Integrating dental health into a family-oriented health promotion approach in Guatemala

Oral Health-Related Quality of Life in a Paediatric Population in the Dominican Republic

Introduction: During the summer of 2019 and within the framework of a social dentistry program carried out in the low-income town of San Francisco de Macorís (Dominican Republic), a descriptive study was carried out on oral health-related quality of life (OHRQoL), aiming to find out the oral health status of a population of children in the aforementioned Dominican city. Objective: The aim of this study was to describe the oral health status of a child population and its relationship with the quality of life perceived by these children in the aforementioned population of San Francisco de Macorís in order to develop an specific oral health program taking into account not only the existing oral health status but also the perceptions and feelings of the child population in this regard. Method: A descriptive cross-sectional study was carried out on a representative sample of children who were examined on their oral health status, following WHO guidelines, by professionals from the University of Seville (Spain) together with professionals from private practice (USA) and students from the Universidad Católica Nordestana (UCNE, Dominican Republic). Likewise, the children's parents voluntarily completed the Oral Quality of Life questionnaire COHIP-19 in its culturally adapted Spanish version. Results: For this purpose, 94 children with a mean age of 10.34 (SD 3.38) were observed in our study following WHO recommendations for oral health studies and evaluating OHQoL using the specific questionnaire validated in Spanish COHIP-19 in its short format (SF). The results show a state of oral health with a significant prevalence of caries (80.9%) and a DMFT of 1.70 (SD 1.90). The OHQoL perceived by these children shows that pain, bad breath or feeling sad because of the condition of their teeth were the factors with the worst evaluation score. Conclusions: The conclusion that mainly emerges from this study is that caries continues to be the main problem to be solved (more than other variables studied, such as malocclusion or fluorosis), and this ailment also causes pain, dysfunction, and bad breath and is therefore perceived as a problem to be solved in the children of this Dominican city.

Use of strontium isotope ratios in geolocation of Guatemalan population: Potential role in identification of remains

Within post‐conflict communities, attempts to identify and repatriate unidentified and missing individuals poses a difficult task. As current forensic strategies commonly lack the capacity to provide region of origin assessments, forensic anthropologists/investigators are often unable to identify sources of DNA for kinship analysis. Using Thermal Ionization Mass Spectrometry (TIMS), hair samples from 10 volunteers were used to assess the variation in strontium isotope ratios (⁸⁷Sr/⁸⁶Sr) between extant people in Guatemala City and Coban; with a leach (external) and digest (dietary) signal analyzed for each sample. A two‐way anova demonstrated that the difference between ⁸⁷Sr/⁸⁶Sr of Guatemala City and Coban was statistically significant (F [1, 16] = 259.839, p < 0.05), with no statistically significant differences observed between leach and digest ⁸⁷Sr/⁸⁶Sr (F [1,16] = 4.319, p = 0.054). Overall, individuals from Coban demonstrate ⁸⁷Sr/⁸⁶Sr comparable to previously recorded baseline values, demonstrating a minimal change in diet which is reflected in associated surveys. Volunteers from Guatemala City, however, show a marked shift in ⁸⁷Sr/⁸⁶Sr away from predicted values highlighting the potential influence of imported goods. The results here highlight the applicability of ⁸⁷Sr/⁸⁶Sr in hair to serve as a potential tool to support the identification of unknown individuals in Guatemala in a forensic context.

Family-Centered Health Promotion: Perspectives for Engaging Families and Achieving Better Health Outcomes

Communities and populations are comprised of individuals and families who together affect the health of the community. The family unit is an unparalleled player for maintaining health and preventing disease for public health because members may support and nurture one another through life stages. Preliminary research confirms that family-oriented health promotion and disease prevention are promising strategies because the family unit is both a resource and a priority group needing preventative and curative services across the life course. Although there are growing numbers of successful efforts, family health systems are generally underutilized in health promotion practice. This lack of utilization in policy and practice have hampered the collection of robust evidence for family health. This paper purports that families are important actors in public health. Yet, since no one pattern for healthy families is known, public health practitioners can consider six principle-based approaches to legitimately and respectfully advance the families’ innate potential for health promotion and disease prevention. Each perspective aims to foster higher capacity for family health systems to function appropriately in public health practice. Health promotion practitioners and researchers can explore family health perspectives with the potential for systems policy and practice adjustments in public health.

Where periodontitis meets metabolic syndrome-The role of common health-related risk factors

OBJECTIVES

To analyse and compare associations between metabolic syndrome (MetS) and its components in periodontitis compared to control patients.

METHODS

This 7-year cross-sectional study retrospectively analysed medical records of 504 individuals aged 18-90 who attended the student dental clinic between 2008 and 2014. Demographics, smoking habits, blood pressure, waist circumference, as well as presence of: periodontitis, MetS, diabetes, hypertension, hyperlipidaemia, stroke, heart disease, cancer and psychiatric disorders were recorded.

