, IOTN 5). CONCLUSIONS The PP was an effective approach for preventing caries-related premature tooth loss in children and conserving relevant arch length. CLINICAL RELEVANCE Children who received continuous dental care starting at the time of birth showed better oral health with less premature loss of deciduous teeth and lower need for orthodontic treatment at the age of 8 years. TRIAL REGISTRATION German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438.
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Affiliation(s)
- Yvonne Wagner
- Department of Orthodontics, Section Preventive Dentistry and Paediatric Dentistry, Jena University Hospital, An der alten Post 4, Jena, Germany.
| | - I Knaup
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
| | - T J Knaup
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
| | - C Jacobs
- Department of Orthodontics, Section Preventive Dentistry and Paediatric Dentistry, Jena University Hospital, An der alten Post 4, Jena, Germany
| | - M Wolf
- Department of Orthodontics, RWTH Aachen University Hospital, Aachen, Germany
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Abstract
Objectives To define an expert Delphi consensus on when to intervene in the caries process and existing carious lesions.Methods Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference.Results Lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations may be placed for form, function, aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated lesions which are cleansable. Cavitated lesions which are not cleansable usually require minimally invasive management. In specific circumstances, mixed interventions may be applicable. Occlusally, cavitated lesions confined to enamel/non-cavitated lesions extending radiographically into deep dentine may be exceptions. Proximally, cavitation is hard to assess tactile-visually. Most lesions extending radiographically into the middle/inner third of dentine are assumed to be cavitated. Those restricted to the enamel are not cavitated. For lesions extending radiographically into the outer third of dentine, cavitation is unlikely. These lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds.Conclusions Comprehensive diagnosis is the basis for systematic decision-making on when to intervene in the caries process and existing lesions.
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Colvara BC, Faustino-Silva DD, Meyer E, Hugo FN, Celeste RK, Hilgert JB. Motivational interviewing for preventing early childhood caries: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2020; 49:10-16. [PMID: 33000877 DOI: 10.1111/cdoe.12578] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 07/13/2020] [Accepted: 09/08/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This systematic review with meta-analysis was performed to assess whether motivational interviewing (MI) is effective in the prevention of early childhood caries (ECC) and to examine potential sources of heterogeneity. METHODS Interventions based on motivational interviewing were considered eligible. The main outcome was new caries lesions (some studies included white-spot lesions in total count), and secondary outcomes included caregivers' oral health knowledge, home-care behaviours, plaque index, gingival index and fluoride varnish applications. Controls were any type of oral health education or negative controls without any specific intervention. RESULTS From a total of 1498 studies identified in the databases search, 1078 were assessed for eligibility by reading titles and abstracts, after removal of duplicates. Full-text screening was performed in 61 articles, with 18 reporting on 14 different studies included in the qualitative synthesis and 8 in the quantitative synthesis (four studies included new white-spot lesions in total count). Subgroup analysis was performed by the control group dmft/dmfs and the test for subgroup differences suggests that there is a subgroup effect (P = .06), so population caries experience modifies the effect of MI-based intervention. In populations with high caries experience, the MI-based approach proved preventing an average of 3.15 (95% CI: -6.14, -0.17) dmfs in young children. In samples with low caries experience, differences were smaller, since the caries levels were already lower (-0.31; 95% CI: -0.63, 0.00). CONCLUSION Motivational interviewing has the potential to modify knowledge and behaviours and reduce ECC with a more significant impact on children with high caries experience.
