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Marchetti G, Vendruscolo JL, Reis GEDS, Fraiz FC, Soares GMS, Assunção LRDS. Are technology-based health education methods able to reduce oral health inequalities between the sexes in adolescents? A cluster randomized trial. Int J Dent Hyg 2022. [PMID: 36301013 DOI: 10.1111/idh.12641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/18/2022] [Accepted: 10/23/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Determine if different technology-based health education interventions can reduce oral health inequalities between the sexes in a sample of adolescents. METHODS A cluster randomized clinical trial was conducted in three phases with an initial sample of 291 male and female adolescents 14-19 years of age. Phase I (n = 288) comprised a clinical examination performed by a calibrated examiner using the simplified oral hygiene index (OHI-S) and gingival bleeding index (GBI). Phase II involved two educational interventions: video (VD; n = 147) or oral counselling (OR; n = 141) with standardized content. In phase III, an App was made available to half of the clusters (OR + App; n = 66/OR without App; n = 71/VD + App; n = 63/VD without App; n = 63), and the clinical examination was performed a second time. Data were evaluated using descriptive analysis and nonparametric tests. RESULTS In phase I, boys had a lower standard of oral hygiene compared with girls, with higher mean OHI-S (p = 0.039) and GBI (p = 0.015). After VD and OR interventions, no significant difference between sexes was found regarding the mean OHI-S. However, males had a higher mean GBI compared with females in the OR group (p = 0.006). When the App was added to OR and VD groups, males in the 'OR without App' group had a higher mean GBI compared with females (p = 0.007). CONCLUSION This clinical trial demonstrated that educational interventions involving information technologies were effective at reducing oral health inequalities between the sexes among adolescents. However, oral counselling alone was not efficient in reducing GBI in male adolescents.
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Affiliation(s)
- Gisele Marchetti
- Department of Stomatology, Universidade Federal do Paraná, Curitiba, Brazil
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Liu J, Gaiha SM, Halpern-Felsher B. School-based programs to prevent adolescent e-cigarette use: A report card. Curr Probl Pediatr Adolesc Health Care 2022; 52:101204. [PMID: 35534403 PMCID: PMC9296568 DOI: 10.1016/j.cppeds.2022.101204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Given high rates and known health consequences of adolescent e-cigarette use as well as adolescents' susceptibility to nicotine addiction, school-based efforts to prevent and reduce adolescent e-cigarette use should continue to be developed, implemented, disseminated, and evaluated. This paper elaborates on best practices for developing and implementing prevention programs, including the importance of grounding programs in theories and frameworks that empower adolescents, including normative and interactive education, and having programs that are easily accessible and free of cost. Programs should also address key factors driving adolescent e-cigarette use, including discussing misperceptions, flavors, nicotine content, addiction, and the role that marketing plays in appealing to adolescents. The paper also discusses the gap areas of currently available prevention programs and highlights the need for evidence-based approaches and the importance of rigorous evaluation of programs.
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Affiliation(s)
- Jessica Liu
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, United States
| | - Shivani Mathur Gaiha
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford Research Park, 3145 Porter Drive, Wing A, Room A104, MC 5395, Palo Alto, CA 94304, United States
| | - Bonnie Halpern-Felsher
- Stanford Reach Lab, Division of Adolescent Medicine, Department of Pediatrics, Stanford University, Stanford Research Park, 3145 Porter Drive, Wing A, Room A104, MC 5395, Palo Alto, CA 94304, United States.
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Moore J, Bond K, Turner LW. Reducing Chronic Disease Risk through Positive Oral Health Practices: A Systematic Review of School-based Dental Health Programs. AMERICAN JOURNAL OF HEALTH EDUCATION 2022. [DOI: 10.1080/19325037.2022.2048749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Solanki R, Tuli A, Dhawan P, Khanduri N, Singh A. QLF-D: A Contemporary Plaque Control Tool in Children. Int J Clin Pediatr Dent 2021; 14:502-505. [PMID: 34824504 PMCID: PMC8585893 DOI: 10.5005/jp-journals-10005-2001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and objectives The main causative factors for maximum periodontal diseases are dental plaque and oral biofilms. This study was done to check the impact of quantitative light-induced fluorescence-digital (QLF-D) as a motivational tool for plaque control among children from various schools situated in Dehradun district along with education using audiovisual aids. Materials and methods A total sample of 800 school-going children including both males and females aged 6 to 12 years from various schools situated in Dehradun district of Uttarakhand were surveyed. A pro forma was prepared and the demographics of the students were noted. All the students were first examined for the Oral Hygiene Index-Simplified (OHI-S) and then the random division was done into two groups, group A (Q-scan) and group B (basic diagnostic aids) for examination of plaque index. Results The results of the study revealed that good OHI-S scores increased significantly from 1st visit to 3rd visit. The plaque scores for the control group, when examined with basic diagnostic aids of all three visits, were significantly good which increased subsequently from 1st visit to 3rd visit. Good plaque index score increased significantly for the test group from 1st to 3rd visit when examined with QLF-D. Conclusion We found in our study that QLF technology is of paramount importance in epidemiological surveys and plays a pivotal role in evaluating masses in maintaining oral health care. How to cite this article Solanki R, Tuli A, Dhawan P, et al. QLF-D: A Contemporary Plaque Control Tool in Children. Int J Clin Pediatr Dent 2021;14(4):502–505.
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Affiliation(s)
- Ratika Solanki
- Department of Pediatric and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Avantika Tuli
- Department of Pediatric and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Preeti Dhawan
- Department of Pedodontics and Preventive Dentistry, BRS Dental College, Panchkula, Haryana, India
| | - Nitin Khanduri
- Department of Pediatric and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
| | - Aditi Singh
- Department of Pediatric and Preventive Dentistry, Seema Dental College and Hospital, Rishikesh, Uttarakhand, India
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Subedi K, Shrestha A, Bhagat T, Baral D. Effectiveness of oral health education intervention among 12-15-year-old school children in Dharan, Nepal: a randomized controlled trial. BMC Oral Health 2021; 21:525. [PMID: 34649553 PMCID: PMC8515708 DOI: 10.1186/s12903-021-01877-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 07/21/2021] [Indexed: 11/06/2022] Open
Abstract
Background School-aged adolescents are in particular need of preventive program to ensure positive long-term oral health and hygiene. The objective of this study was to assess the effectiveness of an oral health education (OHE) intervention on oral hygiene knowledge, attitude and practices (KAP), plaque control and gingival health among 12–15 years old school children in Dharan sub-metropolitan city, Nepal. Methods A randomized controlled trial was conducted with parallel study groups, comprising 12–15-year-old school children, 120 in each group. OHE was given to the experimental group at baseline, third and sixth months and to the control group after completion of the study. Interview of the participants were done using a 23-item questionnaire for assessment of oral hygiene KAP. For each question, correct answer was scored as 1 and wrong answer was scored zero. An overall composite score was then created, by adding the individual scores. Oral examination was done using mouth mirror and WHO probe to record Turesky–Gilmore–Glickman modification of the Quigley-Hein plaque index, Gingival index and Dentition status and treatment needs. Analysis was done using chi-square test for categorical data and independent t test, Mann–Whitney U test, repeated measures ANOVA and post hoc Tukey’s test for quantitative data. The level of significance was set at P < 0.05. Results There was 54.58% improvement in overall oral hygiene KAP in experimental group (P = 0.001) whereas no improvement was seen in control group at the end of the study. The mean plaque score was improved by 57.67% (P = 0.001) in experimental group in comparison to 4.56% in control group. Gingival index was improved by 49.90% (P = 0.001) in experimental group in comparison to 0.7% in control group. Caries experience was increased in both groups but no significant difference was seen. Conclusions The study concluded that oral health education was effective in improving oral hygiene KAP, plaque control and gingival health. Trial registration The trial was retrospectively registered with Clinical Trial Registry India (CTRI) with identifier no. CTRI/2018/05/013985, registered on 05/21/2018. (http://www.ctri.nic.in/Clinicaltrials/pdf_generate.php?trialid=23651&EncHid=&modid=&compid=%27,%2723651det%27). Institutional Review Committee, B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal provided the ethical approval (Ref. No.: 292/074/075-IRC).
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Affiliation(s)
- Krishna Subedi
- Dental Department, Pokhara Academy of Health Sciences, Pokhara, Nepal.
| | - Ashish Shrestha
- Department of Public Health Dentistry, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Tarakant Bhagat
- Department of Public Health Dentistry, College of Dental Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Dharanidhar Baral
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Pullishery F, Abuzenada BM, Alrushnudi NM, Alsafri MM, Alkhaibari WM, Alharbi MF, Aladani JA, Mohammed Z. Comparison of Efficacy of Different Supervision Methods of Toothbrushing on Dental Plaque Scores in 7-9-year-old Children. Int J Clin Pediatr Dent 2021; 14:263-268. [PMID: 34413604 PMCID: PMC8343690 DOI: 10.5005/jp-journals-10005-1927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background and objectives The efficiency of mechanical plaque control in children not only depends on the type of oral aids they use but also on the instructions, training, and motivation given to them. To compare the efficiency of different methods of personal supervision of toothbrushing in reducing the dental plaque levels in 7-9-year-old schoolchildren. Materials and methods A parallel designed double-blinded randomized study was conducted in a private school in Jeddah, Saudi Arabia from September 2018 to December 2018. The children were allocated randomly into two groups based on the type of supervision given. Plaque scores examination was carried out at four intervals as baseline, 7th day, 14th day, and 90th day. Results Plaque scores reduced after 7 days in all groups, even though there was no statistically significant difference observed. At the final examination of plaque scores (90th day), there was a highly statistically significant reduction observed in group I and II compared to group III where the reduction was less evident. Conclusion Supervision of toothbrushing in the correct way was effective in reducing the plaque scores. Our study benefited both parents and children in understanding the correct method of brushing and the importance of plaque control. How to cite this article Pullishery F, Abuzenada BM, Alrushnudi NM, et al. Comparison of Efficacy of Different Supervision Methods of Toothbrushing on Dental Plaque Scores in 7-9-year-old Children. Int J Clin Pediatr Dent 2021;14(2):263-268.
