1
|
Metwally NM, Ragab OAA, Kandil MSH, Elghareb LA. Pain assessment, cognitive and cortical changes with full mouth rehabilitation in a group of children. BMC Oral Health 2024; 24:599. [PMID: 38778294 PMCID: PMC11112780 DOI: 10.1186/s12903-024-04356-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 05/09/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND A change in professionals' perspectives on the value of general anesthesia (GA) for pediatric patients, including those with disabilities, medical conditions, severe oral issues, and challenging behaviors. Full-mouth rehabilitation under GA allows for the comprehensive treatment of all oral health problems in a single visit, without requiring the child's active participation. Extensive dental problems are often associated with severe dental pain, which can impact cognitive function, including perception, attention, memory, reasoning, language, communication, and executive functions. Individuals experiencing pain tend to perform less optimally cognitively. AIM This study aimed to investigate changes in cognition, brain function, and cortical alterations in children who underwent extensive dental rehabilitation under GA. PATIENTS ANDMETHODS Thirty uncooperative, healthy children aged 6-12 with extensive dental issues were enrolled. Pain levels were assessed using the FLACC and WBFPS scales before treatment, one week after, and three months later. Cognitive assessments, including the WCST, processing speed, digit span, and Trail Making Test, as well as EEG measurements, were also performed. RESULTS The results showed a significant improvement in pain levels reported by the children or their caregivers after the dental procedures, both at one week and three months. All cognitive measures, such as digit span, processing speed, and WCST performance, demonstrated substantial improvements after the treatment. The Trail Making Test also exhibited statistically significant variations before and after the dental procedures. Additionally, the MOCA test revealed a notable improvement in cognitive skills following the treatment. Furthermore, the EEG power ratio, an indicator of changes in the power balance within each frequency band, showed a statistically significant difference after the dental procedures. CONCLUSION the findings of this study suggest that full-mouth rehabilitation under GA can lead to improved pain management, as well as enhanced cognitive and brain functions in children. FUTURE PERSPECTIVES More clinical studies with a longer follow-up period and a different age range of children are required to investigate the connection between brain function and oral rehabilitation involving restorations or occlusion issues.
Collapse
Affiliation(s)
- Nancy Mohamed Metwally
- Pediatric Dentistry, Preventive Dentistry Department, Faculty of Dentistry, Oral Health, Tanta University, Tanta, Egypt.
| | | | | | - Lamis Ahmed Elghareb
- Pediatric Dentistry, Preventive Dentistry Department, Faculty of Dentistry, Oral Health, Tanta University, Tanta, Egypt
| |
Collapse
|
2
|
Girard IM, Ward P, Durey A, McLean C, Lund S, Calache H, Baker SR, Slack-Smith L. A qualitative meta-synthesis of carers' perceptions of factors influencing preschool children's oral hygiene practices-A social practices perspective. Community Dent Oral Epidemiol 2024. [PMID: 38769714 DOI: 10.1111/cdoe.12973] [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: 08/24/2023] [Revised: 01/25/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVES This study comprises a synthesis of published qualitative studies from developed countries on the perspectives of carers regarding the oral hygiene toothbrushing practices of preschool children, through the lens of social practice theory. METHODS A search of the following electronic databases was conducted for all available years: MEDLINE, EMBASE and Global Health using the Ovid platform; Dentistry & Oral Sciences Source (DOSS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. Included qualitative studies reported primary caregivers' perceptions of oral hygiene practices (focusing on toothbrushing) in preschool children (0-5 years old) in developed countries. A thematic synthesis of the qualitative findings was undertaken for the results of each study. RESULTS Eleven articles were included in this meta-synthesis. The focus of this paper was toothbrushing practices. A conceptual map of toothbrushing as a social practice was developed. Key findings included practice elements (meanings, competences, and materials), spatial and temporal aspects, and barriers and facilitators to performance. CONCLUSIONS The application of a social practice lens to published qualitative research on the oral hygiene of preschool children provided insights into the meanings and competences related to toothbrushing, as perceived by primary caregivers. However, it also revealed limited information on material, spatial and temporal aspects of toothbrushing practices, indicating the importance of considering social practice theory as a framework in future research to address this gap. Furthermore, exploring toothbrushing in connection with related social practices has the potential to increase understanding of factors influencing oral health in preschool children.
Collapse
Affiliation(s)
- Ivana Matic Girard
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Paul Ward
- Torrens University, Research Centre for Public Health, Equity and Human Flourishing, Adelaide, South Australia, Australia
| | - Angela Durey
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Caitlan McLean
- Torrens University, Research Centre for Public Health, Equity and Human Flourishing, Adelaide, South Australia, Australia
| | - Stephan Lund
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Hanny Calache
- Department of Rural Clinical Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Sarah R Baker
- School of Clinical Dentistry, Sheffield University, Sheffield, UK
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| |
Collapse
|
3
|
Oh M. Empowering Youth for Oral Health: A Transformative Community Initiative. J Physician Assist Educ 2024:01367895-990000000-00145. [PMID: 38727696 DOI: 10.1097/jpa.0000000000000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Affiliation(s)
- Marilou Oh
- Marilou Oh, PA-C, MBA, is the lead PA in the Department of Physical Medicine and Rehabilitation at the University of Utah School of Medicine, Salt Lake City, Utah. She is also the recipient of a NCCPA Health Foundation Grant that generously funded the current program and she is the Coach/Mentor for the FTC S.O.U.P. robotics team
| |
Collapse
|
4
|
Atif M, Tewari N, Saji S, Srivastav S, Rahul M. Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials. Int J Paediatr Dent 2024; 34:229-245. [PMID: 37840214 DOI: 10.1111/ipd.13125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/08/2023] [Accepted: 09/13/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children. AIM This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents. DESIGN Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer. RESULTS The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low. CONCLUSION Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.
Collapse
Affiliation(s)
- Mohammad Atif
- Division of Pediatric and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi, India
| | - Nitesh Tewari
- Division of Pediatric and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi, India
| | - Seba Saji
- Division of Pediatric and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi, India
| | - Sukeshana Srivastav
- Division of Pediatric and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi, India
- Department of Dentistry and Oral Health, Section of Orthodontics, Aarhus University, Aarhus, Denmark
| | - Morankar Rahul
- Division of Pediatric and Preventive Dentistry, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
5
|
Lumsden CL, Edelstein BL, Leu CS, Zhang J, Rubin MS, Andrews H. Change in parental knowledge and beliefs about early childhood dental caries following a pragmatic community-based trial. J Public Health Dent 2024. [PMID: 38684426 DOI: 10.1111/jphd.12620] [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: 08/09/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To evaluate parent knowledge and belief changes following the MySmileBuddy (MSB) early childhood caries (ECC) intervention. METHODS Pre- and post-intervention surveys were completed by 669 parents of children with visually-evident ECC from among 977 participants in a 6-12-month pragmatic community-based caries management trial administered by community health workers (CHWs). Six domains of knowledge about caries and motivating and facilitating determinants were assessed via 26 survey items. Principal components analysis and reliability testing reduced dataset dimensionality. Parent and CHW characteristics were analyzed as potential moderators. Paired T-tests measured pre-to-post-intervention changes. Generalized estimating equations accounted for within-participant correlation with significance set at p < 0.05. RESULTS Twenty items consolidated into five factors (saliva, hygiene, diet, seriousness/susceptibility, and outcome expectations). Six additional items were evaluated individually. Positive post-intervention changes (p < 0.0001) were observed across all factors and all but one individual item (tooth decay is very common). Greatest knowledge increases related to caries as a bacterial disease in two measures, the saliva factor and a single caries belief item tooth decay is an infectious disease (0.59 unit increase, 95% CI [0.55, 0.64] and 0.46 unit increase, 95% CI [0.4, 0.51], respectively), and in the value of fluoridated water over bottled (0.46 unit increase, 95% CI [0.39-0.53]). Most parents improved knowledge of ECC salivary (72%) and dietary risks (57%), and preventative hygiene behaviors (59%). CONCLUSIONS MSB enhanced knowledge and beliefs about caries and confirmed hypothesized mediators of behavior change among parents of high-risk children. Engaging peer-like CHW interventionists may have moderated intervention effects, warranting further exploration.