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Affiliation(s)
| | - Daniel Demétrio Faustino-Silva
- Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC), Porto Alegre, Brazil
| | - Elisabeth Meyer
- Graduate Health Sciences Program, Cardiology Institute (IC/FUC), Porto Alegre, Brazil
| | - Fernando Neves Hugo
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Roger Keller Celeste
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Juliana Balbinot Hilgert
- Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.,Graduate Program in Epidemiology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
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Carmagnola D, Pellegrini G, Malvezzi M, Canciani E, Henin D, Dellavia C. Impact of Lifestyle Variables on Oral Diseases and Oral Health-Related Quality of Life in Children of Milan (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186612. [PMID: 32932788 PMCID: PMC7559912 DOI: 10.3390/ijerph17186612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/04/2020] [Accepted: 09/08/2020] [Indexed: 11/20/2022]
Abstract
A large part of the Italian population doesn’t receive adequate information and support on how to maintain oral health. In this observational, cross-sectional, pilot study, we investigated how some lifestyle-related variables affect oral diseases and oral health-related quality of life (OHRQoL) of children attending public-school summer services in Milan. A survey that included questions on children’s oral disease, OHRQoL and lifestyle-related factors (feeding habits, oral hygiene protective behaviors, dental coaching and socio-economic and educational status), was administered to the children’s caregivers. Data from 296 surveys were analyzed to assess the protective/negative effect of each variable on oral disease and OHRQoL. With respect to disease, the “never” consumption of fruit juice, the use of fluoride toothpaste, higher educational qualification and ISEE (equivalent family income) of those who filled out the form, resulted protective factors. Regarding OHRQoL, the “never” assumption/use of tea bottle, sugared pacifier and fruit juice as well as the use of fluoride toothpaste, a higher educational qualification and ISEE of those who filled out the form, resulted to have protective effects. In conclusion, protective behaviors and socio-economic status affect oral disease and OHRQoL in children of Milan.
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Affiliation(s)
- Daniela Carmagnola
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (D.C.); (E.C.); (D.H.); (C.D.)
| | - Gaia Pellegrini
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (D.C.); (E.C.); (D.H.); (C.D.)
- Correspondence: ; Tel.: +39-3475923198
| | - Matteo Malvezzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20100 Milano, Italy;
| | - Elena Canciani
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (D.C.); (E.C.); (D.H.); (C.D.)
| | - Dolaji Henin
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (D.C.); (E.C.); (D.H.); (C.D.)
| | - Claudia Dellavia
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, 20133 Milano, Italy; (D.C.); (E.C.); (D.H.); (C.D.)
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Tsai C, Raphael S, Agnew C, McDonald G, Irving M. Health promotion interventions to improve oral health of adolescents: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2020; 48:549-560. [PMID: 32767825 DOI: 10.1111/cdoe.12567] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/22/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of health promotion interventions on oral health knowledge, behaviour and status of healthy adolescents. METHODS This review included randomized controlled trials (RCTs) of oral health promotion interventions targeting adolescents. Primary clinical outcomes (gingival health, plaque scores, caries) and secondary proxy outcomes were evaluated. Meta-analysis of primary outcomes was conducted where possible, with subgroup analysis based on intervention (comprehensive health promotion and education-only). RESULTS Thirty-seven eligible publications reporting on 28 unique RCTs of oral health promotion interventions were included. Quality appraisal of studies ranged from 48% to 96%. Interventions reported ranged from single-session interventions to community-wide programmes, including clinical preventive procedures and take-home products. Half used a health behaviour change theory to inform their intervention. The meta-analysis pooling of results favoured the intervention over control for all clinical outcomes, except DMFS in the education-only subgroup. Stronger intervention effects were seen in the comprehensive intervention subgroup than the education-only subgroup for DMFS (P = .02). This effect was slight, but not as clear in all other clinical categories. The majority of studies reported improvements in oral health knowledge, attitudes and behaviours. More positive outcomes were found with longer programmes, especially for dental caries outcomes. CONCLUSIONS Oral health promotion programmes targeting adolescents have the ability to improve clinical oral health outcomes in the short and long term. Programmes should use more behavioural theory-based interactive and strategic methods, including self-awareness and the use of the wider community and peers for oral health promotion activities over a longer intervention duration.
