Knowledge, attitude, and practice of parents of 7-12-year-old children regarding fissure sealant therapy and professional fluoride therapy

The effect of fluoride varnish application on colour change due to paediatric drug usage in polyacid-modified composite resin: an in vitro study

OBJECTIVE

Colour stability is important in the long-term aesthetic success of restorative materials and is affected by both internal and external factors. Internal discolourations are due to the properties of the restorative materials. External discolourations can be associated with frequent consumption of food and beverages and the use of suspensions or syrups containing colourants/additives. Fluoride varnish application has an important place in preventive dentistry. The purpose of the research was to examine the protective effect of fluoride varnish application on the colour change on polyacid-modified composite resin restorative materials caused by the use of various paediatric drugs.

METHODS

Two hundred ten discs were prepared from polyacid-modified composite resin material and divided into two groups: flouride varnish was applied to one group and flouride varnish was not applied to the other group. The groups were further divided into seven subgroups and the samples were kept in artificial saliva, amoxicillin + clavulanic acid, cefuroxime axetil, clarithromycin, paracetamol, ibuprofen, and iron supplement drug solutions. The colour change values of the discs were measured using a spectrophotometer device before immersion in the drug solutions and on the 7th, 14th, 21st, and 28th days after the immersion. The obtained data were calculated and statistically evaluated using IBM SPSS V23 software.

RESULTS

It was found that the application of fluoride varnish in the iron supplement drug group prevented the colour change of the polyacid-modified composite resins for 28 days. In the amoxicillin + clavulanic acid, cefuroxime axetil, and paracetamol groups, the fluoride varnish did not prevent colour change in the polyacid-modified composite resin restorative materials at the end of the 14th day.

CONCLUSION

It is thought that fluoride varnish application may be beneficial as a preservative in the colour change of polyacid-modified composite resins due to the use of various paediatric drugs, and this protective feature may be effective for a specific period of time.

Parental Knowledge, Attitude and Practices Toward Dental Sealants as Preventive Strategy for Dental Caries in Children: A Cross Sectional Study

Aim. This study aimed to evaluate the knowledge, attitude, and practices of parents residing in Pakistan toward pits and fissure sealants in children. Materials and Methods. This descriptive, cross-sectional study was carried out between November 2022 to March 2023. An online questionnaire was distributed through various social media platforms. Independent t-test and Multiple Linear Regression analysis were performed. Results. A total of 570 participants were recruited. For protection against tooth decay, most of the participants 456(80%) believed that fissure sealants should be placed to protect teeth from decay. Placement of fissure sealants was considered to be a cost-effective measure by majority of the 480 (84.2%) respondents. Conclusion. Fissure sealants are one of the most effective preventive measures against tooth decay. The knowledge, attitude and practice of parents were some being aware of fissure sealants and some were not. It appeared to support the placement of fissure sealants for their children.

Is It Mum or the Dad? Parental Factors That Influence the Use and Acceptance of Fluoride Varnish among Parents in Eastern Saudi Arabia

Objective

To investigate parental factors that influence knowledge, use, and acceptance of fluoride varnish (FLV) application.

Methods

This cross-sectional study was conducted during December 2021. A multistage sampling technique was used to recruit parents with children aged 3 to 6 years and residing in Eastern Saudi Arabia, excluding those working in the dental field. The questionnaire consisted of four parts: demographics, knowledge, previous experience, and acceptance of FLV and was pilot-tested and distributed online using social media.

Results

A total of 623 parents responded to the survey. Only 36.9% of parents had good FLV knowledge with dentists being the main source of information. Gender, educational level, family income, being in the medical field, and source of knowledge were factors that significantly (P < 0.05) influenced parental knowledge. Only 24.6% of the parents applied fluoride varnish to their children before, of whom only 29% were satisfied with the experience. Parent's FLV knowledge, view of dental visits, satisfaction with previous experience, perception of children's oral health, and willingness to reapply FLV were factors that significantly (P < 0.05) influenced FLV use. Working in the medical field, perception of dental visits, and the source of knowledge were factors that significantly (P < 0.05) influenced the parent's acceptance to apply FLV. While lack of knowledge about fluoride benefits (15%) was the main reason for parental refusal to apply FLV.

