Effectiveness of Oral Health Educational Methods among School Children Aged 5–16 Years in Improving their Oral Health Status: A Meta-analysis

Promoting Health Literacy in the Workplace Among Civil Servants: Cross-Sectional Study

Background

In 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population.

Objective

This study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces.

Methods

A cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed.

Results

A total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores.

Conclusions

Some French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.

The relationship between the source of oral health information and dental caries: Findings from Child Dental Health Survey 2013 in England

OBJECTIVE

To determine the magnitude and shape of the relationship between dental caries experience and the source of oral health information in England.

METHODS

This was a cross-sectional study using the Child Dental Health Survey 2013 in England. Using a negative binomial model, the relationship between the number of decayed, missing, filled teeth (DMFT) of 12- and 15-year-old students and their primary source of oral health information was assessed. The sources of oral health information included parents, television, newspapers, the Internet, and social media. The adjusted model included age, sex, and the Index of Multiple Deprivation (IMD). R was used for data handling, analysis and reporting.

RESULTS

Overall, 2,372 children were assessed (48.7% female, 48.6% 12-year-old). For the majority, the primary source of oral health information was their parents (89.5%) followed by the Internet (43.4%). Over nine-tenth of the participants had a DMFT = 0. The adjusted model showed that the prevalence rate of DMFT for the children whose primary source of information is their parents (0.45) or television (0.62) is lower than 1. The prevalence rate for the Internet (1.17) and social media (1.67) was higher than 1, but they were removed from the final model due to being non-statistically significant. Age and deprivation had a direct relationship with the prevalence rate of DMFT, meaning that 15-year-olds and children from more deprived areas had a higher prevalence rate of DMFT.

CONCLUSION

Children whose primary source of oral health information was their parents or television had a lower DMFT. On the contrary, using the Internet or social media as the source of oral health information was associated with higher caries experience among schoolchildren.

Effectiveness of school oral health programs in children and adolescents: an umbrella review

AIM

To evaluate the systematic reviews assessing the effectiveness of any type of school-based oral health programs in children and adolescents.

METHODOLOGY

A two-staged search strategy comprising electronic databases and registries based on systematic reviews was employed to evaluate the effectiveness of school-based interventions. The quality assessment of the systematic reviews was carried out using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2) tool. The Corrected Covered Area was used to evaluate the degree of overlap.

RESULTS

Nine reviews were included in this umbrella review. The Critical Covered Area reported moderate overlap (5.70%) among the primary studies. The assessment of risk of bias revealed one study with a high level confidence; one with moderate whereas all other studies with critically low confidence. Inconclusive evidence related to improvements in dental caries and gingival status was reported whereas, plaque status improved in a major proportion of the reviews. Knowledge, attitude, and behavior significantly increased in students receiving educational interventions when compared to those receiving usual care.

CONCLUSIONS

The evidence points to the positive impact of these interventions in behavioral changes and clinical outcomes only on a short term basis. There is a need for long-term follow-up studies to substantiate the outcomes of these interventions.

Impact of an Educational Intervention on Oral Health Knowledge and Bacterial Plaque Control in Male Secondary School Students in a Peruvian Province: A Quasi-Experimental Study

Background

The purpose of this study was to evaluate the effect of an educational intervention on oral health knowledge and bacterial plaque control in male secondary school students in a Peruvian province.

Methods

This quasi-experimental study evaluated 294 male secondary school students in southern Peru. Oral health knowledge was measured with a validated 20-item questionnaire. Bacterial plaque was measured with the Simplified Oral Hygiene Index (OHI-S). This was rated as Excellent: 0, Good: 0.1-1.2, Fair: 1.3-3.0 and Poor: 3.1-6.0, before receiving the educational intervention and after four weeks of receiving it. Variables such as age, area of residence, having health professionals as family members, educational level of mother and father, and living with parents were considered. A significance level of p<0.05 was considered.