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Affiliation(s)
- Fawaz Pullishery
- Division of Community Dental Practice, Faculty of Dentistry, Batterjee Medical College, North Obhur, Jeddah, Kingdom of Saudi Arabia
| | - Basem M Abuzenada
- Division of Operative Dentistry, King Abdulaziz University and Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Nawal M Alrushnudi
- Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Maram M Alsafri
- Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Wafa M Alkhaibari
- Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Mawadda F Alharbi
- Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Jaidaa As Aladani
- Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
| | - Zahra Mohammed
- Dentistry Program, Batterjee Medical College, Jeddah, Kingdom of Saudi Arabia
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Parker K, Nunns M, Xiao Z, Ford T, Ukoumunne OC. Characteristics and practices of school-based cluster randomised controlled trials for improving health outcomes in pupils in the United Kingdom: a methodological systematic review. BMC Med Res Methodol 2021; 21:152. [PMID: 34311695 PMCID: PMC8311976 DOI: 10.1186/s12874-021-01348-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023] Open
Abstract
Background Cluster randomised trials (CRTs) are increasingly used to evaluate non-pharmacological interventions for improving child health. Although methodological challenges of CRTs are well documented, the characteristics of school-based CRTs with pupil health outcomes have not been systematically described. Our objective was to describe methodological characteristics of these studies in the United Kingdom (UK). Methods MEDLINE was systematically searched from inception to 30th June 2020. Included studies used the CRT design in schools and measured primary outcomes on pupils. Study characteristics were described using descriptive statistics. Results Of 3138 articles identified, 64 were included. CRTs with pupil health outcomes have been increasingly used in the UK school setting since the earliest included paper was published in 1993; 37 (58%) studies were published after 2010. Of the 44 studies that reported information, 93% included state-funded schools. Thirty six (56%) were exclusively in primary schools and 24 (38%) exclusively in secondary schools. Schools were randomised in 56 studies, classrooms in 6 studies, and year groups in 2 studies. Eighty percent of studies used restricted randomisation to balance cluster-level characteristics between trial arms, but few provided justification for their choice of balancing factors. Interventions covered 11 different health areas; 53 (83%) included components that were necessarily administered to entire clusters. The median (interquartile range) number of clusters and pupils recruited was 31.5 (21 to 50) and 1308 (604 to 3201), respectively. In half the studies, at least one cluster dropped out. Only 26 (41%) studies reported the intra-cluster correlation coefficient (ICC) of the primary outcome from the analysis; this was often markedly different to the assumed ICC in the sample size calculation. The median (range) ICC for school clusters was 0.028 (0.0005 to 0.21). Conclusions The increasing pool of school-based CRTs examining pupil health outcomes provides methodological knowledge and highlights design challenges. Data from these studies should be used to identify the best school-level characteristics for balancing the randomisation. Better information on the ICC of pupil health outcomes is required to aid the planning of future CRTs. Improved reporting of the recruitment process will help to identify barriers to obtaining representative samples of schools.
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Affiliation(s)
- Kitty Parker
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Room 2.16, South Cloisters, St Luke's Campus, 79 Heavitree Rd, Exeter, EX1 2LU, UK.
| | - Michael Nunns
- College of Medicine and Health, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK
| | - ZhiMin Xiao
- School of Health and Social Care, University of Essex, Colchester, CO4 3SQ, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, L5 Clifford Allbutt Building, Cambridge Biomedical Campus Box 58, Cambridge, CB2 0AH, UK
| | - Obioha C Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Exeter, Room 2.16, South Cloisters, St Luke's Campus, 79 Heavitree Rd, Exeter, EX1 2LU, UK
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Tsai C, Raphael S, Agnew C, McDonald G, Irving M. Health promotion interventions to improve oral health of adolescents: A systematic review and meta-analysis. Community Dent Oral Epidemiol 2020; 48:549-560. [PMID: 32767825 DOI: 10.1111/cdoe.12567] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/22/2020] [Accepted: 07/07/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of health promotion interventions on oral health knowledge, behaviour and status of healthy adolescents. METHODS This review included randomized controlled trials (RCTs) of oral health promotion interventions targeting adolescents. Primary clinical outcomes (gingival health, plaque scores, caries) and secondary proxy outcomes were evaluated. Meta-analysis of primary outcomes was conducted where possible, with subgroup analysis based on intervention (comprehensive health promotion and education-only). RESULTS Thirty-seven eligible publications reporting on 28 unique RCTs of oral health promotion interventions were included. Quality appraisal of studies ranged from 48% to 96%. Interventions reported ranged from single-session interventions to community-wide programmes, including clinical preventive procedures and take-home products. Half used a health behaviour change theory to inform their intervention. The meta-analysis pooling of results favoured the intervention over control for all clinical outcomes, except DMFS in the education-only subgroup. Stronger intervention effects were seen in the comprehensive intervention subgroup than the education-only subgroup for DMFS (P = .02). This effect was slight, but not as clear in all other clinical categories. The majority of studies reported improvements in oral health knowledge, attitudes and behaviours. More positive outcomes were found with longer programmes, especially for dental caries outcomes. CONCLUSIONS Oral health promotion programmes targeting adolescents have the ability to improve clinical oral health outcomes in the short and long term. Programmes should use more behavioural theory-based interactive and strategic methods, including self-awareness and the use of the wider community and peers for oral health promotion activities over a longer intervention duration.
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Affiliation(s)
- Carrie Tsai
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Sarah Raphael
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
| | - Caitlin Agnew
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia.,Hospital and Specialist Dentistry, Head and Neck Services, Auckland District Health Board, Auckland, New Zealand
| | - Gordon McDonald
- Sydney Informatics Hub, The University of Sydney, Sydney, NSW, Australia
| | - Michelle Irving
- Faculty of Medicine and Health, School of Dentistry, The University of Sydney, Sydney, NSW, Australia
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Xiang B, Wong HM, Perfecto AP, McGrath CPJ. The effectiveness of behavioral interventions to improve oral health in adolescents at different periods of follow-up: A systematic review and meta-analysis. PATIENT EDUCATION AND COUNSELING 2020; 103:725-733. [PMID: 31813713 DOI: 10.1016/j.pec.2019.11.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 11/19/2019] [Accepted: 11/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The aim of this review was to examine the effectiveness of behavioral interventions at different follow-up periods to improve adolescents' oral health. METHODS CENTRAL, MEDLINE, EMBASE and other databases were systematically searched. Inclusion criteria were as follows: participants aged 10-19 years old, randomized controlled trials using behavioral interventions, outcome measurements including oral health knowledge, attitudes, practices, and oral health status. For each included study, behavior change techniques (BCT) were identified and the quality and risk of bias assessments obtained. PROSPERO reference: CRD42018090341. RESULTS After searching and screening, 17 clinical trials were included in the systematic review. The most commonly used BCTs were behavior health link, information on consequences, and social comparisons. A significant reduction of plaque index was detected (SMD:-0.46; 95 % CI:-0.82∼-0.10) for 3 months and (SMD:-0.71; 95 % CI:-1.08∼-0.33) for 6 months. The reduction of gingival index after 6 months was also significant (SMD:-0.90; 95 % CI:-1.33∼-0.47). Oral health knowledge and oral health-related behavior were also improved after behavioral interventions. CONCLUSION There is moderate evidence that behavioral interventions are effective in promoting oral health in adolescents. To establish more evidence-based conclusions, further research should focus on: quality control of interventions, full descriptions regarding the BCT, long-term follow-ups, and behavior change reinforcements. PRACTICAL VALUE Given the need of early prevention of oral diseases, well-designed oral health promotion programme are needed to improve behavior and outcome of adolescents' oral health.
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Affiliation(s)
- Bilu Xiang
- Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Hai Ming Wong
- Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
| | - Antonio P Perfecto
- Department of Peadiatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Colman P J McGrath
- Department of Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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Gargano L, Mason MK, Northridge ME. Advancing Oral Health Equity Through School-Based Oral Health Programs: An Ecological Model and Review. Front Public Health 2019; 7:359. [PMID: 31850296 PMCID: PMC6901974 DOI: 10.3389/fpubh.2019.00359] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/12/2019] [Indexed: 12/05/2022] Open
Abstract
In the United States and elsewhere, children are more likely to have poor oral health if they are homeless, poor, and/or members of racial/ethnic minority and immigrant populations who have suboptimal access to oral health care. As a result, poor oral health serves as the primary marker of social inequality. Here, the authors posit that school-based oral health programs that aim to purposefully address determinants of health care access, health and well-being, and skills-based health education across multiple levels of influence (individual/population, interpersonal, community, and societal/policy) may be more effective in achieving oral health equity than programs that solely target a single outcome (screening, education) or operate only on the individual level. An ecological model is derived from previously published multilevel frameworks and the World Health Organization (WHO) concept of a health-promoting school. The extant literature is then examined for examples of evaluated school-based oral health programs, their locations and outcomes(s)/determinant(s) of interest, the levels of influence they target, and their effectiveness and equity attributes. The authors view school-based oral health programs as vehicles for advancing oral health equity, since vulnerable children often lack access to any preventive or treatment services absent on-site care provision at schools. At the same time, they are incapable of achieving sustainable results without attention to multiple levels of influence. Policy solutions that improve the nutritional quality of children's diets in schools and neighborhoods and engage alternative providers at all levels of influence may be both effective and equitable.
