Oral Health Nursing Education and Practice Program: Ten-Year Outcomes

The Oral Health Nursing Education and Practice Program (OHNEP), a core partner of the National Interprofessional Initiative on Oral Health, is a national initiative focused on implementing an interprofessional oral health workforce innovation to influence change in clinical education, practice, and policy. OHNEP aims to address oral health disparities by enhancing the nursing profession's role in integrating oral health and its links to overall health in both academic and clinical settings. Leveraging the opportunity to cultivate faculty, preceptors, and clinicians as oral health champions, OHNEP aims to integrate interprofessional oral health clinical content and competencies in undergraduate and graduate nursing programs through faculty and preceptor development, curriculum integration, and establishing oral health as a standard of care in clinical settings. Outcomes include widespread dissemination of OHNEP virtual products and resources used by a significant number of undergraduate and graduate programs nationwide. OHNEP has a notable impact on policy related to integrating oral health and its links to overall health in undergraduate and graduate nursing programs, thereby increasing interprofessional oral health workforce capacity and aiming to improve oral health equity.

Exploring the experiences and perspectives of women on oral health during pregnancy: A qualitative study in Tasmania, Australia

OBJECTIVE

To explore women's oral health experiences and barriers to dental care and identify potential strategies to improve oral health during pregnancy.

METHODS

A qualitative descriptive study design was used. Purposively elected antepartum and postpartum women ≥18 years of age from Tasmania, Australia, were recruited using maximum variation sampling. Semi-structured interviews were conducted, and all qualitative data were analysed using an inductive thematic approach.

RESULTS

Fifteen women were interviewed with a mean ± SD age of 32.3 ± 4.5 years. Three key themes were generated from the data that described women's perceived changes in their oral health during pregnancy; barriers to oral health care during and after pregnancy; and perceived strategies to improve access to care. Most women acknowledged the importance of maintaining good oral health but reported a decline in their oral health status during pregnancy. Women also identified several barriers to dental care, including treatment costs, competing maternal priorities, limited oral health knowledge and negative perceptions towards dentistry. The provision of preventative oral health care by ANC providers was also limited. Community awareness, patient education resources and assessment tools could support the promotion of oral health care. Women also perceived that interprofessional collaboration between antenatal and dental providers played a key role in promoting oral health.

CONCLUSION

This study explored women's varied oral health experiences and perceptions during pregnancy and highlighted critical barriers and enablers to dental care. Policy-level strategies that promote interprofessional collaboration between antenatal and dental providers and expand dental care access are suggested to overcome barriers to oral health for women during pregnancy.

Perceptions, knowledge, and practices related to oral health in a group of pregnant women: A qualitative study

BACKGROUND

It is well known that the prevalence of dental caries and periodontal disease is increasing in pregnant women. Dental care is mostly sufficient to prevent oral diseases and perform timely interventions. However, few pregnant women go to the dental office during this period due to a lack of knowledge. The perceptions, knowledge, and oral health practices of pregnant women have been scarcely explored and should be taken into account to propose positive interventions in this population.

OBJECTIVES

To identify and explore the perceptions, knowledge, and practices of oral health in a group of pregnant women in Colombia.

MATERIAL AND METHODS

Twenty-four semistructured interviews were conducted in different areas of Colombia. The interviews were conducted via telephone, and the calls were recorded with the consent of the participants. The recordings were transcribed in Word® and checked for typing and transcription errors. The transcripts were analyzed using a hybrid approach combining inductive and deductive coding. The information was organized and encoded using NVivo12 ®software. We followed the Standards for Reporting Qualitative Research (SRQR) checklist.

RESULTS

Pregnant women reported having good oral health. One barrier mentioned for occupation (Job) was pregnancy. The appearance of the oral cavity has not negatively affected the relationships of pregnant women.

CONCLUSIONS

The pregnant women had good oral hygiene habits but did not receive dental check-ups. Knowledge in this group was limited and diverse. The information given by health professionals should be standardized, and some beliefs should be demystified.

RELEVANCE TO CLINICAL PRACTICE

In general, few pregnant women were aware of bleeding gums during pregnancy. Empower pregnant women to take care of themselves through regular dental check-ups with the aim of preventing and treating oral diseases. Oral hygiene education and healthy nutritional habits should be intensified during this stage.

PATIENT OR PUBLIC CONTRIBUTION

The participation in the study included a semistructured interview by telephone with the prior consent of the pregnant woman authorizing her involvement and the recording of the interview.

Knowledge and attitudes on oral health of women during pregnancy and their children: an online survey

BACKGROUND

Life-long healthy behaviors are established during pregnancy and the first years of life. In this cross-sectional survey, new mothers with a high level of schooling living in Northern Italy (Lombardy Region) were interviewed to assess their knowledge and attitudes towards their and child oral health.

METHODS

A questionnaire (27 items) was developed to assess socio-demographic factors, knowledge, and attitudes towards maternal and child oral health. The questionnaire was disseminated in perinatal courses, private gynecological clinics, and via social media. Mothers aged ≥18 years, with at least a child aged 0-36 months, with a high school diploma or higher, were included in the survey.

RESULTS

A total of 1340 women completed the questionnaire, 1297 of whom had a child aged 0-36 months, 792 lived in Lombardy, and 600 had a high level of education and were finally included. About half of the sample (44.67%) was aged between 31 and 35 years, 76.50% were employed, and the majority had only one child (81.50%). During pregnancy, 28.33% of the sample reported problems with teeth and gums, while only 36.00% visited a dentist. More than 40% of the sample said they were not aware of a possible link between oral health and pregnancy, and 73.17% had not received any advice about their oral health or the future health of their baby's mouth. Less than 20% of women were aware of the increased caries risk associated with prolonged or night-time breastfeeding. Better knowledge/attitude was associated with the age of the child (p < 0.05), the number of children (p < 0.05) and whether the mother had received advice during pregnancy (p < 0.05).

CONCLUSIONS

The results of this survey show a lack of dental care during pregnancy, a lack of information about oral health from health professionals during and after pregnancy, and consequently gaps in the knowledge needed to care for the oral health of the woman and her child. There is a need for training in oral health for pregnant women and new mothers, but also a need for behavioural change among health professionals who care for pregnant women.

Promoting openness to autism amongst dental care professional students

INTRODUCTION

Autism spectrum disorders (ASD) is a lifelong condition affecting communication and social interaction, characterised by repetitive or repeated patterns of behaviour. People with ASD experience poor systemic and oral health. They face reduced access to dental care related to provider barriers associated with lack of understanding of ASD, lack of training and a consequent reluctance to treat people with ASD.

MATERIALS AND METHODS

The effectiveness of training given by a person with autism to student dental care professionals was evaluated by measuring change in 62 students' openness to autism scale scores and confidence treating a person with autism. These students included third year dental students and second year dental nursing and hygiene students. This cohort was recruited as part of their curriculum and opted in for inclusion in the study. Data were analysed using SPSS®.

RESULTS

An increase in openness scale scores of 7.6% (p < .05) and in confidence of 4.9% (p < .05) between pre- and post-training was observed. Openness scale score predicted level of confidence at baseline (OR = 0.21 (95% CI = 0.02-0.39)).

CONCLUSION

An educational intervention delivered by a person with autism promoted modest increases in openness towards autism and confidence amongst dental care pre-service professionals. Whilst the results suggest that peer-led dental care professional teaching by people with autism may be beneficial, more research is needed.

Patterns of Change in Parental Health Literacy in Relation to Children's Oral Health

BACKGROUND

Although health literacy (HL) skills may change over time, most research treats HL as a constant, using baseline HL to predict other health-related constructs. Few studies have explored change in HL over time.

OBJECTIVE

We examined person-level differences in HL trajectories. We identified subgroups (latent classes) based on longitudinal assessments of HL and examined the association of class membership with demographic and oral health variables.

METHODS

We used four measurement waves of parental HL data, reflecting the risk of limited HL, collected as part of an intervention to reduce dental decay in American Indian children (N = 579 parent-child dyads at baseline). Repeated measures latent class analysis (RMLCA) models were estimated to identify subgroups of HL trajectories over time. We examined class membership in association with baseline demographics and with 36-month assessments of parental oral health knowledge, beliefs, and behaviors as well as pediatric oral health.

