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Christian B, George A, Veginadu P, Villarosa A, Makino Y, Kim WJ, Masood M, Martin R, Harada Y, Mijares-Majini MC. Strategies to integrate oral health into primary care: a systematic review. BMJ Open 2023; 13:e070622. [PMID: 37407034 PMCID: PMC10367016 DOI: 10.1136/bmjopen-2022-070622] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 05/04/2023] [Indexed: 07/07/2023] Open
Abstract
OBJECTIVES Integration of oral health into primary care has been proposed as a primary healthcare approach for efficient and sustainable delivery of oral health services, and the effective management of oral diseases. This paper aimed to synthesise evidence on the effectiveness of strategies to integrate oral health into primary care. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, Embase, Scopus, ProQuest, Cochrane and Google Scholar were searched without date limits until the third week of June 2022. Reference lists of eligible studies were also searched. Experts in the field and existing professional networks were consulted. ELIGIBILITY CRITERIA Only studies that evaluated integration strategies were included in the review. Eligibility was restricted to English language studies published in academic peer-reviewed journals. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted data and performed the risk of bias assessments. A narrative synthesis approach was used to report review findings. Heterogeneity among included studies precluded a meta-analysis. RESULTS The search identified 8731 unique articles, of which 49 were included in the review. Majority of the studies explored provision of oral healthcare by primary care professionals in primary care settings, where integration was primarily via training/education and/or policy changes. Most studies reported results favouring the integration strategy, such as improvements in referral pathways, documentation processes, operating efficiencies, number of available health staff, number of visits to non-dental primary care professionals for oral health issues, proportion of children receiving fluoride varnish applications/other preventive treatment, proportion of visits to an oral health professional and dental caries estimates. CONCLUSION The findings from this review demonstrate that the majority of identified strategies were associated with improved outcomes and can be used to inform decision-making on strategy selection. However, more research and evaluation are required to identify best practice models of service integration. PROSPERO REGISTRATION NUMBER CRD42020203111.
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Affiliation(s)
- Bradley Christian
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
| | - Ajesh George
- Population Oral Health, School of Dentistry, The University of Sydney, Sydney, New South Wales, Australia
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Prabhakar Veginadu
- Menzies School of Health Research, Alice Springs, Northern Territory, Australia
| | - Amy Villarosa
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, Australia
| | - Yuka Makino
- Noncommunicable Diseases Team, World Health Organization Regional Office for Africa, Brazzaville, Congo
| | - Warrick Junsuk Kim
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
| | - Mohd Masood
- Department of Rural Clinical Sciences, La Trobe University - Bendigo Campus, Bendigo, Victoria, Australia
| | - Rachel Martin
- Australian Centre for Integration of Oral Health, School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Melbourne Dental School, The University of Melbourne, Melbourne, Victoria, Australia
| | - Yuriko Harada
- World Health Organization Regional Office for the Western Pacific, Manila, Philippines
- Oral Health Programme, Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
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Valdepeñas J, Adanero A, Martínez EM, Planells P. Knowledge of dental trauma among dental students. Lecture intervention protocol and follow-up over four academic courses. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2021; 25:238-245. [PMID: 32813319 DOI: 10.1111/eje.12597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 07/21/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND AIMS A study was made to evaluate knowledge of dental trauma among first-year dental students at the start of the career; assess the knowledge gained immediately after a lecture intervention; and evaluate persisting knowledge on an annual basis until the fourth year of the career. MATERIAL AND METHODS The study involved 29 volunteers from the first year of dentistry (School of Dentistry, Madrid Complutense University, Madrid, Spain). All the participants completed a previously validated questionnaire including questions referred to the management of dental trauma at the site of the accident, and other related aspects. This was followed by a brief lecture on the subject, and then the same questionnaire was administered again. Completion of the original questionnaire was subsequently repeated on an annual basis up until the fourth year of the career. Repeated measures analysis was used to assess the evolution of student knowledge. RESULTS Knowledge of the subject was seen to be lacking at the start of the career, but increased significantly as a result of the lecture intervention (P < .001). Over the subsequent courses, although the notions referred to dental trauma were seen to decrease with respect to the first evaluation, they remained high. All of the participants agreed on the need for informative campaigns referred to dental trauma targeted to students in the first courses of the health sciences. CONCLUSIONS It is necessary to impart knowledge on the prevention and immediate management of dental traumatisms in order to improve their prognosis. This learning is especially relevant to students in the first courses of the health sciences.