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Affiliation(s)
| | | | - Mary E. Northridge
- New York University (NYU) Langone Dental Medicine—Brooklyn, Hansjörg Wyss Department of Plastic Surgery, NYU School of Medicine, Brooklyn, NY, United States
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Geetha Priya PR, Asokan S, Janani RG, Kandaswamy D. Effectiveness of school dental health education on the oral health status and knowledge of children: A systematic review. Indian J Dent Res 2019; 30:437-449. [PMID: 31397422 DOI: 10.4103/ijdr.ijdr_805_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective To evaluate the effectiveness of school dental health education on the oral health status, oral health-related knowledge, and practice behavior of 6-12-year-old children. Methods Hand search and electronic search based on the keywords on school dental health education in seven search engines till 2017 identified 7434 articles. Trials involving school-based dental health education with a minimum follow-up period of 6 months were screened. Risk of bias assessment was done independently by two authors. Results Among the 18 articles which fulfilled the eligibility criteria, six were randomized controlled trials (RCTs) and 12 were non-RCTs. Quality assessment showed that 12 trials had a low risk of bias. Oral health-related knowledge improved in children. Oral health-related practice behaviors such as frequency and duration of brushing improved. Use of fluoridated toothpaste was increased. Plaque scores and gingival bleeding scores reduced. Conclusion School dental health education had a positive impact on the oral health status, knowledge, and practice behavior of children. There is a definite need for high-quality RCTs analyzing the effectiveness of school dental health education on specific oral health outcomes.
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Affiliation(s)
- P R Geetha Priya
- Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - Sharath Asokan
- Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - R G Janani
- Department of Pedodontics and Preventive Dentistry, KSR Institute of Dental Science and Research, Tiruchengode, Tamil Nadu, India
| | - D Kandaswamy
- Department of Conservative Dentistry, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
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Evaluation of tooth brushing behavior change by social marketing approach among primary students in Qom, Iran: A quasi-experimental controlled study. PLoS One 2018; 13:e0206042. [PMID: 30346987 PMCID: PMC6197689 DOI: 10.1371/journal.pone.0206042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 10/05/2018] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Nowadays traditional training methods for promotion of oral health behaviors cannot meet the demand of the society and there is a need for effective new methods. The aim of this study was to evaluate the effect of social marketing approach versus the traditional method on promotion of tooth brushing habits in primary school students of Kahak and Jafariyeh, Qom, Iran. MATERIALS AND METHODS This study was conducted in the 2016-2017 academic year. First, the reasons for lack of interest in proper tooth brushing were evaluated. Forgetting and laziness were determined as the most important reasons. According to these results, appropriate intervention tools related to proper tooth brushing habits were designed. Then, the students' tooth brushing habits were recorded before the intervention. Students in Kahak that were considered non-randomly as intervention group received the designed educational package according to the social marketing approach for one and a half months. In Jafariyeh (control group), the students received training only through pamphlets as traditional method. After the intervention, the tooth brushing habits of the students were recorded. The habits before and after the intervention were compared using statistical tests. RESULTS Increased length of tooth brushing to at least two minutes was 28.0% in Kahak and 14.0% in Jafariyeh (P<0.001) and increased frequency of tooth brushing to at least two times per day was 30.5% in Kahak and 11.8% in Jafariyeh (P<0.001). Improvement in tooth brushing habits (at least two minutes twice daily) was 32.9% in Kahak and 13.0% in Jafariyeh (P<0.001). CONCLUSION The use of the social marketing approach is more effective than traditional methods in promoting oral health behaviors.
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Halawany HS, Al Badr A, Al Sadhan S, Al Balkhi M, Al-Maflehi N, Abraham NB, Jacob V, Al Sherif G. Effectiveness of oral health education intervention among female primary school children in Riyadh, Saudi Arabia. Saudi Dent J 2018; 30:190-196. [PMID: 29942102 PMCID: PMC6011217 DOI: 10.1016/j.sdentj.2018.04.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 02/17/2017] [Accepted: 04/17/2018] [Indexed: 11/16/2022] Open
Abstract
Objective This study aimed to examine the effectiveness of oral health intervention on the improvement in knowledge and self-reported oral health behavior among 6–8 year old female primary school children in Riyadh, Saudi Arabia. Materials and methods The sample consisted of 1661 girls in primary schools who are 6 to 8-year-olds (first, second and third graders). The children’s level of knowledge was assessed by a self-administered questionnaire that was formulated for this specific age and divided into two parts; oral health knowledge and self-reported oral health behavior. There were seven multiple choice questions and one true/false question with five underlying parts in the questionnaire which contained basic information about oral health knowledge, oral hygiene practices and certain habits that affect teeth. The questionnaires were distributed before and six weeks after implementation of the oral health educational program to measure the level improvement of knowledge regarding oral health among these children. Results All the questions showed statistically significant improvement in knowledge and self-reported behavior in the post intervention group. There was a significant increase in the level of knowledge by 11.24% and level of self-reported behavior by 25% after intervention (P < 0.001). The highest net change in the knowledge due to intervention was noted among third graders (13.3%), whereas for self-reported oral health behavior, it was noted among first graders (28.3%). Conclusion The results of this study showed that an easy-to-organize and inexpensive school-based intervention can, on a short-term basis, be effective in improving the knowledge and self-reported oral health behavior of children.
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Affiliation(s)
- Hassan Suliman Halawany
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Dental Caries Research Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Corresponding author at: Dental Caries Research Chair, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh 11545, Saudi Arabia.
| | - Abid Al Badr
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Salwa Al Sadhan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Mashaiel Al Balkhi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nassr Al-Maflehi
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Nimmi Biju Abraham
- Dental Caries Research Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Vimal Jacob
- Dental Caries Research Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Gehan Al Sherif
- Dental Caries Research Chair, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Khudanov B, Jung HI, Kahharova D, Lee JW, Hamidov I, Lee ES, Kim BI. Effect of an oral health education program based on the use of quantitative light-induced fluorescence technology in Uzbekistan adolescents. Photodiagnosis Photodyn Ther 2018; 21:379-384. [PMID: 29378255 DOI: 10.1016/j.pdpdt.2018.01.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 12/15/2017] [Accepted: 01/19/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The aim of this study was to determine whether an oral health education program using a Qscan device based on quantitative light-induced fluorescence (QLF) technology could improve the oral hygiene status and oral health literacy of adolescents. MATERIALS AND METHODS One hundred adolescents aged 14-16 years attending a school in Tashkent city were included in this study. The participants were assigned to the following two groups using permuted block randomization technique: (i) control group (traditional learning) and (ii) experimental group (Qscan device-based learning). The participants included in the experimental group received additional education and training on dental plaque removal using the Qscan device. The accumulated levels of plaque were assessed in all participants, who also completed questionnaires about their oral health status, oral health knowledge, attitude, and behavior during an 8-week period. RESULTS There were statistically significant improvements in the experimental group compared to the control group in the plaque index (0.46 vs 0.07, p < .05), oral health knowledge (19.4 vs 28.8, p < .05), attitude (16.7 vs 20.2, p < .05), and behavior (19.9 vs 30.5, p < .05). CONCLUSIONS This study has demonstrated that an oral health education program based on the use of QLF technology could be useful for improving the oral hygiene status and oral health literacy of adolescents in Uzbekistan.
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Affiliation(s)
- Bakhtinur Khudanov
- Department of Preventive Dentistry, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Hoi In Jung
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Oral Science Research Institute, Yonsei University College of Dentistry, Republic of Korea
| | - Dono Kahharova
- Department of Preventive Dentistry, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Jeong-Woo Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Oral Science Research Institute, Yonsei University College of Dentistry, Republic of Korea
| | - Ilhom Hamidov
- Department of Preventive Dentistry, Tashkent State Dental Institute, Tashkent, Uzbekistan
| | - Eun-Song Lee
- Department of Preventive Dentistry & Public Oral Health, BK21 PLUS Project, Oral Science Research Institute, Yonsei University College of Dentistry, Republic of Korea
| | - Baek-Il Kim
- Department of Preventive Dentistry, Tashkent State Dental Institute, Tashkent, Uzbekistan.
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Liu HY, Chen JR, Hsiao SY, Huang ST. Caregivers' oral health knowledge, attitude and behavior toward their children with disabilities. J Dent Sci 2017; 12:388-395. [PMID: 30895080 PMCID: PMC6395374 DOI: 10.1016/j.jds.2017.05.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 04/29/2017] [Indexed: 10/31/2022] Open
Abstract
Background/purpose This study was undertaken to document the knowledge, attitude and behavior among family caregivers, and to identify the related factors influencing their behavior in promoting their and children's oral health. Materials and methods A cross-sectional study was conducted to collect self-administered questionnaires from 503 family caregivers, who cared for 6-12 year-old children with disabilities in 10 special schools. Multiple regression models were used to analyze the association between caregiver's oral health behaviors and related factors. Results Most caregivers were female (74.8%). The top three sources of oral health knowledge among caregivers were dentists (66.60%), books (34.59%) and television (31.21%). Comparison of oral health knowledge and attitude scores among different education levels of caregivers yielded statistically significant differences (p < 0.05). Eighty-four percent of caregivers cleaned their teeth twice a day and 46.12% used dental floss. More than half of caregivers (60.44%) assisted their children to brush teeth. Only 12.65% took their children to receive fluoride varnish services. Caregivers' favorable oral health behavior was found to be significantly associated with a higher education level, better knowledge and positive attitude. The determining factor of caregivers' preventive behavior was attitude. Education level influenced the caregiver's knowledge. Knowledge is positively associated with attitude. Conclusion Inadequate knowledge is the major factor preventing caregivers from favorable oral health behavior. Oral health related educational programs aimed at promoting caregivers' behavior must take into consideration the caregivers' knowledge level first. Education programs should be recommended to caregivers with a lower education level.
