Evaluating an Oral Health Education Intervention in Chinese Undocumented Migrant Mothers of Infants in Northern Ireland

The effectiveness of behaviour change interventions delivered by non-dental health workers in promoting children’s oral health: A systematic review and meta-analysis

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.

Common Risk Factor Approach to Limit Noncommunicable Diseases and Periodontal Disease-The Molecular and Cellular Basis: A Narrative Review

Introduction

The link between periodontal disease and noncommunicable diseases (NCDs) has been the subject of major research over the past several years. The primary objective of this review is to understand the cellular and molecular components that link common risk factors (exposure) in adult patients (population) with periodontal disease and other NCDs (outcome). The secondary objective is to interpret from existing literature the possibility of identifying the molecular plausibility of the Common Risk Factor Approach (CRFA).

Materials and Methods

A literature search was performed in PubMed/MEDLINE, CINAHL, Web of Science, and Google Scholar for all published articles pertaining to the molecular and cellular basis of the risk factors between periodontal diseases and major NCDs. Data from all randomized and nonrandomized clinical trials, cross-sectional studies, case-control, cohort studies, literature, and systematic reviews were included.

Results

Periodontal pathogens, stress, obesity, smoking, and dietary factors are some of the common risk factors between periodontal disease and NCDs.

Conclusion

Understanding the molecular and cellular link of common risk factors between NCDs and periodontal disease would ensure the application of CRFA. The CRFA implies that controlling the risk factors associated with NCDs can have an incredible positive impact on regulating many chronic conditions, which would extend to periodontal health also.

Promoting Inclusion Oral Health: Social Interventions to Reduce Oral Health Inequities

To advance our understanding of inclusion oral health and to address the impact of social exclusion upon oral health, this group of papers sets out to provide an argument for the need for social and community-based interventions, theoretically underpinned by pluralistic definitions of evidence-based practice and the radical discourse of health promotion for those experiencing exclusion. Using the definition and framework of inclusion oral health, these papers illustrate the requirement for mixed-methods research, the incorporation of experts by experience in the research process, and the need for co-design and co-produced interventions. The papers in this Special Issue present various sources of evidence used to transform top-down into bottom-up community-based interventions for people experiencing homelessness, people in custody, and families residing in areas of high social deprivation. The first two papers provide the evidence for extreme oral health in those experiencing exclusion, and the final four papers report on the implementation and evaluation of social or community-based interventions. This collection of research papers will be of interest to all those wishing to reduce health inequities. This will be achieved by focusing on prevention, adopting a common risk factor agenda, and incorporating co-design and co-production elements into interventions, to tackle the oral health inequities felt by those most excluded in our societies.