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Affiliation(s)
- Javier Valdepeñas
- Department of Dental Clinical Specialties, School of Dentistry, Madrid Complutense University, Madrid, Spain
| | - Alberto Adanero
- Department of Pediatric Prostheses and Odontology, School of Biomedical Sciences, European University of Madrid, Madrid, Spain
| | - Eva María Martínez
- Department of Dental Clinical Specialties, School of Dentistry, Madrid Complutense University, Madrid, Spain
| | - Paloma Planells
- Department of Dental Clinical Specialties, School of Dentistry, Madrid Complutense University, Madrid, Spain
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Stafuzza TC, Carrara CFC, Oliveira FV, Santos CF, Oliveira TM. Evaluation of the dentists' knowledge on medical urgency and emergency. Braz Oral Res 2014; 28:S1806-83242014000100240. [PMID: 25141014 DOI: 10.1590/10.1590/1807-3107bor-2014.vol28.0029] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 04/14/2014] [Indexed: 11/22/2022] Open
Abstract
This study aimed at evaluating how well dentists understand medical emergency/urgency procedures and issues during dental treatment at a hospital specialized in cleft lip and palate. It comprised a hundred dentists from the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo (HRAC/USP), Brazil, from different dental specialties. A questionnaire was applied to evaluate their knowledge of medical emergencies/urgencies from June through September 2011. The questionnaire was anonymous, confidential and constructed with closed questions and either yes-no or multiple-choice responses. Results showed that most professionals (87%) were trained in basic life support (BLS), but only 43% considered themselves capable of providing first aid and performing the necessary maneuvers. Most participants (94%) claimed that they knew the difference between medical urgencies and emergencies, and 69% had BLS training in their undergraduate courses, as opposed to 37%, during their specialization. Some participants (23%) mentioned that they had received knowledge of the subject during extracurricular courses and/or graduate courses (12%). Only 9% had not been educated on the subject; however, all participants showed interest in attending a course in BLS. In regard to assessing training that dentists who attended BLS courses received, 49% were satisfied and 42% were dissatisfied. Results of the present study emphasize that dentists from HRAC/USP have little knowledge about BLS procedures to perform them. Dentists must gain adequate education and training to minimize possible technical, ethical and legal problems associated with dental practice. It is necessary to improve both knowledge and practice in order to become well-qualified practitioners.
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Affiliation(s)
- Tássia Carina Stafuzza
- Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Bauru, SP, Brazil
| | | | - Fernanda Veronese Oliveira
- Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Carlos Ferreira Santos
- Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Thais Marchini Oliveira
- Department of Pediatric Dentistry, Orthodontics and Community Health, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Effectiveness of educational poster on knowledge of emergency management of dental trauma--part 2: cluster randomised controlled trial for secondary school students. PLoS One 2014; 9:e101972. [PMID: 25093728 PMCID: PMC4122350 DOI: 10.1371/journal.pone.0101972] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Accepted: 06/10/2014] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the effectiveness of educational poster on improving secondary school students' knowledge of emergency management of dental trauma. Methods A cluster randomised controlled trial was conducted. 16 schools with total 671 secondary students who can read Chinese or English were randomised into intervention (poster, 8 schools, 364 students) and control groups (8 schools, 305 students) at the school level. Baseline knowledge of dental trauma was obtained by a questionnaire. Poster containing information of dental trauma management was displayed in a classroom for 2 weeks in each school in the intervention group whereas in the control group there was no display of such posters. Students of both groups completed the same questionnarie after 2 weeks. Results Two-week display of posters improved the knowledge score by 1.25 (p-value = 0.0407) on average. Conclusion Educational poster on dental trauma management significantly improved the level of knowledge of secondary school students in Hong Kong. Trial Registration HKClinicalTrial.com HKCTR-1343 ClinicalTrials.gov NCT01809457
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Effectiveness of educational poster on knowledge of emergency management of dental trauma-part 1. Cluster randomised controlled trial for primary and secondary school teachers. PLoS One 2013; 8:e74833. [PMID: 24147154 PMCID: PMC3797909 DOI: 10.1371/journal.pone.0074833] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2013] [Accepted: 08/01/2013] [Indexed: 12/13/2022] Open
Abstract
Objective To investigate the effectiveness of educational posters in improving the knowledge level of primary and secondary school teachers regarding emergency management of dental trauma. Methods A cluster randomised controlled trial was conducted. 32 schools with a total of 515 teachers were randomised into intervention (poster) and control groups at the school level. Teachers’ baseline levels of knowledge about dental trauma were obtained by using a questionnaire. Posters containing information on dental trauma management were displayed in the school medical room, the common room used by staff, and on a notice board for 2 weeks in each school of the intervention group; in the control group, no posters were displayed. Teachers in both groups completed the questionnaire after 2 weeks. Results The teachers in the intervention schools (where posters were displayed for 2 weeks) showed statistically significant improvement in scores in cases where they had not previously learned about dental emergencies from sources other than first aid training, with an average score increase of 2.6656 (score range of questionnaire, −13 to 9; p-value <0.0001). Conclusion Educational posters on the management of dental trauma can significantly improve the level of knowledge of primary and secondary school teachers in Hong Kong. KClinicalTrials.com HKCTR-1307 ClinicalTrials.gov: NCT01707355
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