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Affiliation(s)
- Hsiu-Yueh Liu
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.,Department of Medical Research, Kaohsiung Medical University Hospital, Taiwan, ROC
| | - Jung-Ren Chen
- Department of Biological Science and Technology, I-Shou University, Kaohsiung, Taiwan, ROC
| | - Szu-Yu Hsiao
- Division of Special Care Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC
| | - Shun-Te Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC.,Division of Special Care Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC
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16
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Effect of a School-Based Supervised Tooth Brushing Program In Mexico City: A Cluster Randomized Intervention. J Clin Pediatr Dent 2017; 41:204-213. [PMID: 28422600 DOI: 10.17796/1053-4628-41.3.204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
UNLABELLED Large-scale school-based programs effectively provide health education and preventive strategies. SaludARTE is a school-based program, including supervised tooth brushing, implemented in 51 elementary schools in Mexico City. OBJECTIVES To assess the three-month efficacy of supervised tooth brushing in reducing dental plaque, gingival inflammation, and bleeding on probing in schoolchildren participating in SaludARTE. STUDY DESIGN This was a pragmatic cluster randomized intervention, with two parallel branches. Four randomly selected schools participating in SaludARTE (n=200) and one control school, which did not participate in the program (CG) (n=50), were assessed. Clusters were not randomly allocated to intervention. The main outcomes were as follows: mean percentage gingival units with no inflammation, dental surfaces with no dental plaque, and gingival margins with no bleeding. The independent variable was supervised tooth brushing at school once a day after a meal. Guardians and children responded to a questionnaire on sociodemographic and oral hygiene practices, and children were examined dentally. Mean percentage differences were compared (baseline and follow-up). RESULTS A total of 75% of guardians from the intervention group (IG) and 77% from the CG answered the questionnaire. Of these, 89.3% were women, with a mean age of 36.9±8.5 years. No differences in sociodemographic variables were observed between groups, and 151 children from the IG and 35 from the CG were examined at baseline and follow-up. Mean percentage differences for plaque-free surfaces (8.8±28.5%) and healthy gingival units (23.3%±23.2%) were significantly higher in the IG. CONCLUSION The school-supervised tooth brushing program is effective in improving oral hygiene and had a greater impact on plaque and gingivitis than on gingival bleeding. It is necessary to reinforce the oral health education component of the program.
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Aleksejūnienė J, Brukienė V. A cluster randomized theory-guided oral hygiene trial in adolescents-A latent growth model. Int J Dent Hyg 2017; 16:e23-e30. [DOI: 10.1111/idh.12286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2017] [Indexed: 01/18/2023]
Affiliation(s)
- J Aleksejūnienė
- Department of Oral Health Sciences; Faculty of Dentistry; The University of British Columbia; Vancouver BC Canada
| | - V Brukienė
- Institute of Odontology; Faculty of Medicine; Vilnius University; Vilnius Lithuania
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18
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Džiaugytė L, Aleksejūnienė J, Brukienė V, Pečiulienė V. Self-efficacy theory-based intervention in adolescents: a cluster randomized trial-focus on oral self-care practice and oral self-care skills. Int J Paediatr Dent 2017; 27:37-46. [PMID: 26764132 DOI: 10.1111/ipd.12223] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The cluster randomized trial tested the efficacy of professional dental education for improving oral self-care skills (OSC-S) and oral self-care practice (OSC-P) in adolescents. DESIGN All 15- to 16-year-old adolescents from four public schools were invited and 206 agreed to participate. Schools were randomly allocated to the intervention group and to the control group. Five sessions were given for the intervention group and one for the control group. The OSC-S and OSC-P outcomes were measured as % Oral Cleanliness Scores at the baseline, 6-month, and 12-month observations. RESULTS OSC-S and OSC-P correlated significantly (Pearson's) at the baseline (r = 0.777, P < 0.001), at the 6-month (r = 0.745, P < 0.001), and at the 12-month (r = 0.780, P < 0.001) examinations. After the guided oral healthcare interventions, a significant time × group effect was observed (repeated-measures anova, P < 0.001 for the OSC-S (multivariate η2 = 0.355) and for the OSC-P (multivariate η2 = 0.325). CONCLUSION (i) Oral self-care skills and oral self-care practice scores were significantly correlated, (ii) self-efficacy theory-guided intervention was superior to the conventional dental instruction to improve oral self-care in adolescents, and (iii) varying levels of oral self-care improvement were observed among the intervention group adolescents.
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Affiliation(s)
- Lina Džiaugytė
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jolanta Aleksejūnienė
- Department of Oral Health Sciences, Faculty of Dentistry, The University of British Columbia, Vancouver, BC, Canada
| | - Vilma Brukienė
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vytaute Pečiulienė
- Institute of Odontology, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, Morrice HR, Riggs E, Leong PM, Meyenn LK, Yousefi-Nooraie R. WITHDRAWN: Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016; 12:CD009837. [PMID: 28004389 PMCID: PMC6463845 DOI: 10.1002/14651858.cd009837.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. SEARCH METHODS We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. SELECTION CRITERIA Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for both intervention and control groups. Interventions were excluded if they were solely of a chemical nature (e.g. chlorhexidine, fluoride varnish), were delivered primarily in a dental clinical setting or comprised solely fluoridation. DATA COLLECTION AND ANALYSIS Two review authors independently performed screening, data extraction and assessment of risk of bias of included studies (a team of six review authors - four review authors and two research assistants - assessed all studies). We calculated mean differences with 95% confidence intervals for continuous data. When data permitted, we undertook meta-analysis of primary outcome measures using a fixed-effect model to summarise results across studies. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS This review includes findings from 38 studies (total n = 119,789 children, including one national study of 99,071 children, which contributed 80% of total participants) on community-based oral health promotion interventions delivered in a variety of settings and incorporating a range of health promotion strategies (e.g. policy, educational activities, professional oral health care, supervised toothbrushing programmes, motivational interviewing). We categorised interventions as dietary interventions (n = 3), oral health education (OHE) alone (n = 17), OHE in combination with supervised toothbrushing with fluoridated toothpaste (n = 8) and OHE in combination with a variety of other interventions (including professional preventive oral health care, n = 10). Interventions generally were implemented for less than one year (n = 26), and only 11 studies were RCTs. We graded the evidence as having moderate to very low quality.We conducted meta-analyses examining impact on dental caries of each intervention type, although not all studies provided sufficient data to allow pooling of effects across similar interventions. Meta-analyses of the effects of OHE alone on caries may show little or no effect on DMFT (two studies, mean difference (MD) 0.12, 95% confidence interval (CI) -0.11 to 0.36, low-quality evidence), dmft (three studies, MD -0.3, 95% CI -1.11 to 0.52, low-quality evidence) and DMFS (one study, MD -0.01, 95% CI -0.24 to 0.22, very low-quality evidence). Analysis of studies testing OHE in combination with supervised toothbrushing with fluoridated toothpaste may show a beneficial effect on dmfs (three studies, MD -1.59, 95% CI -2.67 to -0.52, low-quality evidence) and dmft (two studies, MD -0.97, 95% CI -1.06 to -0.89, low-quality evidence) but may show little effect on DMFS (two studies, MD -0.02, 95% CI -0.13 to 0.10, low-quality evidence) and DMFT (three studies, MD -0.02, 95% CI -0.11 to 0.07, moderate-quality evidence). Meta-analyses of two studies of OHE in an educational setting combined with professional preventive oral care in a dental clinic setting probably show a very small effect on DMFT (-0.09 weighted mean difference (WMD), 95% CI -0.1 to -0.08, moderate-quality evidence). Data were inadequate for meta-analyses on gingival health, although positive impact was reported. AUTHORS' CONCLUSIONS This review provides evidence of low certainty suggesting that community-based oral health promotion interventions that combine oral health education with supervised toothbrushing or professional preventive oral care can reduce dental caries in children. Other interventions, such as those that aim to promote access to fluoride, improve children's diets or provide oral health education alone, show only limited impact. We found no clear indication of when is the most effective time to intervene during childhood. Cost-effectiveness, long-term sustainability and equity of impacts and adverse outcomes were not widely reported by study authors, limiting our ability to make inferences on these aspects. More rigorous measurement and reporting of study results would improve the quality of the evidence.