KEY RESULTS

A four-class model best fit the data. The largest class (high HL; 49.7% of the sample) was characterized by high levels of HL at all waves. A second class (improving HL; 17.7%) improved over all waves. The remaining two classes were characterized as moderate HL (20%) and low HL (12.6%) and maintained relatively stable HL levels over time. Higher educational attainment was associated with membership in the high HL and improving HL classes. Older age among this young-adult sample and higher income also were associated with high HL class membership. Parents in the high HL and improving HL classes exhibited more favorable performance on measures of oral health knowledge, beliefs, and behavioral adherence than did those in the other classes. Class membership was not associated with pediatric oral health.

CONCLUSIONS

RMLCA demonstrated person-level variability in HL trajectories. Longitudinal patterns were associated with baseline demographics and prospectively with parental oral health knowledge, beliefs, and behaviors, but not with pediatric oral health. [HLRP: Health Literacy Research and Practice. 2023;7(2):e89-e98.].

Integrating Oral Health into Health Professions School Curricula

Oral health is essential to human health. Conditions associated with poor oral health involve all organ systems and many major disease categories including infectious disease, cardiovascular disease, chronic pain, cancer, and mental health. Outcomes are also associated with health equity. Medical education organizations including the Association of American Medical Colleges and National Academy of Medicine recommend that oral health be part of medical education. However, oral health is not traditionally included in many medical school, physician assistant, or nurse practitioner curricula. Several challenges explain this exclusion including lack of time, expertise, and prioritization; we therefore provide suggestions for integrating oral health education into the health professions school curriculum. These recommendations offer guidance for enhancing the oral health curriculum across institutions. We include key organizational and foundational steps, strategies to link oral health with existing content, and approaches to achieve curricular sustainability.

The Impact of Oral Health Training on the Early Year's Workforce Knowledge, Skills and Behaviours in Delivering Oral Health Advice: A Systematic Review

OBJECTIVES

To determine the effectiveness of training the early year's workforce on their knowledge, skills and/or behaviours in delivering oral health advice.

METHODS

Four databases: PubMed, Web of Science, Embase and Scopus were searched to evaluate the effectiveness of oral health training on knowledge, skills and behaviour of the early year's workforce with a minimum of one-month follow-up. Randomised or quasi-randomised trials and before and after studies were included.

RESULTS

All six included studies showed improved knowledge and one of the five studies showed significant changes in behaviours of participants post oral health training. None of the included studies addressed changes in skills as an outcome.

CONCLUSION

This systematic review found evidence that oral health training of the early year's workforce is effective in improving their knowledge but not necessarily their behaviours delivering oral health advice. Although training of the wider workforce on oral health is recommended, high quality research is required with longitudinal follow-up to assess changes in behaviours and ultimately impacts on oral health.

Bridging gaps in oral health education in a medical school in the United States: a pilot study

BACKGROUND

Oral health is an important component of medical education given its connection to overall health and quality of life; however, oral health is infrequently incorporated into medical school curricula in the United States. The aim of this study was to pilot a novel oral health care clerkship for United States medical students that implemented the Smiles for Life (SFL) curriculum, in-person clinical activities, and pre and post curricula assessments to assess knowledge acquisition, attitude change, and clinical skill development.

METHODS

Third year medical students at Albert Einstein College of Medicine, Bronx, New York, volunteered (n = 37) for a clerkship in oral health. Students completed the Smiles For Life National Oral Health Curriculum and participated in three half-day clinical sessions in a hospital-based dental clinic. The participants were evaluated on knowledge acquisition, attitude change, and clinical skill development through a pre and post clerkship assessment in order to assess the efficacy of the intervention.

RESULTS

There was a 23.4% increase in oral health knowledge (p < 0.001) following participation in the online modules and clerkship. Additionally, attitudes in the following domains showed improved familiarity and proficiency: causes and prevention of dental caries (78.4%, p < 0.001) and periodontal disease (83.8%, p < 0.001), provision of oral health information to patients (67.6%, p < 0.001), and ability to conduct an oral examination (62.2%, p < 0.001).

CONCLUSIONS

Third year medical students who participated in a novel oral health clerkship demonstrated significant increases in basic oral health knowledge and reported increased comfort in providing oral examinations and anticipatory guidance to patients. The results support the feasibility of this approach to incorporating oral health education into a medical school curriculum in the United States.

Peer-led oral health education model for elementary school-aged children in British Columbia, Canada

OBJECTIVE

To examine the effectiveness of peer-led preventive oral health education for elementary school-aged children.

METHODS

A controlled, non-randomized interventional study included children in grades 4 to 6 (N = 372) from 6 schools in British Columbia, Canada. The control group (3 schools) received a class-based lecture on oral health. In the intervention group (3 schools), each sixth grader mentored a small group of fourth and fifth graders. The study outcomes were 1) need for oral care referrals (visual screening); 2) oral health knowledge (self-reports); 3) oral self-care practice (OSC-P); and 4) oral self-care skills (OSC-S). Assessments of OSC-P and OSC-S were based on disclosed dental biofilm levels. Study group comparisons were done at baseline and 8 to 12 months.

RESULTS

A high need for oral care referrals was found, with a substantial reduction achieved during the study period. Dietary knowledge improved minimally in the intervention group. In both study groups and within age groups, there was a wide variation in OSC-P and OSC-S. Overall, children's OSC-P scores were substantially higher than their OSC-S scores. Oral self-care outcomes improved over time in both groups (except for fourth graders in the control group), with a more substantial improvement in the intervention group. From baseline to study end, the mean OSC-P improved by 11.9% (intervention group) and 5.9% (control group). Improvement values for OSC-S were 12.8% and 5.2%.

CONCLUSIONS

The need for oral care referrals was reduced, but improvement in oral health knowledge was minimal. Oral self-care outcomes improved more in the intervention than in the control group.

Improved oral health knowledge in a primary care pediatric nurse practitioner program

ABSTRACT

Pediatric nurse practitioners (PNPs) are a significant workforce in primary care and are uniquely positioned to improve oral health in children through ongoing surveillance in the well-child visit. The purpose of this study was to evaluate PNP student satisfaction and knowledge gained with the integration of the Strategic Partnership for Interprofessional Collaborative Education in Pediatric Dentistry (SPICE-PD) oral health education program into the first-year primary care curriculum. A descriptive, comparative design examined dental test scores across the pre-SPICE-PD (2013-2014; n = 26) and post-SPICE-PD (2015-2020; n = 55) cohorts. An electronic survey was completed (n = 47; 67%), and focus group (n = 12) audio-recordings were analyzed using Atlas.ti 8.0. Chi-square test and independent samples t-test were used to assess differences between groups. The SPICE-PD students reported improved knowledge and skill in clinical practice. Focus group themes were oral health education was beneficial, impact of coronavirus disease 2019, and suggestions for improvement. Mean dental test scores improved pre- and post-SPICE-PD (83 vs. 93; p < .001). The SPICE-PD oral health education improved knowledge and was highly satisfying for students. Pediatric nurse practitioners are ideally positioned to integrate oral health into primary care services, thereby improving access to care and ultimately reducing or mitigating early childhood caries. Evaluation of PNP postgraduation practices in the primary care setting is needed to assess whether improved knowledge results in practice change.

An assessment of the effectiveness of oral health education on oral health-related knowledge and attitudes of caregivers of children with hearing impairment

AIM

To assess the effectiveness of oral health education on oral health-related knowledge and attitudes of caregivers of children with hearing impairment and its impact on the oral health status of their children.

MATERIALS

Study design: Non randomised pre- and post-comparison study. Fifty-six pairs of caregiver-child with sensory impairment were chosen and divided into study and control groups. Health education was provided to the caregivers of the study group for 1, 3, 6 and 12-month period and periodic assessment of their knowledge, attitudes and practices (KAP) was performed. The caregivers of the control group did not receive any oral health education during the study period. The oral health status of these children was evaluated using the WHO assessment form (2013) and modified OHI-S (oral hygiene index- simplified) at baseline, 6 month and 12-month period. The effectiveness of KAP of caregivers and the oral health status of their children was correlated at the end of the study.