Collapse
Affiliation(s)
- Christie L Lumsden
- Section of Oral, Diagnostic, and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York, USA
| | - Burton L Edelstein
- Department of Health Policy and Management, Professor Emeritus of Dental Medicine (in Pediatric Dentistry) and Health Policy & Management at Columbia University Irving Medical Center, Columbia University College of Dental Medicine and Mailman School of Public Health, New York, New York, USA
| | - Cheng-Shiun Leu
- Department of Biostatistics, Mailman School of Public Health, New York, New York, USA
| | - Jiaqing Zhang
- Department of Human Development, Teachers College Columbia University, New York, New York, USA
| | - Marcie S Rubin
- Section of Growth and Development, Columbia University College of Dental Medicine, New York, New York, USA
| | - Howard Andrews
- Columbia Data Coordinating Center, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
| |
Collapse
|
6
|
Giles E, Relins S, Gray-Burrows K, Baker SR, Day PF. Dental caries and school readiness in 5-year-olds: A birth cohort data linkage study. Community Dent Oral Epidemiol 2024. [PMID: 38679802 DOI: 10.1111/cdoe.12968] [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: 06/09/2023] [Revised: 03/13/2024] [Accepted: 04/15/2024] [Indexed: 05/01/2024]
Abstract
OBJECTIVE To describe the association between dental caries and school readiness in 5-year-old children taking part in the Born in Bradford (BiB) birth cohort, UK. METHODS The Early Years Foundation Stage Profile (EYFSP) assesses the school readiness of young children and is strongly predictive of future academic attainment. Children are recorded as 'emerging' (below expected), 'expected', or 'exceeding' in five key learning areas. The Oral Health Survey of 5-year-olds (OHS5) is undertaken biennially in England, assessing caries experience at a dentine threshold (d3mft). EYFSP and OHS5 were available for a proportion of children participating in BiB. Odds ratios and confidence intervals for caries experience were established, and odds ratios adjusted for significant sociodemographic variables. RESULTS EYFSP and OHS5 data were available for 2.5% (n = 346) BiB participants. Nearly half (45.2%) had caries. A measure of socio-economic status, receiving free school meals, was the only demographic variable strongly related to caries experience (OR: 2.8, 95% CI: 1.6-4.9). After adjustment, children 'emerging' in EYFSP learning areas had 1.6- to 2.2-fold (95% CI: 1.0-3.8) higher odds of experiencing caries. Children 'exceeding' EYFSP learning areas had 2.3- to 4-fold (95% CI: 0.1-0.9) lower odds of caries experience. CONCLUSION This is the first study to explore the association between caries experience and school readiness using a holistic assessment tool. The association was found across different learning areas and was comparable to and independent of socio-economic status. The findings indicate oral health-related absenteeism is not a causative factor. EYFSP shows potential to enhance the targeting of preventive interventions at a child, class or school level.
Collapse
Affiliation(s)
- Erin Giles
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Samuel Relins
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
| | - Kara Gray-Burrows
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
| | - Sarah R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Peter F Day
- Department of Paediatric Dentistry, School of Dentistry, University of Leeds, Leeds, UK
- Bradford Institute for Health Research, Temple Bank House, Bradford Royal Infirmary, Bradford, UK
- Community Dental Service, Bradford District Care NHS Foundation Trust, Bradford, UK
| |
Collapse
|
7
|
Kopczynski K, Casamassimo P, Amini H, Peng J, Gorham T, Meyer BD. Evaluating the type of pediatric dental care use in the context of neighborhood opportunity. J Am Dent Assoc 2024; 155:294-303.e4. [PMID: 38340112 DOI: 10.1016/j.adaj.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Increasing evidence supports the influence of neighborhood factors on health care use and outcomes. This study measured the association between area-level social determinants of health (SDH) and type of dental care use among Ohio pediatric Medicaid beneficiaries. METHODS A retrospective dental claims analysis was completed for children aged 1 through 5 years enrolled in Ohio Medicaid with a dental visit in 2017. Dental care use was measured from 2017 through 2021 as 1 of 4 visit types: (1) preventive, (2) caries treatment, (3) dental general anesthesia (GA), and (4) dental emergency department. The Ohio Children's Opportunity Index defined area-level SDH at the census tract level. Exploratory analysis included descriptive statistics of area-level SDH for each outcome. Poisson regression models were developed to examine the associations between the number of each dental care use outcome and Ohio Children's Opportunity Index quintiles. Visualizations were facilitated with geospatial mapping. RESULTS Fifty-six percent of children (10,008/17,675) had caries treatment visits. Overall area-level SDH were positively associated with preventive (fifth vs first quintile incidence rate ratio [IRR], 1.09; 95% CI, 1.07 to 1.12), caries treatment (fifth vs first quintile IRR, 1.16; 95% CI, 1.08 to 1.24), and dental GA visits (fifth vs first quintile IRR, 2.13; 95% CI, 1.13 to 4.01). CONCLUSIONS Children with preventive, caries treatment, and dental GA visits were more likely to live in neighborhoods with better SDH. Future efforts should investigate the mechanisms by which area-level factors influence dental access and use. PRACTICAL IMPLICATIONS Neighborhood factors influence pediatric dental care use. Patient home addresses might add value to caries risk assessment tools and efforts by care networks to optimize efficient care use.
Collapse
|
8
|
Yazdanbakhsh E, Bohlouli B, Patterson S, Amin M. Community water fluoride cessation and rate of caries-related pediatric dental treatments under general anesthesia in Alberta, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:305-314. [PMID: 38389035 PMCID: PMC11027763 DOI: 10.17269/s41997-024-00858-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 01/19/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE This study examined the rate of caries-related dental treatments under general anesthesia (GA) in fluoridated and non-fluoridated communities in Alberta, Canada, between 2010 and 2019. METHODS This retrospective, population-based study included all children ( < 12 years of age) living in Calgary (non-fluoridated) and Edmonton (fluoridated) who underwent caries-related dental treatments under GA at publicly funded facilities. Demographics and dental data were extracted from health administrative databases for three time periods of 2010/11 (pre-cessation), 2014/15, and 2018/19 (post-cessation). RESULTS Among 2659 children receiving caries-related treatments under GA, the mean (SD) and median (IQR) age were 4.8 (2.3) and 4 (3-6) years, respectively, and 65% resided in the non-fluoridated area. The analysis revealed that the cessation of water fluoridation was significantly associated with an increased rate of caries-related GA events per 10,000 children in both age groups (0-5 and 6-11 years), with a more pronounced effect in 0-5-year-olds in non-fluoridated areas. The risk of dental treatments under GA was also positively associated with post-cessation time. CONCLUSION Discontinuing water fluoridation appears to negatively affect young children's oral health, potentially leading to a significant increase in caries-related dental treatments under GA and oral health disparities in this pediatric population.
Collapse
Affiliation(s)
- Elnaz Yazdanbakhsh
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Babak Bohlouli
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Steven Patterson
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maryam Amin
- Faculty of Medicine and Dentistry, School of Dentistry, University of Alberta, Edmonton, AB, Canada.
| |
Collapse
|
9
|
Mendonça TS, Carvalho STD, Aljafari A, Hosey MT, Costa LR. Oral Health Education for Children: Development of a Serious Game with a User-Centered Design Approach. Games Health J 2024. [PMID: 38563685 DOI: 10.1089/g4h.2023.0055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Background: Children can learn efficiently with well-designed serious games. The use of applications to promote health has proliferated, but there is a lack of scientific studies on educational games in oral health. Materials and Methods: We developed the Brazilian version of a British and Jordanian oral health education game for children from the perspectives of Brazilian specialists and users. This descriptive study, with a qualitative and quantitative approach, comprised three phases: I-Experts' discussion of the appropriateness of the previous version of the game to Brazil; II-Development of the first Brazilian version of the game; and III-Evaluation of the first version with 15 children from 4 to 8 years of age. Results: In Phase I, the specialists agreed with the development of the Brazilian version of the game, with minor adjustments on: advice on eating; advice on oral hygiene habits, users' age group, game characters, and game purpose. Phase II: a version with a few changes in images and recommendations, written and spoken in Brazilian Portuguese. Phase III: The global average of correct answers in the game's tasks was 75.3%, ranging from 50.0% to 100%. Children reported having fun with the game, and most understood the content and its interface; their parents found the information relevant and enjoyed the gameplay with their children. Conclusions: The Oral Health Education Game offered basic information for preventing dental caries to Brazilian children aged 4-8 years old in an interactive and fun way; it could support professionals in improving oral health education.