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Affiliation(s)
- Andrea M de Silva
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Carlton, Victoria, Australia, 3053
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
| | - Shalika Hegde
- Centre for Applied Oral Health Research (Corporate Level), Dental Health Services Victoria, The Royal Dental Hospital of Melbourne, Carlton, Melbourne, Victoria, Australia, 3053
- School of Health & Social Development, Faculty of Health, Melbourne Burwood Campus, Deakin University, Burwood, Victoria, Australia
| | - Bridget Akudo Nwagbara
- Independent consultant, Abuja, Nigeria
- Nigerian Branch of the South African Cochrane Centre, Calabar, Nigeria
| | - Hanny Calache
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
- Clinical Leadership, Dental Health Services Victoria, 720 Swanston Sreet, Carlton, Victoria, Australia
- School of Dentistry and Oral Health, La Trobe University, Bendigo, Victoria, Australia
| | - Mark G Gussy
- Dept of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, Victoria, Australia, 3552
| | - Mona Nasser
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, The John Bull Building, Tamar Science Park,, Plymouth, UK, PL6 8BU
| | - Hannah R Morrice
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Elisha Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, Australia, 3052
- General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Pamela M Leong
- Early Life Epigenetics, Murdoch Childrens Research Institute, Flemington Road, Carlton, Victoria, Australia, 3053
| | - Lisa K Meyenn
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Carlton, Victoria, Australia, 3053
| | - Reza Yousefi-Nooraie
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, Canada, M5T 3M6
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20
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Ogretme MS, AbualSaoud D, Hosey MT. What preventive care do sedated children with caries referred to specialist services need? Br Dent J 2016; 221:777-784. [PMID: 27981972 DOI: 10.1038/sj.bdj.2016.951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Abstract
Introduction Few studies have assessed the preventive needs of children treated under conscious sedation or their parents'/guardians' views regarding oral health education.Aim To report on the profile of children who required treatment under conscious sedation. Also to obtain the views of the parents or guardians of these children on their experiences of oral health preventive services and the support they would like in order to improve their child's oral health.Method A researcher-administered questionnaire was used to collect quantitative and qualitative responses from a consecutive sample of 123 parents/guardians during their child's sedation appointment at King's College Hospital.Results Caries was the main reason for the child's sedation treatment and 77.2% of them were high caries risk. Parents reported that their general dentist had given advice about sugar (80%) and tooth-brushing (74%), but few had prescribed fluoride varnish (15%), fissure sealants (12%) or a fluoride rinse (36%). Parents felt challenged by the ready availability of sugar, and others suggested difficulty in maintaining healthy oral habits in complex families. Overall, the majority of parents thought leaflets, health professionals' advice, and Internet websites could be informative, and they requested school- and hospital-based prevention programmes.Discussion The majority of children had high caries risk. They had received advice but not professional preventive treatment such as fluoride varnish and fissure sealants. Their parents requested preventive education using new technologies and media and better access through school-based and hospital prevention programmes.
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Affiliation(s)
- M Sipahi Ogretme
- Clinical Tutor, King's College London Dental institute, Bessemer Road, London, SE5 9RS
| | - D AbualSaoud
- Department of Paediatric Dentistry, King's College London Dental institute, Bessemer Road, London, SE5 9RS
| | - M T Hosey
- Department of Paediatric Dentistry, King's College London Dental institute, Bessemer Road, London, SE5 9RS
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de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, Morrice HR, Riggs E, Leong PM, Meyenn LK, Yousefi‐Nooraie R. Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016; 9:CD009837. [PMID: 27629283 PMCID: PMC6457580 DOI: 10.1002/14651858.cd009837.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. SEARCH METHODS We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. SELECTION CRITERIA Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for both intervention and control groups. Interventions were excluded if they were solely of a chemical nature (e.g. chlorhexidine, fluoride varnish), were delivered primarily in a dental clinical setting or comprised solely fluoridation. DATA COLLECTION AND ANALYSIS Two review authors independently performed screening, data extraction and assessment of risk of bias of included studies (a team of six review authors - four review authors and two research assistants - assessed all studies). We calculated mean differences with 95% confidence intervals for continuous data. When data permitted, we undertook meta-analysis of primary outcome measures using a fixed-effect model to summarise results across studies. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS This review includes findings from 38 studies (total n = 119,789 children, including one national study of 99,071 children, which contributed 80% of total participants) on community-based oral health promotion interventions delivered in a variety of settings and incorporating a range of health promotion strategies (e.g. policy, educational activities, professional oral health care, supervised toothbrushing programmes, motivational interviewing). We categorised interventions as dietary interventions (n = 3), oral health education (OHE) alone (n = 17), OHE in combination with supervised toothbrushing with fluoridated toothpaste (n = 8) and OHE in combination with a variety of other interventions (including professional preventive oral health care, n = 10). Interventions generally were implemented for less than one year (n = 26), and only 11 studies were RCTs. We graded the evidence as having moderate to very low quality.We conducted meta-analyses examining impact on dental caries of each intervention type, although not all studies provided sufficient data to allow pooling of effects across similar interventions. Meta-analyses of the effects of OHE alone on caries may show little or no effect on DMFT (two studies, mean difference (MD) 0.12, 95% confidence interval (CI) -0.11 to 0.36, low-quality evidence), dmft (three studies, MD -0.3, 95% CI -1.11 to 0.52, low-quality evidence) and DMFS (one study, MD -0.01, 95% CI -0.24 to 0.22, very low-quality evidence). Analysis of studies testing OHE in combination with supervised toothbrushing with fluoridated toothpaste may show a beneficial effect on dmfs (three studies, MD -1.59, 95% CI -2.67 to -0.52, low-quality evidence) and dmft (two studies, MD -0.97, 95% CI -1.06 to -0.89, low-quality evidence) but may show little effect on DMFS (two studies, MD -0.02, 95% CI -0.13 to 0.10, low-quality evidence) and DMFT (three studies, MD -0.02, 95% CI -0.11 to 0.07, moderate-quality evidence). Meta-analyses of two studies of OHE in an educational setting combined with professional preventive oral care in a dental clinic setting probably show a very small effect on DMFT (-0.09 weighted mean difference (WMD), 95% CI -0.1 to -0.08, moderate-quality evidence). Data were inadequate for meta-analyses on gingival health, although positive impact was reported. AUTHORS' CONCLUSIONS This review provides evidence of low certainty suggesting that community-based oral health promotion interventions that combine oral health education with supervised toothbrushing or professional preventive oral care can reduce dental caries in children. Other interventions, such as those that aim to promote access to fluoride, improve children's diets or provide oral health education alone, show only limited impact. We found no clear indication of when is the most effective time to intervene during childhood. Cost-effectiveness, long-term sustainability and equity of impacts and adverse outcomes were not widely reported by study authors, limiting our ability to make inferences on these aspects. More rigorous measurement and reporting of study results would improve the quality of the evidence.
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Affiliation(s)
| | | | | | | | - Mark G Gussy
- La Trobe UniversityDept of Dentistry and Oral Health, La Trobe Rural Health SchoolPO Box 199BendigoAustralia3552
| | - Mona Nasser
- Plymouth University Peninsula Schools of Medicine and DentistryPeninsula Dental SchoolThe John Bull Building, Tamar Science Park,PlymouthUKPL6 8BU
| | - Hannah R Morrice
- University of MelbourneJack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global HealthCarltonAustralia
| | | | - Pamela M Leong
- Murdoch Childrens Research InstituteEarly Life EpigeneticsFlemington RoadCarltonAustralia3053
| | - Lisa K Meyenn
- Dental Health Services VictoriaCentre for Applied Oral Health ResearchCarltonAustralia3053
| | - Reza Yousefi‐Nooraie
- University of TorontoInstitute of Health Policy, Management and Evaluation155 College StreetTorontoCanadaM5T 3M6
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Vangipuram S, Jha A, Raju R, Bashyam M. Effectiveness of Peer Group and Conventional Method (Dentist) of Oral Health Education Programme Among 12-15 year Old School Children - A Randomized Controlled Trial. J Clin Diagn Res 2016; 10:ZC125-9. [PMID: 27437345 PMCID: PMC4948521 DOI: 10.7860/jcdr/2016/17725.7844] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Accepted: 02/23/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Oral Health Education (OHE) in schools is routinely delivered by the dentist. Another approach which can be cost-effective, easily accessible and equally effective is the trained group of peer students. AIM The objective of the present study was to assess and compare the effectiveness of peer-led and conventional method (dentist-led), OHE on oral health status, oral health knowledge, attitude and practices among 12-15 year old government school children in Bengaluru South Zone-I at baseline, 3 months and 6 months. MATERIALS AND METHODS The study population comprised of 450 subjects, 150 each in peer, dentist and control group. At baseline, a pre-tested 14 item questionnaire was used to assess the existing oral health knowledge, attitude and oral hygiene practices of the subjects. Clinical examination included recording of plaque index and gingival index, by a pre-calibrated examiner. OHE was provided by the peer group and dentist (using power-point presentation, chalk and talk presentation, using charts, posters, booklets and tooth brushing demonstration models). Data was analyzed using Kruskal Wallis and Chi-square test. RESULTS Both the peer-led and dentist-led OHE intervention were effective in improving oral health knowledge, attitude, oral hygiene practices and oral health status at three and six months when compared to control group. The adolescents in the peer-led group, however, exhibited statistically better oral health behavior than their counterparts in the dentist-led group and control group. CONCLUSION The two educator-led strategies (peer group and dentist) had a modest effect on the outcome variables included in the study, the results provide some evidence to show that the peer-led strategy may provide a feasible and almost equally effective alternative to the traditional dentist led strategy of oral health education.