STATISTICAL ANALYSIS

The mean KAP scores between caregivers' of study and control group at different time intervals was compared using repeated measures of ANOVA test. Chi square test was used to compare the presence of bleeding gums and Mann Whitney U Test was used to compare the mean DMFT, deft and OHIs scores at different time intervals between study and control groups. Pearson correlation test was used to assess the relationship between KAP scores and clinical parameters at different time intervals in study and control group of both the populations.

CONCLUSION

The oral health education given to the caregivers has shown a positive impact on the oral health status of their children. Periodic reinforcement of the oral health-related measures among caregivers of children with hearing impairment is recommended.

Oral health in primary care: Integration of enhanced oral health education in a nurse practitioner residency program

ABSTRACT

Access to oral health care is challenging, especially for vulnerable populations and those in rural and underserved areas. The purpose of this brief report is to discuss the implementation strategies of enhanced content in oral health educational materials and share results of acquisition of knowledge and confidence in oral health content by residents in a nurse practitioner residency program. The method included the use of 3 surveys of 34 questions administered at different time points measuring confidence levels and sustainability. Results showed the average level of confidence obtained in Posttest1 and in Posttest 2 after 6 months is greater than the pretest. The paired-sample t-test provides significant evidence of improving mean responses for Questions 10, 11, 16, and 32 in Posttest 1 (p-values: .04 each) and Questions 10, 17, 25, and 31 in Posttest2 (p-values: .04 each) compared with the pretest. In conclusion, the addition of enhanced oral health educational materials in our program resulted in improved knowledge and confidence in the residents to incorporate oral health care in their practices.

Improving oral health in people with severe mental illness (SMI): A systematic review

BACKGROUND

Those with severe mental illness (SMI) are at greater risk of having poor oral health, which can have an impact on daily activities such as eating, socialising and working. There is currently a lack of evidence to suggest which oral health interventions are effective for improving oral health outcomes for people with SMI.

AIMS

This systematic review aims to examine the effectiveness of oral health interventions in improving oral health outcomes for those with SMI.

METHODS

The review protocol was registered with PROSPERO (ID CRD42020187663). Medline, EMBASE, PsycINFO, AMED, HMIC, CINAHL, Scopus and the Cochrane Library were searched for studies, along with conference proceedings and grey literature sources. Titles and abstracts were dual screened by two reviewers. Two reviewers also independently performed full text screening, data extraction and risk of bias assessments. Due to heterogeneity between studies, a narrative synthesis was undertaken.

RESULTS

In total, 1462 abstracts from the database search and three abstracts from grey literature sources were identified. Following screening, 12 studies were included in the review. Five broad categories of intervention were identified: dental education, motivational interviewing, dental checklist, dietary change and incentives. Despite statistically significant changes in plaque indices and oral health behaviours as a result of interventions using dental education, motivational interviewing and incentives, it is unclear if these changes are clinically significant.

CONCLUSION

Although some positive results in this review demonstrate that dental education shows promise as an intervention for those with SMI, the quality of evidence was graded as very low to moderate quality. Further research is in this area is required to provide more conclusive evidence.

Children's Oral Health in Nursing Education and Practice: A Call for Action

Dental caries are preventable but remain all too common.

Mitigating Global Oral Health Inequalities: Research Training Programs in Low- and Middle-Income Countries

Although oral diseases are largely preventable, they are among the most non-communicable diseases globally, and they disproportionately burden disadvantaged communities, specially within low- and middle-income nations. The COVID-19 pandemic has highlighted the social, economic, and health inequalities in our society, including the existing global oral health inequalities. There is a shortage of dentist-scientist all around the world, especially in developing countries, such as Thailand. The National Institute of Dental and Craniofacial Research (NIDCR) and Fogarty International Center (FIC), joined efforts on creating research capacity in oral health in South East Asia through the Fogarty International Center Training Program in Clinical, Public Health and Behavioral Oral Health Research for Thailand (2006-2016). The University of Washington (USA), Thammasat University (Thailand) and Khon Kaen University (Thailand) partnered to conduct short-, medium- and long-term training programs to build regional oral health research capabilities. Investing in research has not only impacted trainees' career development but enhanced advancement of oral health research of South East Asia. The success of partnership calls for expanding oral health research training in other low-income countries.

Chronic Disease Counseling and Screening by Dental Professionals: Results From NHANES, 2011-2016

INTRODUCTION

Dental visits may provide an opportunity to counsel and screen for chronic disease prevention. However, few studies have used nationally representative data to assess the potential role of dental professionals in chronic disease prevention. We examined the percentage of US adults who reported chronic disease counseling and screening by dental professionals.

METHODS

We analyzed data from the National Health and Nutrition Examination Survey 2011-2016 for 5,541 participants aged 30 or older who reported seeing a dental professional in the past year and estimated the percentage who reported receiving counseling about selected chronic disease prevention during the visit. We used logistic regressions to examine associations between risk factors and counseling.

RESULTS

Overall, 4.0% (standard error [SE], 0.3) of adults were told by a dental professional about the benefits of checking blood glucose, 42.4% (SE, 2.9) giving up tobacco (among tobacco users), 26.6% (SE, 1.2) about checking for oral cancer, and 43.0% (SE, 1.8) had an oral cancer examination. Groups with risk factors were more likely to receive health behavior counseling than those without (eg, those previously told they had diabetes risk factors were more likely to receive blood glucose counseling than those without [8.1% vs 3.3%, P < .05]). The pattern for oral cancer counseling and receiving an oral cancer examination was different: adults without oral cancer risk factors (no tobacco use, normal/underweight, and/or excellent/very good health) were more likely to receive oral cancer counseling or screening. Adjusted analyses did not change these associations.

CONCLUSION

Most adults were not counseled about chronic disease prevention during a visit with a dental professional. Current tobacco users and those with overweight or obesity were more likely to report receiving counseling.

Senior Oral Health: A Community-Based, Interprofessional Educational Experience for Nursing and Dental Students

The current article highlights an interprofessional, older adult oral health community program, created through an Accelerating Interprofessional Community-Based Education and Practice grant from the National Center for Interprofessional Practice and Education, designed to address the gap between older adult health education and care delivery. This project developed an advanced practice, nurse-led partnership among The Hartford Institute for Geriatric Nursing and the Oral Health Nursing Education and Practice Program (both located at New York University Rory Meyers College of Nursing), New York University College of Dentistry, and Regional Aid for Interim Needs (RAIN), a community service organization for older adults in the Bronx. Teams of nursing (n = 26), nurse practitioner (n = 16), and dental (n = 64) students provided oral health education and oral hygiene instruction using Tooth Wisdom^® educational materials to older adults, home health aides (HHAs), and volunteers in nine RAIN senior centers. Students demonstrated increases in their self-reported interprofessional competencies based on the Interprofessional Collaborative Competency Attainment Survey. Results also revealed that older adults (n = 500), HHAs (n = 142), and volunteers (n = 21) at the RAIN senior centers who attended the Tooth Wisdom presentation demonstrated an increase in oral health knowledge. [Journal of Gerontological Nursing, 46(8), 37-45.].

Regular dental care in preschoolers in rural Southern Brazil

OBJECTIVE: To evaluate if factors related to the mother’s previous guidance on her children’s dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil. METHODS: A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children’s care in daycare centers or schools and maternal guidance on the child’s dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval. RESULTS: The prevalence of regular use was 11.4% (95%CI 7.5–15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38–4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77–9.61), even with control for socioeconomic, maternal and child variables. CONCLUSION: When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.

Socioeconomic status and family functioning influence oral health literacy among adolescents

OBJECTIVE

Evaluate socio-demographic, family and behavioral factors associated with oral health literacy (OHL) in adolescents.