Collapse
Affiliation(s)
- Thaís Silva Mendonça
- Dentistry Graduate Program, Dental School, Faculty of Dentistry (UFG/GO), Goiânia-GO, Brazil
| | | | - Ahmad Aljafari
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Marie Therese Hosey
- Department of Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, Centre of Oral, Clinical and Translational Science, King's College London, London, United Kingdom
| | - Luciane Rezende Costa
- Dentistry Graduate Program, Dental School, Faculty of Dentistry (UFG/GO), Goiânia-GO, Brazil
- Faculty of Dentistry, UFG/GO, Goiânia-GO, Brazil
| |
Collapse
|
10
|
Kopycka-Kedzierawski DT, Feng C, Billings RJ, Watson GE, Ragusa PG, Flint K, Wong CL, Gill SR, Manning S, O'Connor TG. Psychosocial Risk Exposure Limits Routine Pediatric Oral Health Care. AJPM FOCUS 2024; 3:100191. [PMID: 38357551 PMCID: PMC10864889 DOI: 10.1016/j.focus.2024.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Introduction This study aimed to identify social, psychological, and contextual factors that influenced attendance at routine oral health visits in a cohort of 189 preschool children who were followed over a 2-year period. Methods Generalized estimating equation was used to examine the association between clinic attendance and the predictors. ORs and 95% CIs were reported in the multiple logistic regression models. The study was conducted in Rochester, New York, between February 2016 and February 2021. Results Prior to the COVID-19 pandemic declaration, the rate of canceled and no-show appointments was greater for routine clinic visits (20% and 24%, respectively) than for research visits (14% and 9%, respectively) for the same participants; these rates increased during the pandemic. After adjusting for sociodemographic factors, the likelihood of a canceled or no-show appointment was associated with parental depression (OR=1.06, CI=1.03, 1.09), regardless of the type or occurrence of the visit. Conclusions Findings from this study demonstrate that attendance to oral health care in young children is reliably reduced with parental depression and that this may provide one mechanism for early emerging health inequalities of oral health.
Collapse
Affiliation(s)
| | - Changyong Feng
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
- Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, New York
| | - Ronald J. Billings
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Gene E. Watson
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Pharmacology & Physiology, University of Rochester, Rochester, New York
- Department of Environmental Medicine, University of Rochester, Rochester, New York
| | - Patricia G. Ragusa
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Kimberly Flint
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Cynthia L. Wong
- Department of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
| | - Steven R. Gill
- Department of Pediatric Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Pediatrics, Eastman Institute for Oral Health, University of Rochester, Rochester, New York
- Department of Microbiology and Immunology, University of Rochester, Rochester, New York
| | - Samantha Manning
- Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York
| | - Thomas G. O'Connor
- Department of Psychiatry, University of Rochester, Rochester, New York
- Department of Psychology, University of Rochester, Rochester, New York
- Department of Neuroscience, University of Rochester, Rochester, New York
- Department of Obstetrics and Gynecology, University of Rochester, Rochester, New York
| |
Collapse
|
11
|
Akinkugbe AA, Midya V, Duffy J, Landero J, Wright RO, Wright RJ. Metal mixtures and oral health among children and adolescents in the National Health and Nutrition Examination Survey (NHANES), 2017-2020. Int J Hyg Environ Health 2024; 257:114335. [PMID: 38330728 PMCID: PMC10939733 DOI: 10.1016/j.ijheh.2024.114335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Dental caries is the most common non-communicable human disease, yet little is known about the role of environmental metals, despite teeth consisting of a hard matrix of trace elements. We conducted a cross-sectional study of associations between environmental metals and objective assessment of dental caries and subjective assessments of oral health among a representative sample of U.S. children and adolescents. METHODS Data were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes. RESULTS The blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07). DISCUSSION Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.
Collapse
Affiliation(s)
- A A Akinkugbe
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - V Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Duffy
- Tufts University School of Medicine, Boston, MA, USA
| | - J Landero
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
12
|
Xiong D, Marcus M, Maida CA, Lyu Y, Hays RD, Wang Y, Shen J, Spolsky VW, Lee SY, Crall JJ, Liu H. Development of short forms for screening children's dental caries and urgent treatment needs using item response theory and machine learning methods. PLoS One 2024; 19:e0299947. [PMID: 38517846 PMCID: PMC10959356 DOI: 10.1371/journal.pone.0299947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 02/20/2024] [Indexed: 03/24/2024] Open
Abstract
OBJECTIVES Surveys can assist in screening oral diseases in populations to enhance the early detection of disease and intervention strategies for children in need. This paper aims to develop short forms of child-report and proxy-report survey screening instruments for active dental caries and urgent treatment needs in school-age children. METHODS This cross-sectional study recruited 497 distinct dyads of children aged 8-17 and their parents between 2015 to 2019 from 14 dental clinics and private practices in Los Angeles County. We evaluated responses to 88 child-reported and 64 proxy-reported oral health questions to select and calibrate short forms using Item Response Theory. Seven classical Machine Learning algorithms were employed to predict children's active caries and urgent treatment needs using the short forms together with family demographic variables. The candidate algorithms include CatBoost, Logistic Regression, K-Nearest Neighbors (KNN), Naïve Bayes, Neural Network, Random Forest, and Support Vector Machine. Predictive performance was assessed using repeated 5-fold nested cross-validations. RESULTS We developed and calibrated four ten-item short forms. Naïve Bayes outperformed other algorithms with the highest median of cross-validated area under the ROC curve. The means of best testing sensitivities and specificities using both child-reported and proxy-reported responses were 0.84 and 0.30 for active caries, and 0.81 and 0.31 for urgent treatment needs respectively. Models incorporating both response types showed a slightly higher predictive accuracy than those relying on either child-reported or proxy-reported responses. CONCLUSIONS The combination of Item Response Theory and Machine Learning algorithms yielded potentially useful screening instruments for both active caries and urgent treatment needs of children. The survey screening approach is relatively cost-effective and convenient when dealing with oral health assessment in large populations. Future studies are needed to further leverage the customize and refine the instruments based on the estimated item characteristics for specific subgroups of the populations to enhance predictive accuracy.
Collapse
Affiliation(s)
- Di Xiong
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Marvin Marcus
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Carl A. Maida
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Yuetong Lyu
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Ron D. Hays
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
- RAND Corporation, Santa Monica, California, United States of America
| | - Yan Wang
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Jie Shen
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Vladimir W. Spolsky
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Steve Y. Lee
- Sectopm of Interdisciplinary Dentistry, Division of Diagnostic and Surgical Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - James J. Crall
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Honghu Liu
- Section of Public and Population Health, Division of Oral and Systemic Health Sciences, School of Dentistry, University of California, Los Angeles, Los Angeles, California, United States of America
- Department of Biostatistics, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California, United States of America
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
| |
Collapse
|
13
|
Lan M, Niu E, Liu M, Anderson S, Barham L, Greenfield T, Cherry-Peppers G, Gu X. Pediatric Oral Health Service Access in Racial/Ethnic Minority Neighborhoods: A Geospatial Analysis in Washington, D.C., USA. DENTAL RESEARCH AND ORAL HEALTH 2024; 7:36-42. [PMID: 38646068 PMCID: PMC11027513 DOI: 10.26502/droh.0073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Oral health plays a crucial role in overall well-being. One of the goals set by the US Department of Health and Human Service, Healthy People 2030 is to reducing dental caries in children and adolescents. The study aims to investigate the accessibility of pediatric dental care in neighborhoods with mixed-race and predominantly African American populations in the Washington District of Columbia (DC) area. Our objective is to uncover and highlight the disparities that exist in pediatric dental care within these communities. We have specifically examined the geographic and socio-demographic aspects of pediatric dental care facilities, utilizing geospatial tools such as modeling and mapping, as well as data from the clinical database at Howard University College of Dentistry. The detailed analysis of dental care access revealed significant disparities among various Wards in the region. Specifically, Wards 5, 7, and 8 stood out as having both the highest concentrations of African American residents and the lowest availability of pediatric dentistry providers when compared to the more affluent Wards 1, 2, and 3. Howard University College of Dentistry's pediatric dentistry department played a crucial role in providing dental care services to the community. Over the course of the year 2022, they recorded a total of 3,855 visits from residents of the DC area. Notably, a substantial portion of these visits, specifically 1,566 visits, were from individuals residing in Wards 5, 7 and 8. This data underscores the significant demand for pediatric dental services in these underserved communities and highlights the importance of addressing the disparities in access to care.