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Affiliation(s)
- Swathi Vangipuram
- Senior Lecturer, Department of Public Health Dentistry, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru, India
| | - Abhishek Jha
- Senior Lecturer, Department of Public Health Dentistry, New Horizon Dental College and Research Institute, Bilaspur, Chhattisgarh, India
| | - Rekha Raju
- Professor and Head, Department of Public Health Dentistry, V.S. Dental College and Hospital, Bangaluru, India
| | - Mamtha Bashyam
- Post Graduate Student, Department of Public Health Dentistry, V.S. Dental College and Hospital, Bangaluru, India
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Haleem A, Khan MK, Sufia S, Chaudhry S, Siddiqui MI, Khan AA. The role of repetition and reinforcement in school-based oral health education-a cluster randomized controlled trial. BMC Public Health 2016; 16:2. [PMID: 26728002 PMCID: PMC4700643 DOI: 10.1186/s12889-015-2676-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 12/22/2015] [Indexed: 11/07/2022] Open
Abstract
Background Repetition and reinforcement have been shown to play a crucial role in the sustainability of the effect of Oral Health Education (OHE) programs. However, its relevance to school-based OHE imparted by different personnel is not depicted by the existing dental literature. The present study was undertaken to determine the effectiveness of the repeated and reinforced OHE (RR-OHE) compared to one-time OHE intervention and to assess its role in school-based OHE imparted by dentist, teachers and peers. Methods The study was a cluster randomized controlled trial that involved 935 adolescents aged 10-11 years. Twenty four boys’ and girls’ schools selected at random in two towns of Karachi, Pakistan were randomly assigned to three groups to receive OHE by dentist (DL), teachers (TL) and peer-leaders (PL). The groups received a single OHE session and were evaluated post-intervention and 6 months after. The three groups were then exposed to OHE for 6 months followed by 1 year of no OHE activity. Two further evaluations at 6-month and 12-month intervals were conducted. The data were collected by a self-administered questionnaire preceded by a structured interview and followed by oral examination of participants. Results The adolescents’ oral health knowledge (OHK) in the DL and PL groups increased significantly by a single OHE session compared to their baseline knowledge (p < 0.05) and the increase was sustained over 6 months. Although one-time OHE resulted in a significant improvement in adolescents’ oral health behavior (OHB) related to the prevention of gingivitis in the two groups (p < 0.05), no significant change was observed in their behavior towards prevention of oral cancer. One-time teacher-led OHE was ineffective in improving adolescents’ OHK and OHB. The oral hygiene status (OHS) of the participants in all three groups did not change statistically after one-time OHE. The OHK, OHB and OHS indices increased significantly 6 months after RR-OHE than the initial scores (p < 0.001) irrespective of OHE strategy. Although the OHK scores of the DL and PL groups decreased significantly at 12-month evaluation of RR-OHE (p < 0.05), the said score of the TL group; and OHB and OHS scores of all three groups remained statistically unchanged during this period. Conclusions The repetition and reinforcement play a key role in school-based OHE irrespective of educators. The trained teachers and peers can play a complementary role in RR-OHE.
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Affiliation(s)
- Abdul Haleem
- Department of Oral Health Sciences, Federal Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, 54600, Pakistan.
| | - Muhammad Khalil Khan
- Department of Oral Health Sciences, Federal Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, 54600, Pakistan.
| | - Shamta Sufia
- Department of Community and Preventive Dentistry, de' Montmorency College of Dentistry, Fort Road, Lahore, Pakistan.
| | - Saima Chaudhry
- Department of Oral Pathology, University of Health Sciences, Lahore, Pakistan.
| | - Muhammad Irfanullah Siddiqui
- Department of Community Medicine and Pilgrims, Umm Al-Qura University, Makkah Al-Mukarrama-7607, Mecca, Saudi Arabia.
| | - Ayyaz Ali Khan
- Department of Oral Health Sciences, Federal Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, 54600, Pakistan.
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Angelopoulou MV, Oulis CJ, Kavvadia K. School-based oral health-education program using experiential learning or traditional lecturing in adolescents: a clinical trial. Int Dent J 2014; 64:278-84. [PMID: 25142752 DOI: 10.1111/idj.12123] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The aim of this project was to compare the effectiveness of experiential learning (EL) and traditional lecturing (TL) school-based oral health education on the oral health knowledge, attitude, habits, oral hygiene, gingival health and caries incidence of 13-year-old Greek children. Eighty-seven children for the EL group and 80 for the TL group were selected from two areas of Greece. Information on oral health knowledge, attitude and behaviours were obtained using a questionnaire. Dental plaque was recorded using a modified hygiene index, gingivitis was assessed using the simplified gingival index and dental caries was measured by recording the number of Decayed, Missing and Filled teeth (DMFT) using the British Association for the Study of Community Dentistry (BASCD) criteria. All children were examined by two calibrated dentists, using a World Health Organisation (WHO) periodontal probe and artificial light. Questionnaires were delivered and clinical examinations were performed at baseline and at 6 and 18 months post-intervention. The EL oral health educational programme was implemented by teachers using the programme's manual. Oral health knowledge had improved significantly (P < 0.001) in both groups at 6 and 18 months post-intervention. Oral health behaviour (P < 0.001) and attitude (P < 0.05) had improved significantly at 6 months, and oral hygiene and gingival health had improved significantly at both 6 (P < 0.001) and 18 (P < 0.05) months for the EL group. Lower caries incidence was recorded for the EL group, 18 months post-intervention (P < 0.05). School-based oral health EL for adolescents was found to be more effective than TL in improving oral health attitude and behaviour at 6 months, in improving oral hygiene and gingival health at both 6 and 18 months and in reducing caries incidence 18 months post-intervention.
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Affiliation(s)
- Matina V Angelopoulou
- Department of Paediatric Dentistry, Dental School, University of Athens, Athens, Greece
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Nakre PD, Harikiran AG. Effectiveness of oral health education programs: A systematic review. J Int Soc Prev Community Dent 2014; 3:103-15. [PMID: 24778989 PMCID: PMC4000911 DOI: 10.4103/2231-0762.127810] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
In recent years, attention has been drawn toward assessing the effectiveness of oral health education programs. This is in line with demand for evidence based research and will help to inform policy makers on how to allocate resources. (1) Collect and collate all information on oral health education programs. (2) Assess the programs based on various coding criteria. (3) Assess effectiveness of oral health education programs on oral health status and knowledge, attitude and practice. A search of all published articles in Medline was done using the keywords “oral health education, dental health education, oral health promotion”. The resulting titles and abstracts provided the basis for initial decisions and selection of articles. Out of the primary list of articles, a total number of 40 articles were selected as they fulfilled the following inclusion criteria: (1). Articles on oral health programs with an oral health education component (2). Articles published after the year 1990 (3). Articles published in English. The full text of the articles was then obtained from either the internet or libraries of dental research colleges and hospitals in and around Bangalore. A set of important variables were identified and grouped under five headings to make them amenable for coding. The coding variables were then described under various subheadings to allow us to compare the chosen articles. Oral health education is effective in improving the knowledge attitude and practice of oral health and in reducing plaque, bleeding on probing of the gingiva and caries increment. This study identifies a few important variables which contribute to the effectiveness of the programs. There is an indication in this review that the most successful oral health programs are labor intensive, involve significant others and has received funding and additional support. A balance between inputs and outputs and health care resources available will determine if the program can be recommended for general use.
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Affiliation(s)
- Priya Devadas Nakre
- Department of Public Health Dentistry, Rama Dental College Hospital and Research Centre, Kanpur, Uttar Pradesh, India
| | - A G Harikiran
- Department of Public Health Dentistry, DAPMRV Dental College Hospital and Research Centre, Bengaluru, Karnataka, India
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McKittrick TR, Jacobsen KH. Oral hygiene practices among middle-school students in 44 low- and middle-income countries. Int Dent J 2014; 64:164-70. [DOI: 10.1111/idj.12094] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Suprabha BS, Rao A, Shenoy R, Khanal S. Utility of knowledge, attitude, and practice survey, and prevalence of dental caries among 11- to 13-year-old children in an urban community in India. Glob Health Action 2013; 6:20750. [PMID: 23639177 PMCID: PMC3643074 DOI: 10.3402/gha.v6i0.20750] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/03/2013] [Accepted: 04/05/2013] [Indexed: 12/01/2022] Open
Abstract
Background The school oral health education program is believed to be a cost-effective method for promoting oral health. The KAP (knowledge–attitude–practice) model of oral health education is often the foundation of most health education programs. Objectives To assess the existing knowledge, attitude, and oral health care practices among 11- to 13-year-old children and the association of knowledge with attitude, oral health care practices, and dental caries prevalence. Design Cross-sectional design, involving 858 children studying in class seven at various schools in the city of Mangalore, India. The children were selected using stratified random sampling method. Prevalence of dental caries was determined using decayed, missing, and filled permanent teeth (DMFT) index. A self-administered questionnaire on self-care practices in oral health, knowledge, and attitude toward oral health care was filled by children. The association of different variables with knowledge was analyzed using binary logistic regression analysis. Results The dental caries prevalence was 59.4%, and 54.5% had low knowledge. They lacked knowledge regarding use of fluoridated toothpaste and did not use them. Children with low knowledge had significantly higher odds of having DMFT≥1, not using fluoridated toothpaste, and being afraid of going to the dentist due to possible pain. There was no association of other oral health care practices and attitudes with knowledge. Conclusion Oral health care practices and attitudes are not fully explained by knowledge, and other models of health education need to be considered.
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Affiliation(s)
- Baranya Shrikrishna Suprabha
- Department of Paedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal University, Mangalore, India.