Conclusions

The current study highlights the lack of knowledge and application of FLV among parents. There were more factors influencing mothers' acceptance of FLV application compared to fathers. Age, educational level, working in the medical field, perception, and patterns of dental visits were some of the identified factors. Dentists played a major role in parental knowledge and FLV acceptance. In a country with high caries prevalence, preventive programs such as FLV education and application are crucial.

Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran

INTRODUCTION

The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran.

METHODS

This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05).

RESULTS

The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4).

CONCLUSION

It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.

A model for implementing oral health-promoting school: Integration with dental students' educational curriculum: A protocol study

BACKGROUND

Schools are ideal setting for children's oral health-promoting programs. It is an integrated model for oral health-promoting schools (OHPS) with the capacities of dental school's curriculum and dental students as workforces. In this protocol, the principle of planning and implementation of the oral health program is described.

MATERIALS AND METHODS

Based on the PRECEDE-Policy, Regulatory, and Organizational Constructs in Educational and Environmental Development (PROCEED) planning model, a framework for determining the potential predisposing, reinforcing, and enabling factors that could be intervening was diagnosed. To adapt the phases of the planning model for integration of the "OHPS" principles and the dental students' curriculum, the following steps are supposed to be considered: Phases 1-5 which are to assess the baseline data will include the assessment of children oral health status and parents and teachers' knowledge, attitude, and performance. Phase 6 or implementation phase will be allocated to oral health education interventions for students, parents, and teachers, professional screening, prevention, and referral. Phase 7 or the process assessment phase will be to record the number of screened students, the amount of fissure sealant and fluoride provision, and percentage of trained parents and teachers. Phase 8 or the impact assessment phase will assess the students' improvement in knowledge and practice, decayed, missing, and filled teeth scores, teachers and mothers' oral health attitudes and behaviors, and brushing and flossing behaviors. At the last, cost analysis of the program and long-term monitoring of the interventions is suggested.

CONCLUSION

In case that the effectiveness of this model is proven, it can be implemented by other dental schools for the primary schools in their regions. Considering the number and distribution of dental schools in the country, this model is executable as targeted population oral health promotion approach in 6-12-year-old schoolchildren.

Sealant Utilization and its Influence on Caries Reduction in First Permanent Molars in Saudi Female School Children

Purpose:

This study aimed to assess the utilization of fissure sealants and their influence on caries reduction in first permanent molars (FPMs) among 6-9 years old female schoolchildren in Dammam, Eastern Province of Saudi Arabia.

Materials and Methods:

First to fourth grade female children from public schools in Dammam participated in this cross-sectional study. Dental caries and fissure sealants in FPMs were examined clinically using the World Health Organization guidelines. In addition, the parents of the participants responded to a self-reported questionnaire.

Results:

The study analyzed the data of 449 children. Almost 44.3% of the participants had at least one FPM affected with caries. There were 8.7% of the participants who had fissure sealants in at least one FPM, and out of these, only 2.2% had four FPMs filled with sealants. A significantly greater proportion of participants with sealed FPMs had no caries than the lower proportion of participants without sealants who had caries (P=<0.05). The use of sealants increased significantly from first grade (10.3%) to second grade (30.8%), third grade (38.5%), and fourth grade (20.5%) (P=0.006). High monthly family income (P= 0.047) and having insurance (P=0.017) were significantly associated with increased sealant application. Nearly 21.9% of participants’ parents were aware of caries protective effects of dental sealants.

Conclusion:

The application of sealants was significantly associated with reduced caries in FPMs. Class year, monthly family income, and insurance were significantly associated with having sealants. Caries prevention programs for children should incorporate sealant application.