Collapse
Affiliation(s)
- Minxuan Lan
- Department of Geography and Planning, The University of Toledo, Toledo, OH, USA 43606
| | - Eric Niu
- Livingston High School, Livingston, NJ, USA
| | - Meirong Liu
- School of Social Work, Howard University, Washington, DC, USA
| | | | - LaToya Barham
- College of Dentistry, Howard University, Washington, DC, USA
| | | | | | - Xinbin Gu
- College of Dentistry, Howard University, Washington, DC, USA
| |
Collapse
|
14
|
Shitu K, Alemayehu M, Berassa SH. Oral hygiene behaviour and its determinants among preparatory school students in Gondar city, Northwest Ethiopia: A cross-sectional study. Int J Dent Hyg 2024; 22:177-186. [PMID: 36627237 DOI: 10.1111/idh.12666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 08/17/2022] [Accepted: 01/07/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study aimed to evaluate oral hygiene behaviour and its determinants among preparatory school students in Gondar city, Northwest Ethiopia. METHODS Institutional-based cross-sectional study was conducted among 423 students to evaluate their oral hygiene behaviour and determinant factors (sociodemographic attributes, oral hygiene knowledge, and attitude to oral hygiene behaviours). Linear regression was employed to identify factors associated with oral hygiene behaviour. A p-value of <0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS A total of 407 students participated with a response rate of 96.2%. The mean age of the participants was 18 (SD ±1.3). The mean oral hygiene behaviour (OHB) score was about 7.89 ± 3.43. Only 9.2%, 21.4%, and 5.7% were brushing their teeth at least twice a day, cleaning their tongue, and flossing at least once a day respectively. Father's educational status (able to read and write (β = 1.99, 95% CI: 0.62, 3.38), completed secondary school (β = 1.68, 95% CI: 0.18, 3.18), and diploma and higher (β = 1.75, 95% CI: 0.33, 3.18)), being from private school (β = 3.25, 95%CI: 2.30, 4.19), knowledge about OHB (β = 0.16, 95% CI: 0.01, 0.30), and attitude towards OHB (β = 0.11, 95% CI: 0.08, 0.14) were significant factors positively associated with better oral hygiene behaviour. CONCLUSION Oral hygiene behaviour was poor among preparatory school students in Gondar city. Father's educational status, students' oral hygiene knowledge, and attitude were found to be significant factors affecting students' oral hygiene behaviour. Thus, tailored school-based oral health communication programs are highly required to improve students' oral hygiene behaviour.
Collapse
Affiliation(s)
- Kegnie Shitu
- Department of Health Promotion and Health Behavior, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekuriaw Alemayehu
- Department of Environmental Health and Occupational Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | |
Collapse
|
15
|
Carle AC, Pallotto I, Edwards TC, Carpiano R, Kerr DC, Chi DL. Psychometric properties of the Fluoride Hesitancy Identification Tool (FHIT). PLoS One 2024; 19:e0297188. [PMID: 38232098 PMCID: PMC10793896 DOI: 10.1371/journal.pone.0297188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/31/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Some caregivers are hesitant about topical fluoride for their children despite evidence that fluoride prevents caries and is safe. Recent work described a five domain model of caregivers' topical fluoride hesitancy. We developed the Fluoride Hesitancy Identification Tool (FHIT) item pool based on the model. This study sought to evaluate the FHIT's psychometric properties in an effort to generate a short, simple to score, reliable, and valid tool that measures caregivers' topical fluoride hesitancy. METHODS In 2021 and 2022, we conducted an observational, cross-sectional study of caregivers, collecting data from two independent caregiver samples (n1 = 523; n2 = 612). The FHIT item pool included 33 items. We used confirmatory factor analyses (CFA) to examine whether the FHIT items measured five separate domains as hypothesized and to reduce the number of items. We then fit item response theory (IRT) models and computed Cronbach's alpha for each domain. Last, we examined the construct validity of the FHIT and evaluated scoring approaches. RESULTS After dropping 8 items, CFA supported a five factor model of topical fluoride hesitancy, with no cross-loadings (RMSEA = 0.079; SRMR = 0.057; CFI = 0.98; TLI = 0.98). We further reduced the items to four per domain (20 items total). Marginal alphas showed that the item sets provided reliability of ≥0.90 at hesitancy levels at and above average. The domains correlated more strongly with each other and topical fluoride refusal than with other questions on the survey. DISCUSSION Our results support the FHIT's ability to reliably and validly measure five domains of topical fluoride hesitancy using the average score of the four items in each domain.
Collapse
Affiliation(s)
- Adam C. Carle
- James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States of America
- Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, United States of America
| | - Isabella Pallotto
- Department of Psychology, University of Cincinnati College of Arts and Sciences, Cincinnati, Ohio, United States of America
| | - Todd C. Edwards
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, United States of America
| | - Richard Carpiano
- School of Public Policy, University of California, Riverside, Riverside, California, United States of America
| | - Darragh C. Kerr
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
| | - Donald L. Chi
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, United States of America
- Department of Oral Health Sciences, University of Washington School of Dentistry, Seattle, Washington, United States of America
| |
Collapse
|
16
|
Mattheus D, Loos JR, Vogeler A. The Development and Implementation of a School-Based Dental Sealant Program for Hawaii Public Schools. THE JOURNAL OF SCHOOL HEALTH 2024; 94:87-95. [PMID: 37857279 DOI: 10.1111/josh.13401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/03/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND School-based dental sealant programs are noted to increase sealant uptake among children, especially those from low-income families and those living in rural and underserved areas. However, nationally school-based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school-based dental sealant program for Title 1 public schools in Hawaii. METHODS The Hawaii Keiki: Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school-based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program success. RESULTS The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019-2020), which presented challenges due to the COVID-19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020-2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021-2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY 2022-2023. CONCLUSION Taking advantage of strategic partnerships and key interprofessional team members, a school-based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care.
Collapse
Affiliation(s)
- Deborah Mattheus
- Hawaii Keiki: Healthy & Ready to Learn, Professor, Nancy Atmospera-Walch School of Nursing (NAWSON), University of Hawaii at Manoa (UHM), HI. Honolulu, Honolulu, HI; NAWSON, UHM
| | | | - Azeema Vogeler
- Hawaii Keiki: Healthy & Ready to Learn, Nancy Atmospera-Walch School of Nursing (NAWSON), University of Hawaii at Manoa (UHM), HI. Honolulu, Honolulu, HI; NAWSON, UHM
| |
Collapse
|
17
|
Chang WJ, Chang PC, Chang YH. The gamification and development of a chatbot to promote oral self-care by adopting behavior change wheel for Taiwanese children. Digit Health 2024; 10:20552076241256750. [PMID: 38798886 PMCID: PMC11119524 DOI: 10.1177/20552076241256750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2024] [Indexed: 05/29/2024] Open
Abstract
Background Oral health is closely related to general health and quality of life. School-aged children are at a critical stage for developing their self-care ability in oral health. Digital interventions can encourage and facilitate oral self-care in children. Objective This study aims to present the development of an educational chatbot for school-aged children to address their oral self-care and evaluate its usability. Methods The development and evaluation of the chatbot for oral self-care consisted of four stages: target behavior analysis, intervention design, system development, and the chatbot evaluation. The target behavior analysis identified barriers to children's engagement in oral self-care based on dentists' clinical observations; hence, the requirements for achieving the desired behavior were categorized according to the capability-opportunity-motivation behavior model. Interventional functions were created following the behavior change wheel. A menu-driven chatbot was created and evaluated for usability as well as likeability. Results The barriers and requirements for achieving good behavior in school-aged children's oral self-care were identified by the dental professionals. Intervention strategy incorporated specific functions enriched with gamification features to support school-aged children in developing their abilities for engaging in oral self-care. The intervention functions consist of capability establishment, motivation enhancement, and opportunity creation, which were designed to support children in their oral self-care practices. The designed chatbot was piloted with a convenient sample of 30 school-aged children and their accompanying parents at the pediatric dental clinic. The results indicated good usability, with a mean usability score of 79.91, and high likeability with a mean score of 4.32 out of 5 for the designed chatbot. Conclusions The educational chatbot incorporated a combination of clinical dentistry practice and guidelines, aiming to promote oral self-care behavior in school-aged children. The designed chatbot achieved high scores for its usability and user likability.
Collapse
Affiliation(s)
- Wen-Jen Chang
- Department of Information Management, Chang Gung University, Taoyuan, Taiwan
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Pei-Ching Chang
- Department of Pediatric Dentistry, Chang Gung Memorial Hospital Taoyuan Branch, Taoyuan, Taiwan
| | - Yen-Hsiang Chang
- Department of Dentistry, Linko Chang Gung Memorial Hospital, Taoyuan, Taiwan
| |
Collapse
|
18
|
Pielech M, Sawicki CM. Provider perspectives on pain management practices and needs in pediatric dentistry. J Am Dent Assoc 2023; 154:1067-1076. [PMID: 37877929 PMCID: PMC11078527 DOI: 10.1016/j.adaj.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/03/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Dental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and perceptions among providers. The authors assessed pediatric dentists' use of and attitudes toward evidence-based pain management (EBPM) strategies. METHODS The authors used a 27-item online survey to assess attitudes about EBPM, pain management and assessment practices, tools for disseminating knowledge about EBPM, and opinions regarding priority areas for improving pain management. Descriptive statistics were used to summarize findings; open-ended items were analyzed thematically. RESULTS Participants (N = 625) were pediatric dentists (89.2%) and pediatric dentistry residents (10.8%). Most respondents agreed that pain management is an important aspect of clinical care and thought that improvements in pain management practices are needed. Providers reported spending the most time facilitating pain management during the procedure (compared with before or after), and 73.2% said they feel this is an adequate amount of time. Distraction, tell-show-do techniques, and supportive language were the most used nonpharmacologic pain management strategies, and providers' observational approaches were used most frequently for pain assessment. Top priority areas for improving pain management were reported as developing tools for caregivers and provider resources on nonpharmacologic pain management (ie, continuing education courses). CONCLUSIONS Providers reported high use of EBPM strategies, low use of validated pain assessment tools, and a particular interest for professional development opportunities and patient resources focused on nonpharmacologic pain management. PRACTICAL IMPLICATIONS Findings from this survey can inform dissemination and implementation of science efforts to improve pain management in pediatric dentistry.
