Oral Health Screening Using a Caries Detection Device

The role of Polish school nurses in the oral health promotion for 7-19 year-old children and adolescents

Purpose

The assessment of the role of school nurses in the oral health education and counselling of children and adolescents aged 7–19 years.

Methods

A self-administered questionnaire was used to evaluate nurses’ practice in oral health education, previous training in caries prevention, collaboration with a dentist and self-assessment of knowledge. Data were analysed with the Chi square test.

Results

The study group consisted of 140 Polish school nurses. Respondents declared the following activities: dietary counselling (99.2%), oral hygiene education (92.8%), NHS-funded supervised fluoride prophylaxis (82.8%), and caries screenings (4.3%). 47.1% participated in training on caries prevention, 25.7% had a collaboration with a dentist. Nurses from schools located in towns less frequently provided oral hygiene education (p < 0.005) and dietary counselling, but more often had a collaboration with a dentist (p < 0.05). The youngest nurses were more confident about their knowledge (p < 0.05). There was an association between participation in training on caries prevention and positive opinion on a school-based fluoride prophylaxis (p < 0.01). Nurses who did not include dental topics in their practice worked mainly with pupils older than 15 years, had shorter experience (p < 0.05), secondary education, worked in urban areas and had no training on dental problems (p < 0.01).

Conclusion

Polish school nurses have potentially crucial roles in improving the oral health status in pupils through oral hygiene education, dietary counselling and fluoride prophylaxis included in their duties.

Laser fluorescence in monitoring the influence of targeted tooth brushing on remineralization of initial caries lesions on newly erupted molar teeth - RCT

OBJECTIVE

This study aimed to monitor mineralization changes in initial caries lesions on newly erupted second molars using laser fluorescence (LF) scanning after a 1-month targeted tooth brushing intervention.

METHODS

Altogether, 124 13- to 14-year-old school children were invited to participate. Of those who fulfilled the clinical criteria (at least one initial lesion with LF value >10 in second molars), 51 gave their written consent to participate. Laser fluorescence values were registered at baseline and after 1-month follow-up period. All participants were individually taught targeted tooth brushing of their second molars and randomly provided tooth paste with 0 or 1500 ppm fluoride. Brushing frequency was investigated at baseline and after the follow-up. Change in LF values was compared considering the tooth, content of fluoride in the paste and brushing frequency.

RESULTS

In lesions with LF values ≤30 at baseline, change in LF values demonstrated improvement. Improvement was detected especially in upper molars. In lesions with LF values >30 at baseline, improvement was least detected. Brushing frequency increased slightly during the intervention.

CONCLUSIONS

Laser fluorescence is a simple method and useful in monitoring remineralization of incipient lesions even in weeks. Targeted tooth brushing seems to induce remineralization even in weeks. Laser fluorescence could be a valuable motivating tool in promoting patients' self-care.

Appraisal of the national response to the caries epidemic in children in Nigeria

BACKGROUND

This article reviews the caries profile for children in Nigeria and proposes an appropriate framework for addressing the silent caries epidemic.

DISCUSSION

We reviewed the caries prevalence among children in Nigeria, assessed the existing responses to the caries epidemic including the national oral healthcare delivery situation in the country and discussed the current caries management in children. We then proposed a response framework for Nigeria. We argue that successful interventions will require the adoption of a socio-ecological model. This would ensure that the micro-, meso-, exo- and macrosystems required to support the behavioural, structural and biological interventions for promoting caries prevention are addressed. National oral health surveys are required to help understand the epidemiology, social determinants of and factors that undermine the ability of children to access oral health care. A global caries prevention agenda for children would help get the government's support for a national response agenda. Currently, there is no global call for action on the caries epidemic in children. This lack of an agenda needs to be urgently addressed.

SUMMARY

A combination of approaches for the prevention of caries in children in Nigeria is needed. A national survey is needed to generate the needed evidence for the planning of community relevant responses to the national caries epidemic in children. The design of a global health agenda for children is an important first step that can facilitate the development of a national oral health programme for children in Nigeria.

Epidemiology of early childhood caries: clinical application

Early childhood caries (ECC) is the most communicable and preventable disease process in children younger than 5 years. Instead of moving in the direction epidemiologists would like to see, incidence rates of ECC are moving upward from the targeted 11%, as outlined by Healthy People 2010. The nursing profession can address risk factors, treatment options, and the need to increase awareness of the transmission of ECC along with prevention efforts. Efforts made by nursing students in a service-learning project to increase awareness of ECC are outlined. In addition, intervention strategies disseminated by advanced nurse practitioners and nurse educators to augment these efforts are summarized.

Relationship between laser fluorescence values and visual evaluation of fissure caries in schoolchildren - a field study

BACKGROUND

In our previous study of oral health intervention in children, laser fluorescence (LF) values of occlusal surfaces were reduced after 1 year.

AIM

The aim of this study was to explore the relationship between DIAGNOdent pen values and clinical status of the occlusal surfaces.

DESIGN

The study conducted in 2007 and 2008 in 700 children aged 13-14 included a clinical examination and LFpen measurement of the occlusal surfaces of first and second molars. Four teams consisting of a dental hygienist and a dental nurse performed the examinations on school premises. The dental hygienist scored the surfaces using the Nyvad criteria for caries assessment; the surfaces were then scanned using a DIAGNOdent pen(®) device.

RESULTS

The more severe the visual caries category was, the higher the mean LFpen values were. Correlation coefficients between LF values and NY categories were 0.542 and 0.408 in years 2007 and 2008, respectively (all examiners combined). The LFpen values of active and inactive lesions did not differ significantly.

CONCLUSIONS

The correlation between the mean LFpen values and the NY categories was significant. Fissures can be reliably examined with LF and by visual inspection on school premises if certain special arrangements are made.

How dental care can preserve and improve oral health

Oral health is associated with overall health, and lack of access to dental care has consequences that go far beyond aesthetics. Most oral diseases are preventable and are relatively easy and inexpensive to address at early stages. However, multiple barriers make dental care unreachable for a sizable portion of the United States population, who consequently has higher incidence and prevalence of disease. Achieving meaningful improvements in oral health status among these groups will require a revamping of the dental infrastructure, augmenting the productivity and skills of the dental workforce, and increasing the population's oral health literacy.

Reducing oral health disparities: a focus on social and cultural determinants

Oral health is essential to the general health and well-being of individuals and the population. Yet significant oral health disparities persist in the U.S. population because of a web of influences that include complex cultural and social processes that affect both oral health and access to effective dental health care.

This paper introduces an organizing framework for addressing oral health disparities. We present and discuss how the multiple influences on oral health and oral health disparities operate using this framework. Interventions targeted at different causal pathways bring new directions and implications for research and policy in reducing oral health disparities.