METHODS

Cross-sectional study conducted with adolescents aged 15 to 19 years in Campina Grande, Brazil. Parents/guardians answered a questionnaire addressing socio-demographic data. The adolescents answered validated instruments on family cohesion and adaptability (family adaptability and cohesion evaluation scale), drug use (alcohol, smoking and substance involvement screening test), type of dental service used for last appointment and OHL (Brazilian version of the Rapid Estimate of Oral Health Literacy in Dentistry). Two dentists were trained to evaluate OHL (K = 0.87-0.88). Descriptive analysis was performed, followed by Poisson regression analysis (α = 5%). A directed acyclic graph was used to select independent variables in the study.

RESULTS

The following variables remained associated with better OHL: high mother's schooling level (RR = 1.07; 95%CI: 1.03-1.12), high income (RR = 1.04; 95%CI: 1.01-1.09), white ethnicity/skin color (RR = 1.05; 95%CI: 1.01-1.10), married parents (RR = 1.04; 95%CI: 1.01-1.09), "enmeshed" family cohesion (RR = 1.21; 95%CI: 1.12-1.30), "structured" (RR = 1.06; 95%CI: 1.01-1.12) or "rigid" (RR = 1.11; 95%CI: 1.04-1.19) family adaptability, having more than five residents in the home (RR = 1.07; 95%CI: 1.01-1.14) and having used a private dental service during the last appointment (RR = 1.08; 95%CI: 1.03-1.13).

CONCLUSION

Family functioning and socio-demographic factors influence the level of oral health literacy among adolescents.

Effectiveness of smart phone application use as continuing medical education method in pediatric oral health care: a randomized trial

BACKGROUND

Continuing education aims at assisting physicians to maintain competency and expose them to emerging issues in their field. Over the last decade, approaches to the delivery of educational content have changed dramatically as medical education at all levels is now benefitting from the use of web-based content and applications for mobile devices. The aim of the present study is to investigate through a randomized trial the effectiveness of a smart phone application to increase public health service physicians' (PHS physicians) knowledge regarding pediatric oral health care.

METHOD

Five of all seven DHCs (District Health Center) in Tehran, which were under the supervision of Tehran University of Medical Sciences and Iran University of Medical Sciences, were selected for our study. Physicians of one DHC had participated in a pilot study. All PHS physicians in the other four centers were invited to the current study on a voluntary basis (n = 107). They completed a self-administered questionnaire regarding their knowledge, attitudes, practice in pediatric dentistry, and background. PHS physicians were assigned randomly to intervention and control groups; those in the intervention group, received a newly designed evidence-based smartphone application, and those in the control group received a booklet, a CME seminar, and a pamphlet. A post-intervention survey was administered 4 months later and t-test and repeated measures ANCOVA (Analysis of Covariance) were performed to measure the difference in the PHS physicians' knowledge, attitude and practice.

RESULTS

In both groups, the mean knowledge scores were significantly higher (p-Value < 0.001) in post-intervention data compared to those at baseline. Similar results existed in attitude and practice scores. Although the scores in knowledge in the intervention group indicating potentially greater improvement when compared to those of the control group, the differences between the two groups were not statistically significant (dif: 0.84, 95% CI - 0.35 to 2.02).

CONCLUSION

In the light of the limitations of the present study, smart phone applications could improve knowledge, attitude and practice in physicians although this method was not superior to the conventional method of CME.

TRIAL REGISTRATION

Our clinical trial had been registered in Iranian Registry of Clinical Trials (registration code: IRCT2016091029765N1).

Building a Pediatric Oral Health Training Curriculum for Community Health Workers

OBJECTIVES

Community health workers (CHWs) are a promising approach to oral health promotion in high-risk populations. This article describes the process of creating a pediatric oral health CHW training curriculum.

DESIGN

Existing curricula were identified through outreach efforts to experts in the oral health and CHW fields, as well as PubMed and Google searches. After coding basic information, curricula were mapped to define oral health domains. Then group discussion was employed to determine final curriculum contents.

SETTING

United States.

INCLUSION CRITERIA

Curricula were included if they addressed oral health, were in English or Spanish, involved US populations, did not target dental clinicians, and whether sufficient data could be obtained.

MAIN OUTCOME MEASURES

Curricula were evaluated for delivery format, number of hours, target audience, inclusion of CHWs, completeness, and oral health content.

RESULTS

Eighteen unique curricula were identified; 14 (78%) were CHW specific. Pathologic factors, caries formation, toothbrushing basics, flossing, nutrition, sugar-sweetened beverages, oral health recommendations, baby bottle tooth decay, fluoride treatments, and fluoride were covered to some extent in 75% of curricula. More than half did not mention types of teeth, oral health during pregnancy, antifluoride, cultural humility, and special needs populations. After comparing CHW curricula with non-CHW curricula, the original 26 oral health domains were condensed into 10 CHW training domains.

CONCLUSION

Using existing evidence and expert insight, an oral health CHW training curriculum outline was created that emphasizes behaviors, social support, and navigation assistance to promote preventive oral health behaviors in families of young children. This has implications beyond oral health. CHW programs are expanding to address the social determinants of health. The process of creating this curriculum and its basic elements can be applied to other disease areas. Clearly defined trainings that are made publicly available, such as this one, support efforts to standardize the CHW field in preparation for CHW certification and reimbursement in the future.

Promoting oral health in nursing education through interprofessional collaborative practice: A quasi-experimental survey study design

BACKGROUND

Optimal oral health education is limited in nursing curricula and may therefore, not translate as a priority for nurses in clinical practice.

OBJECTIVES

To evaluate the influence of an educational intervention on knowledge, confidence, practice behaviors, and perceived barriers of nursing students regarding preventive oral health services.

DESIGN

Quasi-experimental pre-post survey study design.

PARTICIPANTS

Sixty-four first-year Accelerated Bachelor of Nursing (ASBN) students at the University of North Carolina at Chapel Hill.

METHODS

Students were asked to complete oral-health-related questionnaires following didactic and clinical simulation on principles of oral health, oral screening, counseling, and referral to a dentist. A post-survey following clinical rotations was completed testing long-term effectiveness.

RESULTS

Fifty-five (86%) ABSN students completed the pre-survey, 49 (77%) completed the post-survey; 44 (69%) completed both. Participants' showed a significant increase in knowledge from pre-post questionnaires for two of five questions (p = 0.04; p < 0.0001). Confidence scores in performing oral screenings (p < 0.0001) and counseling (p = 0.006) increased; while scores regarding referrals decreased (p = 0.718). Post-intervention, 37% reported performing oral screenings, 45% counseling, and 8% dental referrals. Respondents reported a significant increase in willingness to implement oral health services during clinical visits (p < 0.0001).

CONCLUSION

Mixed educational methods can successfully influence oral health knowledge and confidence among ABSN students and their willingness to perform in clinical practice.

[A caregiver-person with schizophrenia partnership to improve oral health education]

INTRODUCTION

Poor oral health in persons with schizophrenia is a major public health issue affecting 600,000 people in France. The aim of this article was to present the different stages in the development of a specific oral health educational program for persons with schizophrenia. It takes into account experimental knowledge of these persons and presents the results of the feasibility study.

PATIENTS AND METHOD

The focus group method was applied to a group of health professionals and users to highlight an exploratory corpus in order to develop an oral health educational program. An expert group including persons with schizophrenia among others validated the fields and tools of this program. A feasibility study was then conducted in a control group of 7 persons with schizophrenia.

RESULTS

Altogether, 26 persons participated in this feasibility study. The main fields investigated by the expert group aimed to promote personal responsibility for one’s health, to improve access to the healthcare system and to promote the global management of health. The feasibility study showed the ability of this program to change persons with schizophrenia representations and knowledge of this health problem. Most educational tools were considered relevant.

CONCLUSION

An oral health educational program was built as part of a caregiver-persons with schizophrenia partnership and showed its feasibility. A multicentric randomized trial is currently ongoing to assess the efficacy of this program with a high level of proof.