Collapse
|
19
|
Hobbs AJ, Mitchell TV, Bray KK, Sutton JD. Dental hygiene student perceptions of a school-based sealant program: A qualitative review. J Dent Educ 2023; 87:1645-1653. [PMID: 37752848 DOI: 10.1002/jdd.13378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 06/28/2023] [Accepted: 08/29/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE/OBJECTIVES The purpose of this 2021 study was to explore experiences acquired from a school-based sealant program (SBSP), to improve understanding of the relationship between SBSP and dental hygiene (DH) student outcomes, and to inform institutions of the value of educational experiences aiming to reduce disparities in access to dental care. METHODS University of Missouri Kansas City School of Dentistry Senior DH students complete a community engaged course which includes participation in community projects and clinical activities targeting Kansas City's urban and surrounding rural environments. The SBSP is a component of this course. This investigation utilized a qualitative methodology to examine SBSP experiences through the experience of the primary investigator, on-site dentist, and DH students involved in the program. RESULTS Data analysis resulted in consensus of five synthesized conceptual models and twenty-three emergent themes. The conceptual models include: competence, roles and responsibilities, social justice, value added, and lessons learned. CONCLUSION Based on triangulated results, SBSPs improve access to care for children, save dental costs, and provide essential experiences for DH students.
Collapse
Affiliation(s)
- Ashley J Hobbs
- Division of Dental Hygiene, School of Dentistry, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Tanya V Mitchell
- Division of Dental Hygiene, School of Dentistry, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Kimberly K Bray
- Division of Dental Hygiene, School of Dentistry, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Julie D Sutton
- Division of Dental Hygiene, School of Dentistry, University of Missouri-Kansas City, Kansas City, Missouri, USA
| |
Collapse
|
20
|
Boachie MK, Molete M, Hofman K, Thsehla E. Cost-effectiveness of dental caries prevention strategies in South African schools. BMC Oral Health 2023; 23:814. [PMID: 37898738 PMCID: PMC10613394 DOI: 10.1186/s12903-023-03474-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/29/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND In South Africa, an estimated 85% of the population relies on the public sector for oral health services. With poor infrastructure and inadequate personnel, over 80% of children with dental caries remain untreated. To reduce this burden of disease, one key goal is to promote good oral health and address oral diseases through prevention, screening, and treatment among children. While all policies have been proven to be effective in the control and prevention of dental caries, it is unclear which of those strategies provide value for money. This study evaluated five caries preventative strategies in terms of the cost and benefits among South African school children. METHODS The study uses a hypothetical South African population of school aged learners aged 5-15. The context and insights of the strategies utilized at the schools were informed by data from both grey and published literature. Using Markov modeling techniques, we conducted a cost-effectiveness analysis of Acidulated Phosphate Fluoride (APF) application, atraumatic restorative treatment (ART), sugar-reduction and fissure sealants. Markov model was used to depict the movement of a hypothetical patient cohort between different health states over time. We assessed both health outcomes and costs of various interventions. The health outcome metric was measured as the number of Decayed, Missing, Filled Tooth (DMFT). The net monetary benefit was then used to determine which intervention was most cost-effective. RESULTS The results showed that school-based caries prevention strategies are cost-effective compared to the status quo of doing nothing. The average cost per learner over the 10-year period ranged from ZAR4380 to approx. ZAR7300 for the interventions considered. The total costs (including screening) associated with the interventions and health outcome (DMFT averted) were: sugar reduction (ZAR91,380, DFMT: 63,762), APF-Gel (ZAR54 million, DMFT: 42,010), tooth brushing (ZAR72.8 million, DMFT: 74,018), fissure sealant (ZAR44.63 million, DMFT: 100,024), and ART (ZAR45 million, DMFT: 144,035). The net monetary benefits achieved for APF-Gel, sugar reduction, tooth brushing, fissure sealant and ART programs were ZAR1.56, ZAR2.45, ZAR2.78, ZAR3.81, and ZAR5.55 billion, respectively. CONCLUSION Based on the net monetary benefit, ART, fissure sealant and sugar-reduction appear to be the most cost-effective strategies for preventing caries in South Africa. In a resource-scarce setting such as South Africa, where there is no fluoridation of drinking water, this analysis can inform decisions about service packages for oral health.
Collapse
Affiliation(s)
- Micheal Kofi Boachie
- Discipline of Public Health Medicine, School of Nursing and Public Health, College of Health Sciences, University of KwaZulu-Natal, 4041, Durban, South Africa.
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa.
| | - Mpho Molete
- Department of Oral Biological Sciences, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Karen Hofman
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| | - Evelyn Thsehla
- SAMRC/Centre for Health Economics and Decision Science - PRICELESS SA, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 2193, Parktown, Johannesburg, South Africa
| |
Collapse
|
21
|
Nawa N, Nishimura H, Matsuyama Y, Doi S, Isumi A, Fujiwara T. Association between the number of convenience stores and caries status in permanent teeth among elementary school children: results from the A-CHILD population-based longitudinal cohort study. Front Public Health 2023; 11:1228197. [PMID: 37954054 PMCID: PMC10637395 DOI: 10.3389/fpubh.2023.1228197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/05/2023] [Indexed: 11/14/2023] Open
Abstract
Background In Japan, people have rich access to 24-h convenience stores where they can buy sweets, juice and fluoride hygiene products, among others. However, the association between the number of convenience stores in a neighbourhood and caries in elementary school children status has not been studied. This study aimed to investigate this particular association. Methods Data were derived from a population-based longitudinal cohort study (A-CHILD study) of elementary school children from first-grade to fourth-grade in Adachi City, Tokyo. Caregivers were asked to complete a questionnaire in 2015, 2016, and 2018. A total of 3,136 caregivers provided a valid response. We analysed the association using multilevel Poisson regression. Results The mean number of caries among children in school districts with low, middle, and high number of convenience stores was 0.31 (SD: 0.81), 0.21 (SD: 0.69), and 0.16 (SD: 0.58). After covariate adjustment, children in the school districts with high and middle number of convenience stores had 44% (mean ratio 0.56, 95% CI: 0.31, 0.998) and 31% (mean ratio 0.69, 95% CI: 0.42, 1.13) fewer caries in their permanent teeth, respectively, than children in the school districts with low number of convenience stores. We also found dose-response relationship (p for trend: 0.042). Conclusion Higher number of convenience stores in a school district was associated with fewer caries in permanent teeth among elementary school children. Further study elucidating the mechanism on this protective association is warranted.
Collapse
Affiliation(s)
- Nobutoshi Nawa
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Hisaaki Nishimura
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yusuke Matsuyama
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Satomi Doi
- Department of Health Policy, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Aya Isumi
- Department of Health Policy, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| |
Collapse
|
22
|
Foláyan MO, Ramos-Gomez F, Fatusi OA, Nabil N, Lyimo GV, Minja IK, Masumo RM, Mohamed N, Potgieter N, Matanhire C, Maposa P, Akino CR, Adeniyi A, Mohebbi SZ, Ellakany P, Chen J, Amalia R, Iandolo A, Peedikayil FC, Aravind A, Al-Batayneh OB, Khader YS, Al-Maweri SA, Sabbah W, Abeldaño Zuñiga RA, Vukovic A, Jovanovic J, Jafar RM, Maldupa I, Arheiam A, Mendes FM, Uribe SE, López Jordi MDC, Villena RS, Duangthip D, Sam-Agudu NA, El Tantawi M. Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China. FRONTIERS IN ORAL HEALTH 2023; 4:1211242. [PMID: 38024146 PMCID: PMC10646161 DOI: 10.3389/froh.2023.1211242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 09/26/2023] [Indexed: 12/01/2023] Open
Abstract
Background Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. Methods We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Results Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. Conclusions The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.