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Mbawalla H, Masalu JR, Masatu M, Åstrøm AN. Changes in adolescents' oral health status following oral health promotion activities in Tanzania. Acta Odontol Scand 2013; 71:333-42. [PMID: 22563991 DOI: 10.3109/00016357.2012.680907] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the impact of oral health promotion integrated with a health promoting school (HPS) initiative on the oral health outcomes of secondary school students. MATERIALS AND METHOD Using an urban-rural stratified cluster randomized approach, the intervention was applied to secondary school students in Arusha, Tanzania. In the urban, three control (n = 315) and two intervention (n = 214) schools performed oral clinical examination and questionnaires at baseline. In rural the corresponding figures at baseline were two (n = 188) and three (n = 360) schools. After 2 years, 374 and 358 students remained in the intervention and control arms. RESULTS Mean number of decayed teeth (DT) increased in the intervention (mean score 1.0 vs 1.7, p < 0.001) and control schools (mean score 1.2 vs 1.7, p < 0.001). Mean number of teeth with plaque decreased significantly in intervention and control schools. No significant difference in caries increment and plaque decline scores was observed between groups. Mean number of teeth with bleeding decreased (0.5 vs 0.3, p < 0.05) in intervention schools, whereas no change was observed in the control schools (0.4 vs 0.5, p = 0.051). Increment in mean number of DT between baseline and follow-up was largest and smallest in students who, respectively, deteriorated and improved their plaque and bleeding scores. CONCLUSION The intervention activities did not show any effect with respect to dental caries, calculus and plaque status among the students investigated. Compared with the control group, more favorable changes in the intervention group occurred with respect to bleeding on probing, suggesting a weak but positive effect on students' oral hygiene status.
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Affiliation(s)
- Hawa Mbawalla
- Department of Clinical Dentistry, Community Dentistry, University of Bergen, Bergen, Norway
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Haleem A, Siddiqui MI, Khan AA. School-based strategies for oral health education of adolescents--a cluster randomized controlled trial. BMC Oral Health 2012; 12:54. [PMID: 23249443 PMCID: PMC3552898 DOI: 10.1186/1472-6831-12-54] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 12/11/2012] [Indexed: 11/10/2022] Open
Abstract
Background Oral health education (OHE) in schools has largely been imparted by dental professionals. Considering the substantial cost of this expert-led approach, the strategies relying on teachers, peer-leaders and learners themselves have also been utilized. However the evidence for comparative effectiveness of these strategies is lacking in the dental literature. The present study was conducted to compare the effectiveness of dentist-led, teacher-led, peer-led and self-learning strategies of oral health education. Methods A two-year cluster randomized controlled trial following a parallel design was conducted. It involved five groups of adolescents aged 10-11 years at the start of the study. The trial involved process as well as four outcome evaluations. The present paper discusses the findings of the study pertaining to the baseline and final outcome evaluation, both comprising of a self-administered questionnaire, a structured interview and clinical oral examination. The data were analyzed using Generalized Estimating Equations. Results All the three educator-led strategies of OHE had statistically higher mean oral health knowledge (OHK), oral health behavior (OHB), oral hygiene status (OHS) and combined knowledge, behavior and oral hygiene status (KBS) scores than the self-learning and control groups (p<0.001). The mean OHK, OHS and KBS scores of the three educator-led strategies did not differ significantly. The peer-led strategy was, however, found to have a significantly better OHB score than the respective score of the teacher-led strategy (p<0.05). The self-learning group had significantly higher OHB score than the control group (p<0.05) but the OHK, OHS and KBS scores of the two groups were not significantly different. Conclusions The dentist-led, teacher-led and peer-led strategies of oral health education are equally effective in improving the oral health knowledge and oral hygiene status of adolescents. The peer-led strategy, however, is almost as effective as the dentist-led strategy and comparatively more effective than the teacher-led and self-learning strategies in improving their oral health behavior. Trail registration SRCTN39391017
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Affiliation(s)
- Abdul Haleem
- Department of Oral Health Sciences, Federal Postgraduate Medical Institute, Shaikh Zayed Medical Complex, Lahore, Pakistan.
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Chandrashekar BR, Suma S, Kiran K, Manjunath BC. The use of school teachers to promote oral hygiene in some secondary school students at Hyderabad, Andhra Pradesh, India: A short term prospective pilot study. J Family Community Med 2012; 19:184-9. [PMID: 23230385 PMCID: PMC3515958 DOI: 10.4103/2230-8229.102319] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN It was a short term prospective pilot study on a group of 116 secondary school students. OBJECTIVES To assess the feasibility of using the services of school teachers to promote oral hygiene in secondary school students and compare the effectiveness of dental health education (DHE) offered by school teachers on a fortnightly basis with what is offered by dental professionals at three- monthly intervals. MATERIALS AND METHODS Six secondary schools were randomly selected. The base-line Oral Hygiene Index simplified (OHI-S) and Plaque index (PI) scores for all the students were recorded. The teachers were trained on dental health facts. The six schools were divided into three groups of two schools with different intervention techniques: Group 1- Schools given no health education, Group 2 - Schools given health education by their school teachers on a fortnightly basis together with simple screening for deposits of gross calculus , Group 3 - Schools which were given health education by dental professionals at intervals of three months without any screening. Grade nine students were selected for pre and post intervention evaluation. The second examination was done six months following the intervention to find out the OHI-S and Plaque index scores. The examination was done by three trained and calibrated dentists. Data analysis was done with SPSS 16 with relevant statistical tests. RESULTS The mean OHI-S and PI scores were significantly less in group 2 and there was a statistically significant difference between the baseline OHI - S, PI score and the scores after six months in all the three groups. CONCLUSION The concept of utilizing the teachers for frequent DHE and screening for any gross deposits of food debris and calculus is feasible. Also frequent DHE by teachers was more effective than the infrequent DHE by the professionals.
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Affiliation(s)
| | - Shankarappa Suma
- Department of Orthodontics, People's Dental Academy, Bhanpur, Bhopal, India
| | - Kaverikana Kiran
- Department of Pedodontics, Kamineni Institute of Dental Sciences, Sreepuram, Narketpally, Nalgonda District, Andhra Pradesh, India
| | - Badhravathi C. Manjunath
- Department of Public Health Dentistry, Jaipur Dental College, Dhand, Amer Tehsil, Jaipur, Rajasthan, India
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Tolvanen M, Lahti S, Poutanen R, Seppä L, Hausen H. Children's oral health-related behaviors: individual stability and stage transitions. Community Dent Oral Epidemiol 2011; 38:445-52. [PMID: 20545718 DOI: 10.1111/j.1600-0528.2010.00549.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED In 2001-2005 in Pori, Finland, a program of oral health promotion (OHP) was targeted to schoolchildren and people involved in their life to provide social support for participants of the experimental group of a randomized clinical trial (RCT) on controlling caries. OBJECTIVES Our aim was to describe the individual stability and stage transitions for behaviors among children exposed to OHP in Pori and to ascertain whether these phenomena differed in the group that was also exposed to the experimental regimen of the RCT. METHODS The study population consisted of all 5th and 6th graders who started the 2001-2002 school year in Pori (n = 1691); 1362 of them were monitored throughout the 3.4-year study. Of these children, 1138 were exposed to OHP and 224 to OHP and the experimental regimen of the RCT. Data on toothbrushing and use of xylitol products, candies, and soft- and sports drinks were gathered with questionnaires. Behavior variables were dichotomized into good and poor. The stability of behaviors and stage transitions was evaluated. RESULTS Over half of the children had stable behaviors throughout the study. For those children whose behaviors changed, the behavior was more likely to improve than to worsen. For most behaviors, good behavior at baseline was associated with the ability to maintain the achieved good behavior and to recover from lapses to poor behaviors. CONCLUSION In childhood, behaviors, especially good ones, are rather stable. If healthy behaviors are learned young, lapses into poor behaviors, for instance during the teens, are likely be temporary rather than permanent.
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Affiliation(s)
- Mimmi Tolvanen
- Department of Community Dentistry, Institute of Dentistry, University of Oulu, Oulu, Finland.
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Tolvanen M, Lahti S, Hausen H. Changes in toothbrushing frequency in relation to changes in oral health-related knowledge and attitudes among children - a longitudinal study. Eur J Oral Sci 2010; 118:284-9. [DOI: 10.1111/j.1600-0722.2010.00737.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saied-Moallemi Z, Virtanen JI, Vehkalahti MM, Tehranchi A, Murtomaa H. School-based intervention to promote preadolescents' gingival health: a community trial. Community Dent Oral Epidemiol 2009; 37:518-26. [PMID: 19694774 DOI: 10.1111/j.1600-0528.2009.00491.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health. METHODS A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE). RESULTS At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class-work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome. CONCLUSIONS When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.
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Affiliation(s)
- Z Saied-Moallemi
- Department of Oral Public Health, Institute of Dentistry, University of Helsinki, PO Box 41, FI-00014, Helsinki, Finland.
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Tolvanen M, Lahti S, Poutanen R, Seppä L, Pohjola V, Hausen H. Changes in children’s oral health-related behavior, knowledge and attitudes during a 3.4-yr randomized clinical trial and oral health-promotion program. Eur J Oral Sci 2009; 117:390-7. [DOI: 10.1111/j.1600-0722.2009.00640.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Levin KA, Currie C. Inequalities in toothbrushing among adolescents in Scotland 1998-2006. HEALTH EDUCATION RESEARCH 2009; 24:87-97. [PMID: 18245045 DOI: 10.1093/her/cym096] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
The aim of this study was to examine trends in toothbrushing and inequalities in toothbrushing among girls and boys in Scotland between 1998 and 2006. A secondary aim was to investigate the association between the health promoting school (HPS) initiative and toothbrushing. Data from the Health Behaviour in School-aged Children 1998, 2002 and 2006 surveys were analysed using multilevel logistic regression for boys and girls aged 11, 13 and 15 years. Girls' twice-a-day toothbrushing increased with age while that of boys' remained stable. Toothbrushing increased significantly between 1998 and 2006 for all but 15-year-old girls. Family structure was significantly associated with toothbrushing for 11-year-old boys and 13-year-old boys and girls. Socio-economic inequalities in toothbrushing were significant for both boys and girls at all ages. Largest inequalities were seen among 13-year-old girls and 15-year-old boys. Inequalities persisted over time for all but 15-year-old boys who saw a significant reduction between 1998 and 2006. The HPS initiative in schools in deprived areas was associated with increased odds of twice-a day toothbrushing among 11-year-old boys and 15-year-old girls.