Evaluating the Effectiveness of Human Papillomavirus Educational Intervention among Oral Health Professionals

This study aims to evaluate the effectiveness of an educational intervention that was designed to increase human papillomavirus (HPV) awareness and knowledge among oral health providers (OHPs). HPV educational lectures and a dental information toolkit on HPV were offered to OHPs in New England in 2016-2017. OHPs included dentists and dental hygienists. Post intervention surveys were distributed 1 month later. A total of 230 participants attended the educational lectures and received the toolkit. Descriptive statistics were used to compare the difference in knowledge and preparedness about HPV before and after the intervention. Eighty-nine OHPs completed the surveys. The response rate was 38.7%; however, for each question, the number of responses varied. Fifty-four (54%) (n = 26) of survey respondents were between 55 and 75 years of age with 73.5% (n = 36) being female and 55% (n = 45) working in private practice. Post intervention, 67.5% (n = 27) of the respondents felt more prepared, 82.6% (n = 38) reported clarity of their roles in educating their patients about HPV, and 91.6% (n = 44) reported an increase in knowledge about HPV. The HPV educational intervention was well received and successful at improving self-reported knowledge, comfort level, and preparedness of OHPs in discussing HPV with their patients. OHPs have the great opportunity to educate their patients about HPV and HPV vaccination. Further continuing education efforts may improve OHPs' participation in HPV prevention.

Shaping Core Health Messages: Rural, Low-Income Mothers Speak Through Participatory Action Research

Rural, low-income families are disproportionately impacted by health problems owing to structural barriers (e.g., transportation, health insurance coverage) and personal barriers (e.g., health literacy). This paper presents a Participatory Action Research (PAR) model of co-created Core Health Messages (CHMs) in the areas of dental health, food security, health insurance, and physical activity. The research project engaged a multi-disciplinary team of experts to design initial health messages; rural, low-income mothers to respond to, and co-create, health messages; and stakeholders who work with families to share their insights. Findings reveal the perceptions of mothers and community stakeholders regarding messages and channels of message dissemination. By using PAR, a learner engagement approach, the researchers intend to increase the likelihood that the CHMs are culturally appropriate and relevant to specific populations. The CHM-PAR model visually illustrates an interactive, iterative process of health message generation and testing. The paper concludes with implications for future research and outreach in a technological landscape where dissemination channels are dynamic. This paper provides a model for researchers and health educators to co-create messages in a desired format (e.g., length, voice, level of empathy, tone) preferred by their audiences and to examine dissemination methods that will best reach those audiences.

ORAL HEALTH PROMOTION IN PATIENTS WITH MORBID OBESITY AFTER GASTROPLASTY: A RANDOMIZED CLINICAL TRIAL

BACKGROUND

The bariatric surgery may have negative repercussions on oral conditions.

AIM

To evaluate the impact of oral health educational/preventive program developed with patients submitted to gastroplasties.

METHOD

The sample consisted of 109 patients randomly allocated to two groups: intervention group (IG), where they participated in the oral health promotion program that include multiple educational-preventive approaches; control group (CG), where they received usual care from the bariatric clinic staff, without participation in the program. The oral conditions investigated in the pre-operative and postoperative periods of one month (1M) and six months (6M) were: dental caries, periodontal disease, tooth wear, dental plaque and salivary flow.

RESULTS

After bariatric surgery, patients in IG presented: fewer changes in enamel (6M: p=0.004), dentin (6M: p=0.005) and gingival bleeding (6M: p<0.0001), reduction in plaque index (1M, 6M: p<0.0001) and increased salivary flow (6M: p=0.039), when compared with CG. Incipient tooth wear was recorded in both groups (6M: p=0.713).

CONCLUSION

There was a positive impact of the implemented program in the prevention of the main oral health problems in patients who underwent gastroplasties, contributing to their quality of life.

Readability and suitability of oral health education pamphlets produced by the Ministry of Health Malaysia

INTRODUCTION

Printed health education materials can only be effective if they are readable and suitable for the target audience. This study examined the readability and suitability of oral health education (OHE) pamphlets produced by the Oral Health Program (OHP), Ministry of Health (MOH) Malaysia.

METHODS

The Khadijah Rohani's Readability Formula (KRRF) and Suitability Assessment of Materials (SAM) instrument were used to assess the readability and suitability of the pamphlets respectively. All 23 Bahasa Malaysia pamphlets retrieved from the official portal of OHP on the 31st January 2019 were assessed for suitability. However, only five pamphlets were found to be eligible for readability assessment because the KRRF, the single formula available for Bahasa Malaysia text is applicable only for materials with 300 words or more. The readability is interpreted based on the level of formal education in Malaysia.

RESULTS

All pamphlets achieved superior suitability rating with a minimum and maximum score of 75% and 95% respectively. However, a few pamphlets did not fulfil SAM superior and adequate criteria for the following factors and were rated not suitable: did not include summary (73.9%), have few or no headers (4.3%), did not use captions to explain graphics (17.4%), and did not provide interactive learning (21.7%). Readability of the pamphlets eligible for assessment ranged from primary six to secondary three.

CONCLUSIONS

OHE pamphlets produced by the MOH are readable by most Malaysians. Most pamphlets are generally suitable for the intended audience although a few performed poorly in several areas.

Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis

The objective of this study was to evaluate the clinical effectiveness and cost-effectiveness of oral-health promotion programs (OHPPs) aiming to improve children’s knowledge of favorable oral health behavior to lower decayed/-missing/-filled teeth (DMFT) while reducing the financial cost on health institutions. An electronic search was performed in seven databases. Studies were restricted to human interventions published in English. The search study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the risk of bias was assessed based on the Drummonds Checklist. A total of 1072 references were found. Among these, 19 full texts were included. Most studies had a strong quality. The overall pooled impact of OHPPs estimates children suffering from DMFT/S to have 81% lower odds of participating in OHPP (95% CI 61–90%, I²: 98.3%, p = 0). Furthermore, the program was shown to be effective at lowering the cost in 97 out of 100 OHPPs (95% CI 89–99%, I²: 99%, p = 0). Three subgroups analyses (age groups, study countries, studies of the last five years) were performed to evaluate the influence modification on the pooled effect. A comprehensive analysis of the OHPPs confirmed a reduction effect on child DMFT, hence, lowering the financial burden of dental-care treatment on health institutions.

Oral Health Training in Osteopathic Medical Schools: Results of a National Survey

Context

Oral health is a critical aspect of overall health, yet many vulnerable communities struggle to access regular dental care and instead seek urgent treatment from physicians. In addition to addressing the consequences of untreated dental disease, physicians are in an ideal position to provide preventive and referral dental services to patients. Osteopathic physicians make up a substantial portion of the physician workforce and can play a central role in increasing oral health care provision in medical settings.

Objective

To assess the extent of oral health curricula in osteopathic medical schools in the United States, including content taught, evaluation practices, and influences and barriers to providing oral health training perceived by educators at these institutions.

Methods

An invitation to participate in the survey was sent electronically to deans of education at all osteopathic medical schools in the United States. Four email reminders followed the initial invitation. In addition to descriptive statistics, the associations between the number of curriculum hours, affiliation with a dental school, and curricular content were evaluated.

Results

Of the 42 institutions contacted, 22 responded (response rate, 52%). The majority of respondents (20 of 22 [91%]) reported the presence of some oral health education at their institutions. Eighteen of 20 respondents (90%) reported that their institution offered at least 1 hour of oral health curriculum over the course of students' education. Greater numbers of curriculum hours were not significantly associated with dental school affiliation or a formalized relationship with oral health educators. Institutions affiliated with dental schools were significantly more likely to include oral health in interprofessional education exercises (P=.023) but were not significantly more likely to cover any specific oral health topics. Seven of 17 respondents (41%) were satisfied with the level of oral health competence their graduates possessed.

Conclusion

Oral health education is present at many osteopathic medical schools, but the content covered and the extent of training varies considerably.

Integrating Oral Health: Physician Assistant Education in 2017

PURPOSE

This study describes the inclusion of oral health in physician assistant (PA) education programs in 2017. A 2014 study found that 78% of responding programs (n = 98 of 125) had integrated this content into their curriculum. The current study represents a partnership between the National Interprofessional Initiative on Oral Health, the Center for Integration of Primary Care and Oral Health, and the PA Leadership Initiative in Oral Health. The PA profession was one of 14 health professions surveyed to assess the quantity and quality of oral health integration, including barriers to and facilitators of change.