Collapse
Affiliation(s)
- Moréniké Oluwátóyìn Foláyan
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Nigeria
| | - Francisco Ramos-Gomez
- Division of Preventive and Restorative Oral Health Sciences, UCLA School of Dentistry, Los Angeles, CA, United States
| | | | - Nouran Nabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Germana V. Lyimo
- Department of Dentistry, Muhimbili National Hospital, Dar es Salaam, Tanzania
| | - Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Ray M. Masumo
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Nadia Mohamed
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | - Nicoline Potgieter
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, Cape Town, South Africa
| | | | - Pamela Maposa
- Department of Paediatrics, University of Zimbabwe, Harare, Zimbabwe
| | | | - Abiola Adeniyi
- School of Policy and Global Affairs, Fairleigh Dickinson University, Vancouver, BC, Canada
| | - Simin Z. Mohebbi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdurrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jieyi Chen
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Rosa Amalia
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Alfredo Iandolo
- Department of Endodontics, Faculty of Dentistry, University of Salerno, Salerno, Italy
| | - Faizal C. Peedikayil
- Department of Pediatric and Preventive Dentistry, Kannur Dental College, Anjarakandy, India
| | - Athira Aravind
- Department of Pediatric and Preventive Dentistry, Kannur Dental College, Anjarakandy, India
| | - Ola B. Al-Batayneh
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yousef S. Khader
- Department of Public Health and Community Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London, United Kingdom
| | - Roberto Ariel Abeldaño Zuñiga
- Postgraduate Department, University of Sierra Sur, Oaxaca, Mexico
- Centre for Social Data Science, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland
| | - Ana Vukovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Julijana Jovanovic
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Ilze Maldupa
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
| | - Arheiam Arheiam
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Fausto M. Mendes
- Department of Dental Public Health and Preventive Dentistry, Faculty of Dentistry, University of Benghazi, Benghazi, Libya
| | - Sergio E. Uribe
- Department of Conservative Dentistry and Oral Health, Riga Stradins University, Riga, Latvia
- School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
- Baltic Biomaterials Centre of Excellence, Headquarters at Riga Technical University, Riga, Latvia
| | | | - Rita S. Villena
- Department of Pediatric Dentistry, School of Dentistry, University San Martin de Porres, Lima, Perú
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR China
| | - Nadia A. Sam-Agudu
- International Research Center of Excellence, Institute of Human Virology Nigeria, Abuja, Nigeria
- Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Paediatrics and Child Health, University of Cape Coast School of Medical Sciences, Cape Coast, Ghana
| | - Maha El Tantawi
- Oral Health Initiative, Nigerian Institute of Medical Research, Yaba, Nigeria
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| |
Collapse
|
23
|
Mann AE, O'Connell LM, Osagie E, Akhigbe P, Obuekwe O, Omoigberale A, Kelly C, Coker MO, Richards VP. Impact of HIV on the Oral Microbiome of Children Living in Sub-Saharan Africa, Determined by Using an rpoC Gene Fragment Metataxonomic Approach. Microbiol Spectr 2023; 11:e0087123. [PMID: 37428077 PMCID: PMC10434123 DOI: 10.1128/spectrum.00871-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/11/2023] [Indexed: 07/11/2023] Open
Abstract
Children living with HIV have a higher prevalence of oral diseases, including caries, but the mechanisms underlying this higher prevalence are not well understood. Here, we test the hypothesis that HIV infection is associated with a more cariogenic oral microbiome, characterized by an increase in bacteria involved in the pathogenesis of caries. We present data generated from supragingival plaques collected from 484 children representing three exposure groups: (i) children living with HIV (HI), (ii) children who were perinatally exposed but uninfected (HEU), and (iii) unexposed and therefore uninfected children (HUU). We found that the microbiome of HI children is distinct from those of HEU and HUU children and that this distinction is more pronounced in diseased teeth than healthy teeth, suggesting that the impact of HIV is more severe as caries progresses. Moreover, we report both an increase in bacterial diversity and a decrease in community similarity in our older HI cohort compared to our younger HI cohort, which may in part be a prolonged effect of HIV and/or its treatment. Finally, while Streptococcus mutans is often a dominant species in late-stage caries, it tended to be found at lower frequency in our HI cohort than in other groups. Our results highlight the taxonomic diversity of the supragingival plaque microbiome and suggest that broad and increasingly individualistic ecological shifts are responsible for the pathogenesis of caries in children living with HIV, coupled with a diverse and possibly severe impact on known cariogenic taxa that potentially exacerbates caries. IMPORTANCE Since its recognition as a global epidemic in the early 1980s, approximately 84.2 million people have been diagnosed with HIV and 40.1 million people have died from AIDS-related illnesses. The development and increased global availability of antiretroviral treatment (ART) regimens have dramatically reduced the mortality rate of HIV and AIDS, yet approximately 1.5 million new infections were reported in 2021, 51% of which are in sub-Saharan Africa. People living with HIV have a higher prevalence of caries and other chronic oral diseases, the mechanisms of which are not well understood. Here, we used a novel genetic approach to characterize the supragingival plaque microbiome of children living with HIV and compared it to the microbiomes of uninfected and perinatally exposed children to better understand the role of oral bacteria in the etiology of tooth decay in the context of HIV exposure and infection.
Collapse
Affiliation(s)
- Allison E. Mann
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| | - Lauren M. O'Connell
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| | - Esosa Osagie
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Paul Akhigbe
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Ozoemene Obuekwe
- University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Colton Kelly
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
- School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - the DOMHaIN Study Team
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
- Institute of Human Virology Nigeria, Abuja, Nigeria
- University of Benin Teaching Hospital, Benin, Edo State, Nigeria
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, New Jersey, USA
- School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Modupe O. Coker
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, New Jersey, USA
| | - Vincent P. Richards
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| |
Collapse
|
24
|
Nguyen TM, Lin C, Raichur A, Patterson A, Hall M, Aldrich R, Robinson S. Prioritizing population oral health through public policy in Australia: the Victorian experience. Health Promot Int 2023; 38:daad086. [PMID: 37555701 PMCID: PMC10411047 DOI: 10.1093/heapro/daad086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/10/2023] Open
Abstract
Dental caries, a non-communicable disease, is one of the most prevalent diseases globally and share common modifiable risk factors with obesity such as excess sugar intake. However, prioritization by governments to improve population oral health has been limited and is typically excluded from the discourse of public health policy development. Therefore, interventions that target dental caries can have other co-benefits including obesity prevention. In Victoria, Australia, local government authorities have a regulatory requirement to develop their Municipal Health and Wellbeing Plans. The aim of this paper is to identify whether prioritization for oral health by local government authorities in Victoria has changed through the subsequent renewal of the Victorian Public Health and Wellbeing Plans 2011-2015 and 2019-2023. Three desktop audits for all publicly available Municipal Health and Wellbeing Plans by local government authorities in Victoria were conducted between 2014 and 2022. Key terms related to oral health was searched within these policy documents and categorized into six indicators: (i) included oral health as a priority, (ii) linked healthy eating and oral health, (iii) supported the Achievement Program, (iv) included the Smiles 4 Miles program, (v) advocated for fluoridated drinking water, and (vi) included other strategies related to oral health. Overall, there was statistically significant reduction in five of the six indicators, with the exception for prioritization of other strategies related to oral health such as targeting excess sugar intake and smoking. A multi-sectoral approach, that includes oral health would be advantageous to address the growing burden of non-communicable diseases.
Collapse
Affiliation(s)
- Tan Minh Nguyen
- Oral Health Economics Research Stream, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Clare Lin
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Anil Raichur
- Community Based Health Services Policy & Improvement, Commisioning and System Improvement, Victorian Department of Health, State Government of Victoria, Melbourne, Victoria, Australia
| | - Amy Patterson
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | - Martin Hall
- Dental Health Services Victoria, Carlton, Victoria, Australia
| | | | - Suzanne Robinson
- Oral Health Economics Research Stream, Deakin Health Economics, Institute for Health Transformation, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| |
Collapse
|
25
|
Petimar J, Gibson LA, Wolff MS, Mitra N, Corby P, Hettinger G, Gregory EF, Edmondson E, Block JP, Roberto CA. Changes in Dental Outcomes After Implementation of the Philadelphia Beverage Tax. Am J Prev Med 2023; 65:221-229. [PMID: 36863896 PMCID: PMC10363192 DOI: 10.1016/j.amepre.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/02/2023] [Accepted: 02/03/2023] [Indexed: 03/04/2023]
Abstract
INTRODUCTION Beverage taxes are associated with declines in sugar-sweetened beverage sales and consumption, but few studies have evaluated the associations of these taxes with health outcomes. This study analyzed changes in dental decay after the implementation of the Philadelphia sweetened beverage tax. METHODS Electronic dental record data were obtained on 83,260 patients living in Philadelphia and control areas from 2014 to 2019. Difference-in-differences analyses compared the number of new Decayed, Missing, and Filled Teeth with that of new Decayed, Missing, and Filled Surfaces before (January 2014-December 2016) and after (January 2019-December 2019) tax implementation in Philadelphia and control patients. Analyses were conducted in older children/adults (aged ≥15 years) and younger children (aged <15 years). Subgroup analyses stratified by Medicaid status. Analyses were conducted in 2022. RESULTS The number of new Decayed, Missing, and Filled Teeth did not change after tax implementation in Philadelphia in panel analyses of older children/adults (difference-in-differences= -0.02, 95% CI= -0.08, 0.03) or younger children (difference-in-differences=0.07, 95% CI= -0.08, 0.23). There were similarly no post-tax changes in the number of new Decayed, Missing, and Filled Surfaces. However, in cross-sectional samples of patients on Medicaid, the number of new Decayed, Missing, and Filled Teeth was lower after tax implementation in older children/adults (difference-in-differences= -0.18, 95% CI= -0.34, -0.03; -22% decline) and younger children (difference-in-differences= -0.22, 95% CI= -0.46, 0.01; -30% decline), with similar results for number of new Decayed, Missing, and Filled Surfaces. CONCLUSIONS The Philadelphia beverage tax was not associated with reduced tooth decay in the general population, but it was associated with reduced tooth decay in adults and children on Medicaid, suggesting potential health benefits for low-income populations.