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Affiliation(s)
- Carrie Tsai
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Raphael
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Caitlin Agnew
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia.,Hospital and Specialist Dentistry, Head and Neck Services, Auckland District Health Board, Auckland, New Zealand
| | - Gordon McDonald
- Sydney Informatics Hub, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Irving
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
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Innes NPT, Chu CH, Fontana M, Lo ECM, Thomson WM, Uribe S, Heiland M, Jepsen S, Schwendicke F. A Century of Change towards Prevention and Minimal Intervention in Cariology. J Dent Res 2020; 98:611-617. [PMID: 31107140 DOI: 10.1177/0022034519837252] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature-coupled with limited diagnostic tools and therapeutic treatment options-meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession's move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession's greatest challenge is moving this evidence into practice.
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Affiliation(s)
- N P T Innes
- 1 School of Dentistry, University of Dundee, Dundee, UK
| | - C H Chu
- 2 Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - M Fontana
- 3 Cariology and Restorative Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - E C M Lo
- 2 Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - W M Thomson
- 4 Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - S Uribe
- 5 School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
| | - M Heiland
- 6 Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Jepsen
- 7 Periodontology, Operative, and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - F Schwendicke
- 8 Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Brief Motivational Interventions: Strategies for Successful Management of Complex, Nonadherent Dental Patients. Dent Clin North Am 2020; 64:559-569. [PMID: 32448459 DOI: 10.1016/j.cden.2020.02.005] [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: 11/20/2022]
Abstract
Motivational interviewing (MI) is an evidence-based approach to resolving patient ambivalence to change. MI techniques can be effectively used by dentists in assessing and managing substance use risk and may add minimal time to the patient interview. Although MI's greatest utility has been in the area of improving general oral hygiene in order to reduce caries and other preventable conditions, its use in addressing controlled substance risk is well established in other health care disciplines. These techniques do not require special training in mental health assessment and can be effectively used by dentists and dental hygienists.
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Motivational interviewing to prevent early childhood caries: A randomized controlled trial. J Dent 2020; 97:103349. [PMID: 32330548 DOI: 10.1016/j.jdent.2020.103349] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/15/2020] [Accepted: 04/19/2020] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Prevailing health education (PE) often fails to achieve sustained behavioral changes. This randomized controlled trial integrated motivational interviewing (MI) and a patient communication tool featuring interactive caries risk assessment (RA) into PE and investigated the effectiveness of PE, PE + MI, and PE + MI + RA in preventing early childhood caries. METHODS This study targeted children aged 3-4 years with unfavorable oral health behaviors. 692 parent-child dyads were recruited, randomly assigned into three groups (PE, PE + MI, and PE + MI + RA), and received respective interventions. A questionnaire was completed at baseline and after 6 and 12 months to collect information on socio-demographic background, parental efficacy and children's oral health behaviors. Children's oral hygiene status and dental caries were recorded at baseline and after 12 months. RESULTS 655 (94.7%) parent-child dyads remained in the study after 12 months. Caries increment was significantly lower in PE + MI group (β=-0.717, 95% CI: -1.035, -0.398) and PE + MI + RA group [β=-0.600, 95% CI: -0.793, -0.407] than in PE group. There was significantly greater reduction in plaque score in PE + MI group (β=-0.077, 95% CI: -0.106, -0.048) and PE + MI + RA group (β=-0.075, 95% CI: -0.113, -0.036), as compared with PE group. Significantly greater improvements were found in parental efficacy and children's oral health behaviors in PE + MI and PE + MI + RA groups than in PE group (all p < 0.05). There was no significant difference between PE + MI group and PE + MI + RA group across all outcome measures (all p > 0.05). CONCLUSIONS Intergration of motivational interviewing improves the effectiveness of prevailing health education in preventing early childhood caries, enhancing parental efficacy, and improving children's oral health behaviors. Incorporation of the communication tool for caries risk assessment does not further improve the effectiveness of motivational interviewing in protecting children's oral health. CLINICAL SIGNIFICANCE The findings of this study provide much needed evidence for dentists, dental auxiliary staff and public health workers to select effective intervention to empower parents for improving children's oral health behaviors and preventing early childhood caries.
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