Effect of sense of coherence on oral health behavior and status: A systematic review and meta-analysis

The sense of coherence (SOC) is defined as a personal orientation to life. People with higher SOC are better at dealing with stressful situations, psychological stress, and problems and are more able to manage them, leading to better general health. The purpose of this study was to evaluate the effect of SOC on the oral health status of people in different age groups. A systematic search up to May 2019 was carried out in PubMed,Scopus, Psycho info, and Persian sources. Studies were included if they evaluated the relationship between SOC and oral health behaviors (OHBs) or oral health status including dental caries. The Newcastle-Ottawa checklist was used to appraise the selected articles and meta-analysis of included studies were performed using Comprehensive Meta-Analysis software. Value of P < 0.05 was considered to be statistically significant. Odds ratio (OR) was used to measure effect size with 95% confidence interval (CI). The random-effects model was chosen in the presence of heterogenicity. I ² index and Q index were used to measure the heterogeneity present between the studies. Fifteen articles received the minimum score of criticism. In general, SOC could significantly affect the oral health and OHBs of adults independently of the underlying factors. There was a significant relationship between SOC and tooth decay in adolescents, but this association was poor after adjusting for the underlying factors. In children, only one article revealed an association with OHBs. Meta-analysis revealed that SOC was significantly associated with the caries rate (OR = 0.78, CI 95% = 0.9-0.67, P = 0.001) and tooth brushing frequency (OR = 1.22, CI 95% = 1.1-1.31 and P < 0.001). Sense of coherence appears to be one of the effective factors in predicting oral health behaviors and ultimately oral health, especially in adults. The number of articles available for children and adolescents was not sufficient in this regard.

Fissure sealant therapy as a portable community-based care in deprived regions: Effectiveness of a clinical trial after 1 year follow-up

The aim of this study was to evaluate the effectiveness of the fissure sealant therapy in suboptimal setting (as part of a community-based program using the portable equipment and provided by dental students) on the caries status of school children. This pragmatic split-mouth randomised clinical trial was conducted in rural area of Iran. At baseline, 124 patients, including 185 paired teeth with deep pits and fissures of opposite quadrants that were either healthy or at early stages of enamel decay (International Caries Detection and Assessment System [ICDAS] 0-2), were randomly allocated to receive fissure sealant or acted as control. The incidence of new caries (ICDAS code 3-6) and the sealant's retention status after 1-year follow-up were evaluated. Using chi-square test, the relative risk (RR) and the Number Needed to Treat (NNT) to prevent new caries were calculated. After 1 year, 109 patients including 163 paired teeth were available. Sixty-seven (41.4%) and 44 (27.2%) teeth had complete and partial retained sealants respectively. The risk of caries incidence in non-sealed teeth was almost three times more than sealed teeth (RR = 2.88, 95% CI: 1.4-1.97, p = 0.002) and the NNT was 10 (95% CI: 6-26). A significant association was noted between the status of sealant retention after 1 year and the incidence of new caries (p < 0.001). Fissure sealant as part of a community-based program was effective in controlling caries incidence.

Investigating the Level of Knowledge of the Community about Oral and Dental Health

Objectives  This study aimed to determine the knowledge and approaches of the participants about oral and dental health.

Materials and Methods  This was a questionnaire-based cross-sectional survey. Participants’ demographic characteristics, tooth brushing habits, selection of toothpaste, and reasons for visiting the dentist were examined in this study. Participants’ knowledge levels of fluoride and their attitudes toward the most common fluoride applications among preventive treatments were also evaluated. Data entry and analyses were performed using SPSS statistical software. Descriptive and inferential statistics and chi-square test were used for analyzes.