Collapse
Affiliation(s)
- Joshua Petimar
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
| | - Laura A Gibson
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark S Wolff
- School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Nandita Mitra
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Patricia Corby
- School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Gary Hettinger
- Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Emily F Gregory
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Emma Edmondson
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jason P Block
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, Massachusetts
| | - Christina A Roberto
- Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| |
Collapse
|
26
|
Ruff RR, Habib R, Godín TB, Niederman R. School-based caries prevention and the impact on acute and chronic student absenteeism. J Am Dent Assoc 2023; 154:753-759. [PMID: 37500236 DOI: 10.1016/j.adaj.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Poor oral health is significantly associated with absenteeism, contributing to millions of lost school hours per year. The effect of school-based dental programs that address oral health care inequities on student attendance has not yet been explored. METHODS CariedAway was a longitudinal, cluster-randomized, noninferiority trial of minimally invasive medicines for caries used in a school-based program. We extracted data on school absenteeism and chronically absent students from publicly available data sets for years before, during, and after program onset (2016-2021). Total absences and the proportion of chronically absent students were modeled using multilevel mixed-effects linear and 2-limit tobit regression, respectively. RESULTS In years in which treatment was provided through a school-based caries prevention program, schools recorded approximately 944 fewer absences than in nontreatment years (95% CI, -1,739 to -149). Averaged across all study years, schools receiving either treatment had 1,500 fewer absences than comparator schools, but this was not statistically significant. In contrast, chronic absenteeism was found to significantly decrease in later years of the program (b, -.037; 95% CI, -.062 to -.011). Excluding data for years affected by COVID-19 removed significant associations. CONCLUSIONS Although originally designed to obviate access barriers to critical oral health care, early integration of school-based dental programs may positively affect school attendance. However, the observed effects may be due to poor reliability of attendance records resulting from the closing of school facilities in response to COVID-19, and further study is needed. PRACTICAL IMPLICATIONS School-based caries prevention may also improve educational outcomes, in addition to providing critical oral health care. This clinical trial was registered at ClinicalTrials.gov. The registration number is NCT03442309.
Collapse
|
27
|
Imani K, Mancl LA, Hill CM, Chi DL. Preventive dental care utilization and dental caries for Medicaid-enrolled adolescents in Oregon. J Public Health Dent 2023; 83:309-316. [PMID: 37525392 PMCID: PMC10528592 DOI: 10.1111/jphd.12583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/09/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES This study aimed to evaluate the relationship between preventive dental care utilization and untreated dental caries for Medicaid-enrolled adolescents and to determine if the relationship is moderated by chronic conditions (CC). METHODS This analysis was based on 2015-2016 Medicaid claims files and survey data collected from adolescents ages 12-18 years enrolled in Oregon Medicaid, who received a dental screening between December 2015 and December 2016 (n = 240). To assess the relationship between preventive dental care utilization and untreated dental caries (defined as decayed tooth surfaces), prevalence ratios (PR) and 95% confidence intervals (CI) were generated using log-linear regression models. We also tested for an interaction between preventive dental care utilization and CC. RESULTS About 60.4% of adolescents utilized preventive dental care, 21.7% had CC, and 29.6% had ≥1 decayed tooth surfaces. There were no significant differences in untreated dental caries between adolescents who did and did not utilize preventive dental care (PR: 0.73, 95% CI: 0.33-1.60; p = 0.43). There was not a significant interaction between preventive dental care utilization and CC (p = 0.65). Preventive dental care utilization was not significantly associated with untreated dental caries for adolescents with CC (PR: 0.51, 95% CI: 0.10-2.65; p = 0.42) nor among adolescents without CC (PR: 0.79, 95% CI: 0.33-1.91; p = 0.61). CONCLUSIONS Preventive dental care was not shown to be associated with lower untreated dental caries for Medicaid-enrolled adolescents or those with CC. Future work that is adequately powered should continue to elucidate this relationship in Medicaid enrollees.
Collapse
Affiliation(s)
- Kimia Imani
- Department of Oral Health Sciences, University of Washington, Seattle, Washington, USA
| | - Lloyd A. Mancl
- Department of Oral Health Sciences, University of Washington, Seattle, Washington, USA
| | - Courtney M. Hill
- Department of Oral Health Sciences, University of Washington, Seattle, Washington, USA
| | - Donald L. Chi
- Department of Oral Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
| |
Collapse
|
28
|
Rudasill KM, Page McGinnis C, Cheng SL, Cormier DR, Koziol N. White privilege and teacher perceptions of teacher-child relationship quality. J Sch Psychol 2023; 98:224-239. [PMID: 37253581 DOI: 10.1016/j.jsp.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 10/04/2022] [Accepted: 04/11/2023] [Indexed: 06/01/2023]
Abstract
In this study, we investigated differences in teachers' perceptions of the teacher-child relationship from kindergarten through second grade as a function of child race and gender from the perspective of critical race theory and the cultural synchrony hypothesis. Given the extensive evidence of White privilege and anti-Black racism in the US education system, we expected that teachers, particularly White teachers, would perceive their relationships with White children more positively than with Black children. Controlling for family SES and child gender, results supported this hypothesis. Black boys had the highest risk of being perceived by teachers as having poor relationships with teachers in kindergarten (highest conflict and lowest closeness) and White girls had the lowest risk. In addition, teachers perceived relationships with Black boys as increasing in conflict across first and second grades at higher rates than with White and female children. These findings remained after examining teacher-child racial match as a moderator. Our results indicate that racism and sexism work together to explain the perceptions teachers have of children in the early elementary grades. Implications for training teachers and school psychologists on anti-racism and cultural competency are discussed.
Collapse
Affiliation(s)
| | | | - Sheng-Lun Cheng
- National Taipei University of Technology, Room 209, General Studies Building, No. 1, Section 3, Zhongxiao E Rd, Da'an District, Taipei City, 106, Taiwan
| | - Dwayne Ray Cormier
- Virginia Commonwealth University, 1015 West Main Street Richmond, VA 23284, United States
| | - Natalie Koziol
- University of Nebraska-Lincoln, 75 Carolyn Pope Edwards Hall University of Nebraska-Lincoln Lincoln, NE 68588, United States
| |
Collapse
|
29
|
Keeper JH, Kibbe LJ, Thakkar-Samtani M, Heaton LJ, Desrosiers C, Vela K, Amaechi BT, Jablonski-Momeni A, Young DA, MacLean J, Weyant RJ, Zandona AF, Sohn W, Pitts N, Frantsve-Hawley J. Systematic review and meta-analysis on the effect of self-assembling peptide P 11-4 on arrest, cavitation, and progression of initial caries lesions. J Am Dent Assoc 2023:S0002-8177(23)00189-7. [PMID: 37245138 DOI: 10.1016/j.adaj.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 02/14/2023] [Accepted: 03/10/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND Simple noninvasive evidence-based interventions for caries are needed to overcome limitations in the restorative paradigm. The self-assembling peptide P11-4 is a noninvasive intervention that regenerates enamel in initial caries lesions. STUDIES REVIEWED The authors conducted a systematic review and meta-analysis on the effectiveness of the P11-4 products Curodont Repair (Credentis; now manufactured by vVARDIS) (CR) and Curodont Repair Fluoride Plus (Credentis; now manufactured by vVARDIS) on initial caries lesions. Primary outcomes were lesion progression after 24 months, caries arrest, and cavitation. Secondary outcomes were changes in merged International Caries Detection and Assessment System score categories, quantitative light-induced fluorescence (QLF; Inspektor Research System), esthetic appearance, and lesion size. RESULTS Six clinical trials met the inclusion criteria. Results of this review represent 2 primary and 2 secondary outcomes. When compared with parallel groups, use of CR likely results in a large increase in caries arrest (relative risk [RR], 1.82 [95% CI, 1.32 to 2.50]; 45% attributable risk [95% CI, 24% to 60%]; number needed to treat [NNT], 2.8) and likely decreases lesion size by a mean (SD) of 32% (28%). The evidence also suggests that use of CR results in a large reduction in cavitation (RR, 0.32 [95% CI, 0.10 to 1.06]; NNT, 6.9) and is uncertain about lowering merged International Caries Detection and Assessment System score (RR, 3.68 [95% CI, 0.42 to 32.3]; NNT, 19). No studies used Curodont Repair Fluoride Plus. No studies reported adverse esthetic changes. PRACTICAL IMPLICATIONS CR likely has clinically important effects on caries arrest and decreased lesion size. Two trials had nonmasked assessors, and all trials had elevated risks of bias. The authors recommend conducting longer trials. CR is a promising treatment for initial caries lesions. The protocol for this systematic review was registered a priori with PROSPERO (304794).