METHODS

An electronic cover letter explaining the research purpose was emailed to all US PA education program directors along with a link to a web-based survey. Most questions were followed by predefined response options; some questions offered an opportunity to include narrative responses or comments.

RESULTS

There was greater inclusion of oral health curriculum in 2017 than in 2014, for both the number of programs including oral health education and the breadth of their curriculum.

CONCLUSIONS

Efforts to equip PA faculty to integrate oral health core clinical competencies into their curriculum should continue, because existing strategies appear to be sustainable and effective in expanding oral health content across PA programs.

Keeping caries at bay in breastfeeding babies

As an infant grows, human milk may become the substrate for cariogenic bacteria. Here's what to watch for and how to counsel parents.

Perceptions and attitudes of patients towards medication-related osteonecrosis of the jaw (MRONJ): a qualitative study in England

OBJECTIVE

To explore the impact of medication-related osteonecrosis of the jaw (MRONJ) on quality of life and to explore the attitudes and perceptions of patients towards the multidisciplinary approach to the prevention of the condition.

DESIGN

Interpretivist methodology using qualitative semistructured interviews.

SETTING

Primary care general medical practices and secondary care dental services in England.

PARTICIPANTS

23 patients; 6 with MRONJ, 13 prescribed bisphosphonates, 4 with osteoporosis not currently prescribed any medication.

RESULTS

Patients felt that MRONJ had a significant negative impact on their quality of life and had poor knowledge of the preventive strategies recommended in the literature. Patients demonstrated positive attitudes towards a multidisciplinary approach to care; however, they perceived prescribers as having the key role in articulating risk. Four salient and inter-related themes emerged from the interviews: (1) perception of knowledge, indicating limited awareness of the condition, risk factors and preventive strategies; (2) quality of life, indicating the lived experiences of patients and the physical, psychological and social impacts of MRONJ; (3) interprofessional management, indicating a perceived organisational hierarchy, professional roles and responsibilities, prioritising aspects of care, articulation of risk and communication and (4) wider context, indicating demands on National Health Service resources and barriers to dental care.

CONCLUSIONS

MRONJ has a significant detrimental impact on quality of life, yet appropriate preventative education is not apparent. Effective interprofessional patient education and prevention to mitigate against the risk of developing MRONJ is required.

Strengthening Indigenous cultural competence in dentistry and oral health education: Academic perspectives

INTRODUCTION

Indigenous Australians continue to experience significant oral health disparities, despite numerous closing-the-gap initiatives. Higher education institutions and accrediting bodies recognise the need to incorporate Indigenous culture more widely into dentistry curricula to address these inequalities. This study aimed to define and explore current Indigenous cultural competence curricula, identify enablers and barriers for integration of Indigenous cultural competence curricula and ascertain innovative strategies to aid students in becoming culturally competent upon graduation, from academics' perspectives.

METHODS

Academics from the Doctor of Dental Medicine (DMD) and Bachelor of Oral Health (BOH) programmes at the University of Sydney, School of Dentistry participated in semi-structured interviews to define and explore current and future curricula practices to enable students to become competent in Indigenous culture. Thematic analysis was conducted to synthesise academics' responses.

RESULTS

Thirteen School of Dentistry academics participated in interviews. Following analysis of the data, six key themes emerged: Theme One: Transfer of Indigenous cultural knowledge, Theme Two: Barriers to developing Indigenous cultural curriculum. Theme Three: Importance of cultural immersion, Theme Four: Resources required for Indigenous cultural education, Theme Five: Proposed Indigenous cultural content, Theme Six: Strategies to incorporate Indigenous culture into curricula.

CONCLUSION

Improving Indigenous cultural competence amongst dentistry academics and students requires an educational and philosophical shift, incorporating the social determinants of health whilst maintaining the strengths of the biomedical foundations of dental care. It requires the inclusion of an informed history of Indigenous Australians, immersion within Indigenous communities and reflection upon these experiences, to facilitate culturally appropriate ways to improve the provision of dentistry and oral health for Indigenous peoples.

Evaluation of the psychometric properties of the Brazilian version of the Oral Health Literacy Assessment in Spanish and development of a shortened form of the instrument

OBJECTIVE

The objective of this study was to investigate the psychometric properties of the Oral Health Literacy Assessment in Spanish (OHLA-S) for the Brazilian-Portuguese language using robust analysis and with the results disclose possibilities to develop a shorter and more valid instrument.

METHODS

OHLA-S is an oral health literacy instrument comprising a word recognition section and a comprehension section. It consists of 24 dental words. It was translated into the Brazilian-Portuguese language (OHLA-B) and its psychometric properties were evaluated in a random sample of 250 adults aged 20-59 years. To assess the dimensionality and factor structure were tested by means of Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Reliability was assessed using two indicators: Cronbach's alpha and McDonald's Omega.

RESULTS

EFA and CFA demonstrated that the OHLA-B with 24 items did not present an adequate adjustment of the model, compromising its validity. In addition, reliability values at 0.50 for Cronbach's alpha and 0.67 for McDonald's omega were below the minimum acceptable rate of 0.70. As no support was found for the original structure, we decided to proceed with the withdrawal of individual items and successive reanalysis of the model until the indicators were adjusted in a shorter instrument. A new structure with 15 items produced an instrument with two dimensions and a better goodness of fit than the original instrument. The Alpha and Omega reliability index values increased to 0.83 and 0.80, respectively, and all scores were better in the OLHA-B with 15 items than in the instrument with 24 items.

CONCLUSION

OLHA-B with the original structure composed by 24 items did not show acceptable construct validity. The shorter version with 15 items showed more promising results for assessing oral health literacy levels in the Brazilian population.

Assessment, Education, and Access: Kona Hawai'i WIC Oral Health Pilot Project

The Kona WIC oral health pilot project was developed to assess the oral health beliefs and behaviors of parents of children and pregnant women at the Kona WIC site and to demonstrate the ease of providing oral health education to families in order to improve oral health behaviors. Data were collected from 50 families about the oral health behaviors and dental care of a total of 73 children, including 5 pregnant women, four of whom had a child enrolled in WIC and one pregnant woman without any previous children. Data revealed that 68% of children with teeth had been seen by a dentist within 6 to 12 months of the study visit. Mothers were seen less often, with 55% stating that they had not been seen for a dental visit for over one year. Parental knowledge about the effects of fluoride on teeth was limited; however, 90% of the parents would allow fluoride varnish applied to their child's teeth, 88% would give daily fluoride drops/tablets to their child, and 78% would support water fluoridation if it would help to improve their children's oral health. Additionally, for children old enough to receive fluoride supplementation, 60% were not given a prescription by their health care providers, and 58% had not received any fluoride varnish applications. By offering oral health education in a WIC clinic and assisting clients to seek out comprehensive care within a dental home, children and caregivers can be provided essential education and resources early in a child's life or women's pregnancies to reduce poor oral health outcomes.

Effectiveness of an Educational Module on Dental Hygiene Students' Attitudes Towards Persons with Disabilities

Purpose: Persons with disabilities (PWDs) perceive gaps in health care providers' understanding of their health care needs are more likely to delay or not seek health care as compared to persons without disabilities. Oral health is considered an essential component of overall health, however, disparities exist in the United States, especially for persons with disabilities. Improving the education and training of dentists and dental hygienists may contribute to reducing oral health care barriers for PWDs. The purpose of this study was to investigate whether offering an education module about individuals with disabilities would change dental hygiene students' attitudes and capacity for informed empathy for PWDs.Methods: An educational module utilizing a DVD featuring authentic representation of PWDs, along with student discussions and self-reflection was developed and delivered to 165 (n=165) dental hygiene students attending a 2-year community college and a 4-year university. Students consenting to participate in the study were assessed regarding their attitudes and comfort towards caring for PWDs prior to, and following the educational module. Pre- and post-assessment measures included the validated Attitude Toward Disabled Persons, and Attitudes toward Patient Advocacy Microsocial (AMIA) scale. The Interpersonal Reactivity Index (IRI) was used as a pre-assessment measure.Results: A total of 58 (n=58) dental hygiene students, 35 (n=35) from a 4-year university and 23 (n=23) from a 2-year community college, consented for this study, for an overall participation rate of 35%. Scores increased significantly for both student groups after delivering the education module on the AMIA patient advocacy scale. Differences in IRI scores between the 2-year and 4-year dental hygiene programs approached statistical significance.Conclusion: An education module based on informed empathy with a focus on the experiences of PWDs can result in improved attitudes toward advocacy for this population.