Results  A total of 2,744 voluntary participants including 1,938 (70.6%) females and 806 (29.4%) males responded; 1,391 (50.7%) participants know the contents of their toothpaste; 1,680 (61.2%) participants point out that fluoride is effective in preventing dental caries. Female participants reported a statistically significant difference in their knowledge of what is fluoride when compared with male participants ( p = 0.0001). The knowledge level of participants who had higher levels of education were statistically significantly different when compared with the participants who had lower education levels about fluoride and fluoride applications ( p = 0.0001).

Conclusions  The results of this study indicate that participants’ attitudes toward oral health and dental care need to be improved.

Reduction of Dental Caries Among Children and Adolescents From a 15-Year Community Water Fluoridation Program in a Township Area, Korea

Since 2000, a community water fluoridation program (CWFP) has been implemented in Hapcheon for over 15 years. We aimed to evaluate the caries-reducing effect on permanent teeth after this implementation. In 2015, evaluation surveys were conducted by our study group, 498 subjects aged 8, 10, 12, and 15 years. As the control, 952 similarly aged subjects were selected from the Sixth Korean National Health and Nutrition Examination Survey (2013-2015 KNHANES). Data of a prospective cohort of 671 8-,10- and 12-year-olds, collected when CWFP started, were used for the evaluation. Caries-reducing effects were estimated by decayed, missing and filled teeth (DMFT) scores between CWFP and control groups, pre- and post-program. Confounders including the mean number of sealant teeth and gender were adjusted for. The mean adjusted DMFT scores of 10-, 12- and 15-year-olds in Hapcheon were significantly lower compared to KNHANES DMFT scores; in addition, those of 8-, 10- and 12-year-olds after the 15-year CWFP were significantly lower than in 2000. The caries-reducing effect among 12-year-olds was 37.6% compared to those recorded in KNHANES, and 67.4% compared to those in 2000. In conclusion, the caries-reducing effect was so high that health policy makers should consider CWFP as a priority policy for caries-reducing in Korean children and adolescents.

Oral health of 6-7 year-old children according to the Caries Assessment Spectrum and Treatment (CAST) index

Background

The index of Caries Assessment Spectrum and Treatment (CAST) reveals a range of caries development from a non-cavitated status to advanced lesions. The aim of the present study was to explore the oral health status of 6- to 7-year-old children based on the CAST index in relation to oral health knowledge and background determinants.

Methods

A multi-stage cluster random sampling method was applied and after ethical clearance, clinical examination was performed (Kappa = 0.89). The status of caries and oral hygiene was recorded according to the CAST index and OHI-Simplified (OHI-S) index, respectively. A self-administered questionnaire was used to collect the data of parental knowledge of oral health. SPSS version 22.0 was used for data analysis and p-value less than 0.05 were considered significant.

Results

Seven hundred and thirty-nine children and their parents in 24 schools participated in this study (88%), of whom 48.6% were boys and the rest were girls. In permanent molars, a healthy status (code 0–2) was observed in 89.3–93.7% of the teeth. In primary molar teeth, dentinal lesions ranged from 25.3 to 31.2%, the prevalence of pulp involvement was between 2.9 and 10.5%, and less than 1% had abscess/fistula. Serious morbidity (codes 6 and 7) were more common in the first primary molars than the second ones. Multi-variable logistic regression analysis indicated that children with a low level of father’s education were 2.45 times more likely to have a CAST score of 3 and higher (95% CI 1.35–4.46, p = 0.003) compared to children whose fathers had academic education. For each one-unit increment of OHI_S, the likelihood of a CAST score 3 and higher in primary dentition increased by 1.77 times (OR = 1.77; 95% CI 1.08–2.93, p = 0.02).

Conclusion

The consequences of dental caries including abscess and fistula were more prevalent in the first and second primary teeth. There was a significant correlation between a CAST score of 3 and higher with father’s education (as an indicator of social rank) and oral hygiene status. The CAST index is a useful and practical index in epidemiological surveys.

Electronic supplementary material

The online version of this article (10.1186/s12903-018-0709-x) contains supplementary material, which is available to authorized users.