What influences the provision and reception of oral health education? A narrative review of the literature

A Typology of Empathic Communication Strategies in Dental Visits

INTRODUCTION

Dentists' empathy for patients is associated with enhanced patient satisfaction and clinical outcomes, and with reduced patient anxiety and dentist burnout. Cognitive empathy has been distinguished from emotional empathy, but how these broad types are expressed within the dentist-patient relationship has not been explored. The purpose of this study is to further differentiate types of empathy expressions in routine dental visits.

MATERIALS AND METHODS

Third-year students (n = 80) treated standardised patients (n = 11) portraying one of two patient profiles, each of which had multiple treatment needs in addition to a major systemic health problem: cancer or rheumatoid arthritis. After each visit, the patients completed assessment rubrics which included opportunities to comment on performance on four skillsets: visit initiation, patient interviewing, treatment planning and global communication. These comments were qualitatively content analysed. Comments (n = 301) were first deductively coded for valence (positive vs. negative evaluation) and empathy type (cognitive vs. emotional). Subsequently, comments were inductively coded for subtypes.

RESULTS

Three subtypes of cognitive empathy were identified in patient comments: facilitating comprehension, resolving treatment barriers and relieving physical discomfort. Five types of emotional empathy were identified: comforting emotionally, validating, sympathising, encouraging and inspiring confidence. Unexpectedly, four subtypes emerged which could not definitively be classified as exclusively cognitive or emotional, so a hybrid type was identified for these subtypes: respecting, moderating, attending and destigmatizing.

CONCLUSION

Patients distinguish subtypes of cognitive and emotional empathy, but some hybrid expressions are powerful because they simultaneously convey both types of empathy.

Patient-provider communication during consultations for elective dental procedures: A scoping review

INTRODUCTION

Patient-provider communication (PPC) is a critical component of patient-centered care. Original studies have examined specific factors related to PPC during consultations for elective dental procedures, but this evidence has yet to be comprehensively summarized. This scoping review aimed to understand better the extent and depth of the available literature regarding factors that influence PPC during consultations for elective dental procedures.

METHODS

The authors considered electronically available, English-language, original research published since 1990 assessing communication during consultations for elective dental procedures. Four electronic databases, Google Scholar, and reference lists of inclusions were searched until August 2023. No quality assessment was completed. Two independent researchers assessed article eligibility. Data were charted with a narrative review approach.

RESULTS

A total of 37 studies were included. The most popular discipline studied was orthodontics. Prospective cohorts and cross-sectional were the most common study designs. Information recall, patient satisfaction, and patient comprehension were the most common outcome measures. Most studies employed questionnaires, surveys, or interviews for data collection. Nineteen factors related to PPC during elective dental consultations were identified and categorized into information delivery (4), patient-related (9), and provider-related factors (6).

CONCLUSIONS

This scoping review is the first to present a list of evidence-supported factors related to PPC in elective dental consultations. Identifying these factors is an important first step to better understanding their influence on PPC and designing interventions targeting those that may be modifiable. PPC during elective dental consultations is a dynamic, ongoing process. Several recommendations emerged that may help improve PPC, including appropriate information delivery, patient engagement, providing adequate time, and educating ourselves on approaches to PPC.

The Background of a Patient Undergoing Long-Term Periodontal Disease Maintenance Using Step for Coding and Theorization: A Case Report

Periodontal maintenance is crucial for long-term periodontal stability, but some patients do not undertake maintenance following their initial treatment. To date, the motivations, backgrounds, and concerns of patients who underwent maintenance have not been researched. Therefore, we analyzed the subject's intentions and the behavior of the patient affected by periodontal maintenance using Step for Coding and Theorization (SCAT). The subject was a 50-year-old woman diagnosed with periodontitis. Periodontal therapy included oral hygiene instruction, scaling, root planing, and periodontal surgery. She has been continuing maintenance for 21 years. An interview was conducted on a one-to-one basis, between the patient and the surgeon, using a semistructured interview. The contents of the interview included her reasons for visiting the university hospital and her reasons for continuing maintenance. For the qualitative analysis using SCAT, the vocabulary obtained from the interview was filled out in a SCAT form. We determined that the relationship between the dental personnel and the patient was good, and we could convey the importance of maintenance to the patient. Appropriate periodontal treatment and the maintenance of a good relationship with the dental health oral care provider are key factors in improving the rate of maintenance visits and ensuring long-term periodontal stability.