RESULTS

The study population composed of 231 (45.8%) males and 273 (54.2%) females, with an average age of 55.79 ± 16.91 years. A patient profile associated with periodontitis was identified and included male sex, older age, smoking, higher smoking pack-years, abdominal obesity, higher systolic and diastolic blood pressures, the presence of MetS or its components, hypertension, hyperlipidaemia, diabetes or diseases associated with its consequences such as ischaemic heart disease and stroke. Following multivariate logistic regression analysis, age and smoking retained a significant association with periodontitis, whereas the systemic disorders did not.

CONCLUSIONS

The association between periodontitis and MetS may be explained by shared common profile and risk factors. An appropriate risk factors management approach should be adopted by both dental and general health clinicians and health authorities, to control common high-risk behaviours.

Lifestyle and dental attendance as predictors of oral health-related quality of life

OBJECTIVES

To evaluate the impact of health-related behaviors and dental attendance on oral health-related quality of life (OHRQoL).

METHODS

One hundred and ninety-two individuals presenting for dental treatment were included in a cross-sectional survey using a self-administered questionnaire that assessed demographics, smoking and alcohol consumption, physical activity habits, dental attendance, and dental pain utilizing a numeric rating scale (NRS). Results of the Oral Health Impact Profile (OHIP)-14 questionnaire were considered as the dependent variable. A conceptual hierarchical data analysis model from distal to proximal determinants of the median OHIP-14 total score was adopted.

RESULTS

Analysis of the OHIP-14 domains and total score revealed several significant protector characteristics: younger age, academic education, no alcohol consumption, regular physical activity, fewer smoking pack years, routine dental attendance, and lower NRS scores. Routine dental attendance was related to lower NRS scores (P < 0.001) which in turn were associated with lower OHIP-14 scores (P = 0.018). Better health-related behaviors (P = 0.039) and routine dental attendance (P = 0.029) also correlated directly with lower OHIP-14 scores.

CONCLUSIONS

Better health-related behaviors and routine dental attendance have a protective effect on OHRQoL. Clinicians should assess these behaviors during routine diagnostic workups. Global health authorities need to integrate oral and general health care and improve both OHrQoL and HrQoL.

Acceptability of delivery of dietary advice in the dentistry setting to address obesity in pre-school children: a case study of the Common Risk Factor Approach

OBJECTIVE

The Common Risk Factor Approach proposes that public health efforts can be improved by multiple agencies working together on a shared risk factor. The present study aimed to assess the acceptability to parents, dental practice staff and commissioners of the delivery of dietary advice in the dentistry setting in order to address obesity.

DESIGN

Semi-structured focus groups with dental practice staff and one-to-one interviews with parents of pre-school children and public health commissioners involved in an oral health promotion initiative delivering dietary advice in dental surgeries. Data were analysed using the Framework Approach.

SETTING

General dental practice surgeries and pre-schools in areas of high deprivation in north-east England.

SUBJECTS

Parents (n 4), dental practice staff (n 23) and one commissioner.

RESULTS

All participants found acceptable the concept of delivering public health messages in non-conventional settings. Dental practice staff were concerned about the potential for conflicting messages and deprioritisation of oral health advice, and they identified practical barriers to delivery, such as lack of training. Parents were very apprehensive about the potential of such approaches to stigmatise overweight children, including bullying. Uncertainty over the causes of obesity led to confusion about its solutions and the roles of public health and health care.

CONCLUSIONS

Major concerns about the implementation of the Common Risk Factor Approach were raised by parents and dental practice staff. Specific dietary guidance for both oral health and healthy weight, as well as further research into issues of suitability, feasibility and stigmatisation, are needed.

Oral health promotion in Gauteng: a qualitative study

Introduction and background:

One of the aims of the South African Oral Health Promotion Framework is to integrate oral health promotion activities into general health promotion using the Common Risk Factor Approach (CRFA). Though policies have directed that oral health should be integrated into general health promotion in South Africa, little is known about the implementation of the CRFA in daily oral health promotion practice.

Aim:

This study aimed to assess how health promoters in Gauteng integrate oral health into their general health promotion activities.

Objectives:

The objectives were (i) to describe how health promoters undertake health promotion in Gauteng; (ii) to describe how health promoters incorporate oral health promotion into health promotion activities; and (iii) to describe the opportunities and challenges for health promoters in applying the CRFA.

Method:

This was a qualitative study and data were collected using semi-structured interviews. A purposive sample of 10 formally trained health promoters agreed to be interviewed. Thematic analysis was used to analyse the data.

Results:

Participants’ work was centred mostly on healthy lifestyle campaigns and there was little integration of oral health into health promotion activities. While most health promoters had an understanding of the CRFA, this understanding was not common amongst other levels of management. Oral health literacy was low and health promoters perceived few opportunities for using a CRFA when weighed against other priorities such as poverty and HIV/AIDS.

Conclusion:

Currently there is little evidence of integration of oral health into general health promotion activities.