Factors associated with a positive willingness to practise oral health care in the future amongst oral healthcare and nursing students

OBJECTIVES

The purpose of this study was to identify the weak points in the knowledge and attitudes of first-year oral health care and nursing students towards oral health care and to identify the factors associated with their positive willingness to practise oral health care after becoming a health professional in order to develop oral healthcare curricula.

MATERIALS AND METHODS

The subjects were 88 first-year dental students (DSs), 64 dental hygiene students (DHSs) and 119 nursing students (NSs) enrolled in schools in Japan, as of April 2017. A questionnaire was distributed to subjects in each school to assess their knowledge and attitudes towards oral health care.

RESULTS

Less than half knew that oral health care was also provided in cancer hospitals, hospices, acute care hospitals, maternity wards and psychiatric wards. Only 46.2% knew that oral health care was effective in the prevention of aspiration pneumonia. The level of knowledge and attitudes in NSs regarding oral health care were likely to be lowest amongst the student groups. Only NSs' high interest towards oral health care was associated with their positive willingness to practise oral health care in the future although oral health students' high perceptions and interest regarding oral health care were associated with the willingness.

CONCLUSION

This study showed oral healthcare and nursing students' weak points regarding their attitudes and knowledge of oral health care at early stages. Oral health academic staff and professionals should develop effective oral healthcare curricula for oral healthcare students and help nursing staff develop a collaborative nursing oral healthcare curriculum to motivate nursing students.

Evaluation of an interprofessional education program for advanced practice nursing and dental students: The oral-systemic health connection

BACKGROUND

In response to the growing body of evidence supporting the need for expanded interprofessional education among health professions, an interprofessional education program, based on the Interprofessional Education Collaborative Core Competencies, was piloted with nurse practitioner and dental students.

OBJECTIVES

The purpose of this pilot study was to evaluate a technology enhanced interprofessional education program focused on the oral-systemic health connection for nurse practitioner and dental students.

DESIGN

A two-group comparative study using cross-sectional data and a quasi-experimental one-group pre-test/post-test design were used to evaluate students' knowledge of IPE core competencies, attitudes toward interprofessional education and interdisciplinary teamwork, and self-efficacy in functioning as a member of an interdisciplinary team.

SETTING AND PARTICIPANTS

This program was implemented with master of science in nursing students pursuing a primary care nurse practitioner (NP) degree and dental students at a large urban academic health sciences center. Cohort 1 (N = 75) consisted of NP (n = 34) and dental students (n = 41) at the end of their degree program who participated in a one-time survey. Cohort 2 (N = 116) was comprised of second-year NP students (n = 22) and first-year dental students (n = 94) who participated in the IPE program.

METHODS

Students participated in a multi-faceted educational program consisting of technology- enhanced delivery as well as interactive exercises in the joint health assessment course. Data were collected prior to the initiation and at the conclusion of the program.

RESULTS

Nurse practitioner and dental students who participated in the program had better self-efficacy in functioning as a member of an interdisciplinary team than graduating students who did not participate. Students from both nursing and dentistry who participated in the program had significantly improved self-efficacy in functioning in interprofessional teams from pre- to post-test.

CONCLUSION

An interprofessional education program can be a valuable addition to the health professions curriculum of nurse practitioner and dental students. Care must be taken to address logistical issues when working with students in different academic programs.

Predictors of academic performance in the discipline specific bioscience paper: A retrospective quantitative study [corrected]

INTRODUCTION

The cohort of students enrolled in the discipline-specific bioscience paper reflects a structural diversity in that it includes students of multiple ethnicities, varied age groups, differing scholastic and life experiences. These divergent identities of students are known to influence academic performance. The purpose of this retrospective quantitative study was to determine the ability of a set of variables such as age, gender, ethnicity, level of prior education, the place from which prior education was obtained, work experience and prior academic achievement to predict academic performance in the discipline-specific bioscience paper.

METHOD

The sample for this study was a purposive sample of all oral health students who had enrolled in the paper at the Auckland University of Technology from 2011 to 2014. The desensitised empirical data of 116 students from the University's database were subject to multivariable regression analysis. Pearson's correlation coefficients were calculated.

RESULTS

Prior academic achievement was a statistically significant predictor variable (P < 0.001) for the academic performance in the discipline-specific bioscience paper and was also positively correlated (r = 0.641, P < 0.001) to the grades in the discipline-specific bioscience paper.

CONCLUSION

Prior academic achievement was the only variable that was demonstrated to be correlated to and predictive of the academic performance in the discipline-specific bioscience paper.

Tobacco education in UK dental schools: A survey of current practice

OBJECTIVE

To investigate the current provision of tobacco education (tobacco use and cessation), assessment and e-cigarette education in UK dental and dental hygiene and therapy (DHT) undergraduate programmes.

MATERIALS AND METHODS

The study was conducted using a self-administered questionnaire sent to all UK institutions training dental and DHT students during the academic year 2015/2016.

RESULTS

Twenty-five programmes returned completed questionnaires (response rate 68%). All programmes (100%) reported delivering tobacco education, delivered by multiple individuals in 78% of the programmes. Assessment of the theoretical and practical aspects of tobacco education was reported in 80% and 72% of the programmes, respectively. More formal teaching time was devoted to the theoretical aspects (100% >2 hours) rather than the practical aspects (76% > 2 hours) of tobacco education. All programmes expected their graduates to be clinically competent at discussing the health consequences of smoking, deliver a brief smoking cessation intervention, and referring patients to stop smoking services. The use of the National Centre for Smoking Cessation and Training "Very Brief Advice" (NCSCT VBA) training package was reported to be mandatory in 36%, and recommended, in 44% of programmes. Specialised stop smoking services delivered teaching in 40% of both dental and DHT training programmes whilst another 40% reported previous input from specialist smoking cessation services but not in 2015/2016. Most programmes reported delivery of teaching on electronic cigarettes, with 12% delivering a standalone lecture on this topic.

CONCLUSIONS

Tobacco education is an important component of dental training. Dental education programmes should remain responsive to a rapidly changing field and fully utilise the available resources.

How do educators in one New Zealand undergraduate Bachelor of Oral Health course teach and nurture professionalism?

INTRODUCTION

Research on integrated dental hygiene and dental therapy courses is scarce; studies reporting on how staff in these combined scope courses teach professionalism are even more scarce. This study aimed to partially fill these research gaps.

METHOD AND MATERIALS

In 2016, online surveys were sent to 34 staff members who taught into the integrated Bachelor of Oral Health (BOH) course at the University of Otago's Faculty of Dentistry; 13 were returned. Two focus groups were conducted with six BOH educators.

RESULTS

Aspects of professionalism were taught and nurtured in the formal curriculum, the clinic and the informal curriculum. In the formal curriculum, policies outlining the professional standards of behaviour expected of oral health practitioners and students in New Zealand and the Faculty were discussed. In the clinic, educators taught professionalism through modelling clinical skills, assessing students' performance and commenting on their reflective logbooks. In the informal curriculum, BOH teachers nurtured professionalism through discussions about standards of behaviour outside of the university. Role modelling was the most common method that participants reported they taught or nurtured professionalism in their students.

DISCUSSION

Professionalism is a complex concept that is taught and nurtured in a number of ways over all aspects of the course.

CONCLUSION

Oral Health educators need to maintain a high standard of professionalism when interacting with students and patients, as well as in public spaces, in order to model professionalism to their students.

Formative evaluation of a teledentistry training programme for oral health professionals

INTRODUCTION

The objective of this study was to conduct a formative evaluation of a teledentistry (TD) programme that was developed for a predominantly rural state in the Midwestern United States.