Peruvian Children's Access to Oral Health Information during the COVID- 19 Pandemic

Aim

The aim of this study was to determine the impact of COVID-19 pandemic on access to oral health information of Peruvian children.

Materials and Methods

The Demographic and Family Health Survey generates annually a national database of Peruvian children between 0 and 11 years old, which is collected through direct interviews applied in the homes of residents of the country. A cross-sectional study was applied with this information collected during 2019 and 2020, with a final sample of 39 124 subjects, 15 974 from the year 2019 (62.03%) and 7088 from the year 2020 (55.54%). The dependent variable was access to oral health information and the independent variable was year; in addition, there were considered sociodemographic and geographical covariates. Finally, there were executed descriptive, bivariate, and multivariate analyses.

Results

Access to oral health information was 59.85% (n = 23 062). For the bivariate analysis, the dependent variable showed association with year, natural region, sex, altitude, health insurance coverage, area, place of residence and wealth index. During multivariate analysis, year manifested a negative association with access to oral health information (aPR: 0.89; 95%CI: 0.85-0.92; P < 0.001), adjusted for co-variables that previously manifested association.

Conclusion

Access to oral health information for Peruvian children had a negative impact during 2020, in which COVID-19 pandemic occurred.

Effect of Conventional and "Dental Truth or Dare" Board Game on Oral Hygiene Knowledge and Oral Hygiene Status of Preschool Children

Aim: To compare the benefits of didactic versus board game-based oral health instruction on oral health knowledge (OHK) and oral hygiene of preschool students. Materials and Methods: Participants were selected through computer-assisted randomization. (Eighty students were selected in both the 3- to 4-year-old and 5- to 6-year-old age groups, respectively, for a total of 160 participants). Forty participants of each age group were assigned randomly to Group A (PowerPoint^® presentation) and 40 to Group B ("Dental Truth or Dare" board game-based instruction). OHK and debris index-simplified (DI-S) were assessed at preintervention, and at 1-week, 1-month, and 3-month postintervention timepoints. Results: OHK scores increased significantly in the 3- to 4-year-old subset of Group A at the 1-week postintervention timepoint but declined and approximated the baseline value at the 3-month timepoint. In contrast, compared to baseline, significantly improved OHK scores were observed at all 3 timepoints in both age groups in Group B, and were especially pronounced in the 5- to 6-year-old subset. Although the 3-month scores were slightly lower than the 1-week scores, they were well above baseline values. Pre- and postintervention DI-S scores did not change significantly in the 3- to 4-year-old subset of Group A. However, significant increases in good DI-S scores and decreases in fair and poor scores were observed between baseline and 3-month timepoints in the 5- to 6-year-old subset of Group A and in both age subsets of Group B (P ≤ 0.05). OHK and DI-S scores were significantly higher among 5-6-year-olds than among the 3-4-year olds in both Groups A and B (P ≤ 0.05). Age and board game intervention were the main determinants of higher OHK and lower DI-S scores. The impact of intervention mode (board game) was greater than that of age. Conclusion: Board game-based oral hygiene education conferred significant short-term retention, enhanced OHK, and reduced DI-S. We conclude that gaming is an easily implemented and cost-effective educational tool for the improvement of oral hygiene in preschool children.

'It's their mouth at the end of the day': dental professionals' reactions to oral health education outcomes

Introduction Research has established varying levels of efficacy of oral health education (OHE) efforts. However, little is known regarding how outcomes impact dental professionals and their OHE practice. This study explores dental professionals' reactions to varying OHE outcomes and their motivations to persist with their efforts.Methods Qualitative, semi-structured interviews were conducted with dental team members working in mainly NHS general dental practices in South Wales, UK. Interviews were conducted face-to-face pre-COVID-19 and then by telephone, transcribed and analysed thematically.Results In total, 30 interviews were conducted (17 dentists, 6 dental therapists and 7 dental nurses). Pleasure was gained from improved patient oral health. Responses to non-adherence included disappointment, frustration and acceptance. Acceptance centred around a shared responsibility for oral care between clinician and patient and reassurance that they had 'done their job'. The unpredictability of patient adherence aided OHE motivation; efforts might eventually inspire patient action or might align with patient readiness to change.Conclusions This study reveals how OHE outcomes impact on dental professionals' perceptions of their role and personal motivations for continued educational efforts with patients. Greater emphasis on both preventative dentistry and self-care, coupled with understanding of the complex factors influencing oral health behaviour, would aid motivation for OHE.