Results

The comparison between the level of oral health knowledge and the OHI-S, before and after 4 weeks of receiving the educational intervention, showed a significant improvement (p<0.05) in all the categories of the variables studied. Likewise, before the educational intervention, there were significant differences in global knowledge about oral health among the categories of the following variables: age group (p=0.040), area of residence (p<0.001), educational level (father) (p=0.011) and living with parents (p<0.001). However, after four weeks of receiving the educational intervention, no significant differences were observed in all the variables studied (p>0.05). Regarding the OHI-S, no significant differences were observed in any of the variables studied, both before (p>0.05) and after four weeks (p>0.05) of receiving the educational intervention.

Conclusion

After four weeks, the educational intervention significantly improved oral health knowledge and significantly reduced plaque bacterial plaque in male secondary school students in a Peruvian province, regardless of age, area of residence, having health professional family members, educational level of mother and father, and living with parents.

Supporting health education policies: translation, cross-cultural adaptation and validation of a health literacy instrument, in French

Background

Oral health is a fundamental human right and is inseparable and indivisible from overall health and well-being. Oral Health Literacy (OHL) has been proved to be fundamental to promoting oral health and reducing oral health inequalities. To our knowledge, no OHL instrument to evaluate OHL level is currently validated in French language despite the fact it is the fifth most widely spoken languages on the planet. The Oral health literacy Instrument (OHLI) appears to be the most interesting OHL instrument to adapt into French because it is already available in English, Spanish, Russian, Malaysian, and it contains both reading comprehension and numeracy sections. Its psychometric properties have been rated as adequate.

Objective

The aim of this study was to translate and adapt cross-culturally the OHLI into French, to evaluate its psychometric properties and to compare its results to oral health knowledge.

Method

This study followed and applied well-established processes of translation, cross-cultural adaptation and validation, based on the recommendations of the World Health Organization guidelines and on the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) study design checklist for patient-reported outcomes. Two psychometric assessments were planned, the comparison of OHLI-F scores according to education level and frequency of dental visits, and the test-retest reliability of the OHLI-F.

Results

A total of 284 participants answered the OHLI-F. The OHLI-F scores were significantly different between participants with different levels of education and frequency of dental visits (p < 0.001). Participants with an education level lower than the baccalaureate, and those who never visit the dentist or only in case of pain, had significantly lower OHLI-F scores. Internal consistency was excellent (Cronbach's alpha = 0.881-0.914). Test-retest reliability was very high (intraclass correlation = 0.985 to 0.996).

Conclusion

The OHLI-F has demonstrated adequate psychometric properties and can therefore be used to measure oral health literacy in French-speaking populations.

Development and feasibility of an oral health e-learning program for long-term Japanese overseas workers: a pilot randomized controlled trial

BACKGROUND

This study aimed to assess the feasibility and acceptability of an oral health self-care e-learning intervention for overseas workers as well as the research procedures for a future controlled trial.

METHODS

We randomly allocated participants to either the intervention (n = 48) or control (n = 51) group. The intervention group received a standardized leaflet plus a theory-based oral health e-learning program. The control group received only the standardized leaflet. We assessed health behaviour related to fluoride toothpaste use, oral care knowledge, motivation, oral care self-efficacy, and oral health related quality of life (QoL). Chi-square and t test analyses were performed to make comparisons between the two groups. To evaluate the research process, participants in the intervention group were asked open-ended questions to assess the acceptability and feasibility of the research procedures in practice.

RESULTS

A total of 82 participants (Intervention = 36, Control = 46) were included in the analysis. The dropout rate was 17.2%. The modal time taken to complete the e-learning intervention was more than 30 min (33.3%). Of the 36 respondents in the intervention group, 27 (70.4%) said that the e-learning intervention had changed their behaviour. At the three months follow-up, oral care knowledge alone was improved in the e-learning group.

CONCLUSION

This pilot study provides evidence that the theory-based self-care for oral health e-learning intervention is feasible in overseas workers. Next, this feasible and acceptable pilot study should be used with an appropriate sample size in a randomized controlled trial.

TRIAL REGISTRATION

The trial protocol was registered with UMIN-CTR (ID: UMIN000045883) on 27/10/2021.