MATERIALS AND METHODS

Formative evaluation data were collected on programme activities from the TD programme records. In addition, the effectiveness of the TD training programme was evaluated using a self-administered paper-based survey administered to the participants, immediately following completion of the training activity. Ninety-three dental students, oral health and other health professionals participated in the TD training programme.

RESULTS

Overall, the trainees rated the TD training programme highly, with regard to the content, format and skills improvement. The evaluation also demonstrated a positive change in all trainees' attitudes following the training sessions, with most trainees acknowledging a positive impact of the training on their knowledge and competency.

DISCUSSION AND CONCLUSIONS

We identified challenges in the development of the TD programme and in expanding access to oral health care for rural communities. Challenges included reimbursement and a limited interest amongst established dental offices. Dental schools can play an important role in preparing both dental health professionals and other health professionals in the use of TD by providing training and oral health expertise. The use of TD by non-dental providers for consultation, referral and disease management has the potential to improve oral health outcomes, particularly for rural and underserved populations. Evaluation data provide critical feedback to programme planners and administrators.

The Expanding Dental Workforce: The Impact of Nondental Providers

This article describes the evolution of nondental health providers engaging in oral health and the influences that have played a role. This discussion is followed by a review of why oral health is a natural fit for medical care, an examination of the current trends and successes in oral health education and practice in the health professions, and the need for a comprehensive approach. The article concludes by reviewing the impact these efforts are having and defining roles for each profession in the future with thoughts about what will be required to obtain these goals.

Parkinson's Disease Oral Health Module: Interprofessional Coordination of Care

Introduction

Patients with Parkinson's disease (PD) suffer progressive neurodegeneration and experience motor and nonmotor symptoms. Oropharyngeal dysfunctions are increasingly recognized as nonmotor PD symptoms that negatively impact a patient's quality of life. This module was primarily created to update dental health professionals and educate dental students on the oral health needs of patients with PD, with an emphasis on interprofessional collaboration and evidence-based dentistry. The module may also benefit other health professionals from different disciplines working with patients with PD.

Methods

The module was developed to be delivered in one 55-minute large-group session followed by a short assessment and case study discussion. Associated materials include PowerPoint slides with transcript, a narrated video version of the PowerPoint lecture, a quiz, and the case study. Thirty-four first-year dental students were invited to watch the narrated presentation, complete a pre-/postsurvey, and take the quiz.

Results

All participants agreed dental schools should provide education regarding oral health in patients with neurological disorders, as only 29% of them had previously taken a related class. After watching the presentation, students reported that most of the information was new content and that the difficulty level met their expectations. All students reported that the lecture increased their interest in interprofessional collaboration. In a quiz taken immediately after the presentation, the class average grade was 82.7, with 94% of the class passing the quiz with a grade of 70 or more.

Discussion

Educating dental professionals regarding care of patients with PD must emphasize interprofessional collaborations among health care providers.

Implementation and dissemination of the Sikh American Families Oral Health Promotion Program

The Sikh American Families Oral Health Promotion Program used a community-based participatory approach to develop, implement, evaluate, and disseminate a culturally tailored oral health/healthy living curriculum for the Sikh—South Asian community. Here, we examine the impact of community engagement throughout the process of program implementation in five Gurdwaras (places of worship) in New York and New Jersey and dissemination of the findings through targeted venues and the curriculum via e-Health resources. An interactive curriculum was developed (consisting of four core and three special topics) based upon a community-led needs assessment, adaptation of evidence-based oral health curricula, guidance from professional dental and medical associations, and input from Community Advisory Board (CAB) members. The Consolidated Framework for Implementation Research guided a mixed-method evaluation, consisting of both process and outcome measures. Five trained community educators delivered a total of 42 educational sessions. Improved oral hygiene behaviors and self-efficacy were found among program participants. For participants with no dental insurance prior to program enrollment (n = 58), 81.0% credited the program with helping them obtain insurance for themselves or their children. Further, for participants with no dentist prior to program enrollment (n = 68), 92.6% credited the program with helping them or their children find a local dentist. Short videos in Punjabi were created in response to feedback received from community educators and CAB members to reach men, especially. Community engagement was key to successful program implementation and dissemination, from the implementation leaders (community educators) to the opinion leaders and champions (CAB members).

A Novel Interprofessional Faculty Approach for Integrating Oral Health Promotion Competencies into a Physical Therapist Curriculum

AIMS

Oral health is integral to overall health and wellness. All healthcare providers can contribute to improving health by including an oral health screening (OHS) in the physical examination. The aims of this study were to 1) develop and test a novel oral health curriculum and 2) compare the effectiveness of two distinct methods of instruction, a) simulation with physical therapists (PT) and dental professional co-debriefing and b) video observation with PT faculty- only instruction.

METHODS

PT students (n=202) completed one of two educational experiences to learn how to perform an OHS, evaluate oral health findings, provide oral health education, and make an appropriate dental referral. Four distinct patient-specific cases were tested.

RESULTS

Results indicated multiple teaching strategies, including a simulation with co-debriefing, improved PT student performance in OHS. Between-case analysis indicated that students performed better in making appropriate referrals for pathology-based cases than preventative care-based cases. Conversely students' patient education was better for preventative cases than pathology-based cases. Curricular revisions improved student performance in providing relevant patient education. A comparison of student performance using simulation with co-debriefing vs video observation with PT faculty-only instruction found no statistically significant difference.

CONCLUSIONS

This novel oral health curriculum is a useful approach for teaching PT and other health professions students how to execute an OHS.

Physician Assistant Student Perceptions of an Interprofessional, Peer-to-Peer Oral Health Curriculum Led by Dental Students

PURPOSE

Physician assistants (PA) are health care team members who often work in primary care. Providing oral health education to PAs during training could improve oral health for vulnerable patients who seek treatment in the primary care setting and who are less able to access dental care. The purpose of this study was to assess the effectiveness of a peer-to-peer oral health curriculum taught by dental students to their PA student colleagues.

METHODS

Dental students presented an interactive, case-based curriculum, followed by a hands-on oral examination training session. PA student feedback was obtained, and results were analyzed.

RESULTS

Students found the content to be highly relevant and well presented. Conveying oral health competencies to future primary care providers may reduce oral health disparities.

CONCLUSIONS

PA students reported improved understanding of oral health and indicated they would incorporate what they had learned into their future clinical practice.

Beta Testing an Oral Health Edutainment Card Game Among 12-13-Year-Old Children in Bangalore, India

BACKGROUND

Card games are easy, cost effective, culturally acceptable, as well as sustainable and require minimal infrastructure over other edutainment approaches in achieving health and oral health promotion goals. Therefore, we wanted to conceptualize, develop, and beta test an innovative oral health edutainment card game for preadolescent children in Bangalore, India.

MATERIALS AND METHODS

An innovative oral health card game, titled "32 warriors" was conceptualized and developed to incorporate age appropriate, medically accurate oral health information. The card game aimed at empowering children to take appropriate care of their oral health. The card game was beta tested on 45 children, aged between 12 and 13 years. Using prepost design, a 32-itemed, closed-ended questionnaire assessed children's oral health knowledge, attitude, and feedback on the game. Change in mean scores for knowledge and attitude was assessed using "Wilcoxon Sign Rank test" at P < 0.05. "Effect size" was calculated. Feedback was categorized in terms of type of response and its frequency.

RESULTS

Statistically significant improvement was observed in group mean overall score, mean knowledge, and attitude scores, respectively (pre 14.7 ± 2.91 and post 18.6 ± 4.35, P = 0.003; 11.8 ± 2.73, 14.76 ± 4.0, P = 0.000; 2.93 ± 1.09, 3.84 ± 1.02, P = 0.000), with mean effect size 0.5. Participants reported that they enjoyed the game and learned new things about oral health.

CONCLUSION

The card game is appealing to children and improves their oral health knowledge and attitude as evidenced by beta test results. We need to further explore the demand, feasibility, and cost effectiveness of introducing this game in formal settings (school based)/informal settings (family and other social settings).