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Affiliation(s)
- K A Levin
- Child.dolescent Health Research Unit, The Moray House School of Education, The University of Edinburgh, St Leonard's Land, Edinburgh, UK.
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Levin KA, Jones CM, Wight C, Valentine C, Topping GVA, Naysmith R. Fluoride rinsing and dental health inequalities in 11-year-old children: an evaluation of a supervised school-based fluoride rinsing programme in Edinburgh. Community Dent Oral Epidemiol 2008; 37:19-26. [PMID: 19046333 DOI: 10.1111/j.1600-0528.2008.00445.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Previous studies have shown that fluoride mouthrinsing programmes are effective in reducing caries among children and adolescents. National surveys of child dental health in the UK confirm that there is variation in oral health. In particular, children of low socioeconomic status in Scotland have a disproportionately high share of dental disease. This study aimed to evaluate an existing school-based fluoride mouthrinsing programme on dental caries in populations stratified by socioeconomic status. METHODS A random sample of 1333 children surveyed by the National Dental Inspection Programme with average age 11.4 years was included in the study. Caries prevalence data were collected for the 661 rinsers and 672 nonrinsers. Chi-squared tests and t-tests were carried out to test differences in proportion and in mean D(3)MFT, respectively. The data were modelled using multilevel logistic regression, adjusting for age, sex, deprivation and rinse status. RESULTS There is a strong negative association between deprivation and prevalence of D(3)MFT = 0. There is no significant difference in prevalence of D(3)MFT between rinsers and nonrinsers, however, mean D(3)MFT is greater for nonrinsers within each deprivation category. After adjusting for age, sex and deprivation, the odds of a tooth being decayed missing or filled for a child who rinsed are 0.79 (0.64, 0.98) compared with those of a child who did not. CONCLUSIONS Fluoride rinsing can be effectively targeted at children from deprived areas through school-based initiatives. There are some difficulties in recruiting all children from the more deprived backgrounds, but overall reductions in D(3)MFT were observed.
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Affiliation(s)
- Kate A Levin
- Child and Adolecent Health Research Unit, University of Edinburgh, Edinburgh, UK.
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Folta SC, Goldberg JP, Economos C, Bell R, Landers S, Hyatt R. Assessing the use of school public address systems to deliver nutrition messages to children: Shape up Somerville--audio adventures. THE JOURNAL OF SCHOOL HEALTH 2006; 76:459-64; quiz 482-4. [PMID: 17026639 DOI: 10.1111/j.1746-1561.2006.00141.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Given the current childhood obesity epidemic, it is especially important to find effective ways to promote healthful foods to children. School public address (PA) systems represent an inexpensive and a replicable way of reaching children with health messages. To test the effectiveness of this channel, messages were created to promote 2 dried bean (legume) dishes that had been added to the school lunch menu. Six elementary schools were pair matched, and 1 school from each pair was randomly chosen to play the messages. The impact of the intervention on choice of the 2 new entrees was assessed. Results indicate that for all schools combined, choice was not significantly affected. However, compared to their matched control schools, choice was significantly higher in the school that received the highest dose of the intervention and was significantly lower in the school that received the lowest dose. Choice was not changed in the school that received an intermediate dose. These results suggest that PA systems show promise as an effective and appropriate communications channel but only in schools that are able to play messages frequently.
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Affiliation(s)
- Sara C Folta
- John Hancock Center for Physical Activity and Nutrition, Gerald J. and Dorothy R Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
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Masanja IM, Mumghamba EGS. Knowledge on gingivitis and oral hygiene practices among secondary school adolescents in rural and urban Morogoro, Tanzania. Int J Dent Hyg 2006; 2:172-8. [PMID: 16451492 DOI: 10.1111/j.1601-5037.2004.00096.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess and compare knowledge on gingivitis and oral hygiene practices among rural and urban secondary school students. DESIGN A cross-section descriptive study involving secondary school students aged between 13 and 17 years in Morogoro rural and urban districts. METHODS Questionnaire was used to collect information about knowledge on causes, signs, symptoms, complications, treatment modalities and prevention of gingivitis, as well as on oral hygiene practices. RESULTS A total of 196 students participated in this study, of which 58.7% were females, and 52% were from urban schools. The responses were graded into three criteria namely 'lack of knowledge', 'partial knowledge' and 'total or full knowledge'. There was a partial knowledge about gingivitis and full knowledge of the basic oral hygiene measures among secondary school teenagers. The difference between rural and urban residence on the level of understanding was statistically significant in relation to tooth brushing practices (P = 0.0088), necessity of using toothpaste (P = 0.0204), reasons for using toothpaste (P = 0.0057), signs and symptoms of gingivitis (P = 0.0261) and treatment of gingivitis (P = 0.0106). However, there were no statistically significant differences in distribution of study participants, understanding of tooth brushing practices, reasons for tooth brushing, causes, prevention and complications of gingivitis. CONCLUSION Secondary school teenagers have partial knowledge about gingivitis and a good knowledge of the basic oral hygiene measures necessary to maintain proper oral health. A small difference on knowledge in specific areas was noted among rural and urban respondents.
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Affiliation(s)
- I M Masanja
- Department of Restorative Dentistry, School of Dentistry, Muhimbili University College of Health Sciences (MUCHS), Dar Es Salaam, Tanzania
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Abstract
Among the many formative issues in adolescents, determinants for health behaviors are being shaped. The development of positive oral health behavior in adolescents is a complex process. Areas specifically related to oral health include self-concept and its relation-ship to oral health and compliance with orthodontic care; tobacco use; special considerations including anorexia, bulimia, and troubled youths; and health promotions. Knowledge is necessary, but there must also be shifts in attitudes and the development of health-related behaviors. Establishing these attitudes and behaviors in adolescence is crucial, because patterns of behavior developed in adolescence can form the basis for future health.
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Affiliation(s)
- Diana M Gardiner
- Educational Services, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, Box 512, New Orleans, LA 70119, USA.
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Abstract
AIM The aim of this study was to develop and evaluate a teaching programme based on the national curriculum for use in a primary school setting. DESIGN National Curriculum guidelines were combined with oral health education messages to draw up lesson plans for teachers to deliver. A questionnaire was used to demonstrate children's oral health knowledge prior to the teaching programme, and at 1 and 7 weeks following the programme. The study took place in inner-city, state-run primary schools in Manchester and North London, UK. The subjects were children between the ages of 7 and 8 years from Manchester (n = 58) and North London (n = 30). The main outcome measure was change in knowledge attributable to a newly developed teaching programme. RESULTS The children in Manchester had a higher level of knowledge prior to the teaching programme. Following the teaching programme, children in both schools showed a significant improvement in dental health knowledge (P < 0.001). Seven weeks later, the Manchester children showed no significant loss of knowledge (P < 0.001). CONCLUSIONS The aims of the National Curriculum were easily integrated with oral health messages. A more widely available teaching resource, such as the one described in this study, would be useful to encourage the teaching profession to take on oral health education without more costly input from dental professionals.
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Affiliation(s)
- A Chapman
- Division of Child Dental Health, University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY, UK
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Affiliation(s)
- Richard G Watt
- Department of Epidemiology and Public Health, University of College London Medical School, UK
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Freeman R, Bunting G. A child‐to‐child approach to promoting healthier snacking in primary school children: a randomised trial in Northern Ireland. HEALTH EDUCATION 2003. [DOI: 10.1108/09654280310459121] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Redmond CA, Hamilton FA, Kay EJ, Worthington HV, Blinkhorn AS. An investigation into the value and relevance of oral health promotion leaflets for young adolescents. Int Dent J 2001; 51:164-8. [PMID: 11563681 DOI: 10.1002/j.1875-595x.2001.tb00834.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To determine if oral health promotion leaflets of a novel design and content would be read by, acceptable to and influence 11-12-year-old children. METHOD Three related leaflets were incorporated into a dental health education programme aimed at 11-12-year-old children. The leaflets were designed specifically, following consultation with focus groups. They had a romantic story line and emphasised the immediate gains from good dental health, relevant to this age group. A random sample of pupils completed a written questionnaire on the impact of the leaflets at the end of the one-year programme. These sample pupils underwent a clinical examination to measure plaque before and after the programme. RESULTS 2,678 pupils with a mean age of 12.1 years participated in the programme. 895 were randomly selected to join the assessment study. Most pupils 81%, (725) reported they had read the leaflets; 61% (442) finding them enjoyable to read, 51% (370) attractive to look at and 71% (515) finding the story lines interesting. However, girls appreciated the leaflets more than the boys. There was some suggestion that the leaflets played a positive role in the overall success of the programme in that most pupils 83% (602) reported they thought more about caring for their teeth after reading the leaflets and 58% reported their brushing frequency had increased. CONCLUSION The results indicate that for adolescents, leaflets which feature interpersonal relationships are well accepted and can stimulate better oral health behaviour.
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Abstracts. Br Dent J 1999. [DOI: 10.1038/sj.bdj.4800359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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