Collapse
|
30
|
Karkoutly M, Kataish A, Al Kurdi S, Almonakel MB, Bshara N. Knowledge, perceptions, and behavior regarding children's oral health among Syrian pediatricians: a cross-sectional study. BMC Oral Health 2023; 23:272. [PMID: 37165414 PMCID: PMC10170676 DOI: 10.1186/s12903-023-03022-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 05/05/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Oral health has a direct impact on health-related quality of life (HRQoL). Hence, general health and oral health cannot be separated. Pediatricians play a pivotal role in providing primary care for infants and are the first to interact with them since birth. Therefore, the aim of this study was to evaluate the knowledge, perceptions, and behavior of Syrian pediatricians regarding children's oral health. METHODS This was a cross-sectional study. The questionnaire consisted of six main sections and required answers regarding demographic characteristics, knowledge, behavior, perceptions, and training received in oral health. The association between categorical variables was tested with Pearson's chi-square tests and Fishers exact tests using SPSS ver. 23. RESULTS The response rate was 43.12% (229/531). Most of the participants (64.02%) got a poor level of knowledge and no significant association was found between knowledge level and years of experience (p = 0.270). The majority of the participants (99.13%) perceived that diet, bacteria, and sugar exposure time are the etiological factors of dental caries. The overwhelming majority of the participants (98.25%) acknowledged the need for further oral health training during residency. CONCLUSIONS Most pediatricians reported a poor level of knowledge. It is recommended to update the postgraduate and residency curriculum to equip pediatricians with adequate knowledge regarding children's oral health.
Collapse
Affiliation(s)
- Mawia Karkoutly
- Pediatric Dentistry Department, Faculty of Dentistry, Dental College, Damascus University, Damascus, Syrian Arab Republic.
| | - Ammar Kataish
- Department of Pediatrics, Faculty of Medicine, Damascus University, Damascus, Syria
| | - Saleh Al Kurdi
- Pediatric Dentistry Department, Faculty of Dentistry, Dental College, Damascus University, Damascus, Syrian Arab Republic
| | - Mhd Bashier Almonakel
- Pediatric Dentistry Department, Faculty of Dentistry, Dental College, Damascus University, Damascus, Syrian Arab Republic
| | - Nada Bshara
- Pediatric Dentistry Department, Faculty of Dentistry, Dental College, Damascus University, Damascus, Syrian Arab Republic
| |
Collapse
|
31
|
Matic Girard I, Ward P, Durey A, Lund S, Calache H, Baker SR, Slack-Smith L. Primary caregivers' perceptions of factors influencing preschool children's oral health: social practices perspective-a protocol for qualitative metasynthesis. BMJ Open 2023; 13:e068444. [PMID: 37041059 PMCID: PMC10106023 DOI: 10.1136/bmjopen-2022-068444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION The role of primary caregivers in setting the foundation for a child's oral health throughout life is well recognised. Due to the dominant behaviour-based approach, research to date has mainly focused on exploring individual primary caregivers' oral health knowledge and behaviours. A social science approach involving social practice theories moves beyond individual attitudes, behaviour and choices to offer a better understanding of the ways in which collective activity relates to health. This qualitative metasynthesis will involve an interpretive synthesis of data found in published qualitative literature from developed countries. The aim of the metasynthesis is to identify social practices in families from published qualitative research with caregivers on preschool children's oral health. METHODS AND ANALYSIS This is a protocol for qualitative metasynthesis. The following databases will be used: MEDLINE, EMBASE, Global Health and Dentistry & Oral Sciences Source (DOSS) using the web-based database search platform Ovid, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus. The research team has determined search strategies by using relevant key terms. Qualitative studies published in English language on family factors related to preschool children (aged 0-5 years) from developed countries (2022 United Nations classification) will be included. Qualitative data analysis will involve thematic analysis of the reported factors influencing oral health of preschool children, from the perspective of social practice theory. Researchers will use NVivo software for organising and managing the data. ETHICS AND DISSEMINATION No ethics approval is required, as this study does not involve human subjects. Findings will be disseminated through professional networks, conference presentations and submission to a peer-reviewed journal.
Collapse
Affiliation(s)
- Ivana Matic Girard
- The School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Paul Ward
- Public Health, Torrens University Australia, Adelaide, Western Australia, Australia
| | - Angela Durey
- The School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Stephan Lund
- The School of Allied Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Hanny Calache
- Department of Rural Clinical Sciences, La Throbe Rural Health School, La Trobe University, Melbourne, Victoria, Australia
| | - Sarah R Baker
- Unit of Oral Health: Dentistry and Society, School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | - Linda Slack-Smith
- The School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
32
|
Ruff RR, Monse B, Duijster D, Itchon GS, Naliponguit E, Benzian H. Effectiveness of school-based strategies to prevent tooth decay in Filipino children: A cluster-randomized trial. Community Dent Oral Epidemiol 2023; 51:219-227. [PMID: 35112386 DOI: 10.1111/cdoe.12729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 12/09/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Evidence for affordable and pragmatic programmes to address the burden of untreated tooth decay in children in low- and middle-income settings is limited. This study aimed to (1) assess the effect of a government-run, school-based daily group toothbrushing programme compared to standard school-based oral health education on the incidence of dental caries and odontogenic infections in Filipino children over a period of 3 years; and (2) assess the additional preventive effect of on-demand oral urgent treatment (OUT) and weekly fluoride gel application. METHODS A cluster-randomized trial was conducted in Camiguin, Philippines. Schools in three regions were randomly assigned to one of three intervention groups: The Essential Health Care Programme (EHCP), which includes daily toothbrushing with fluoride toothpaste; EHCP plus twice-yearly access to on-demand urgent oral treatment (EHCP + OUT) and EHCP plus weekly application of high-concentrated fluoride gel (EHCP + Fluoride). Schools in a nearby province with a similar child population were selected as external concurrent control group. Clinical oral examinations were performed by calibrated dentists from a random sample of 682 seven-year-old students who were examined at baseline and over the following 3 years. Outcome variables were the number of decayed primary teeth, the number of decayed, missing and filled permanent teeth (DMFT) and surfaces (DMFS), and the number of permanent teeth with pulpal involvement, ulcerations, fistula or abscess (PUFA). Data were analysed using multilevel mixed-effects negative binomial regression. RESULTS Three years after implementation, increments in dental caries and odontogenic infections in permanent teeth did not significantly differ between the EHCP and control group, yet the incidence of DMFT was lower by 22% in children receiving EHCP. Compared to controls, children receiving EHCP + Fluoride had a significantly lower increment of DMFT, DMFS and PUFA by 40%, 40% and 47%, respectively. Children receiving EHCP + OUT had lower incidence rates of DMFT and DMFS than control children by 23% and 28%, respectively. A lower incidence rate was also found for PUFA, but the effect was not statistically significant. CONCLUSIONS Findings suggest that the weekly application of fluoride gel and urgent oral treatment, in addition to daily school-based toothbrushing with fluoride toothpaste, are realistic and effective strategies to lower the burden of dental caries in Filipino children. Implementation challenges may explain why no substantial caries-preventive benefits were demonstrated for school-based toothbrushing only. Intervention compliance should be considered in future programme implementation and evaluation research.
Collapse
Affiliation(s)
- Ryan Richard Ruff
- Department of Epidemiology & Health Promotion, College of Dentistry, New York University, New York, New York, USA
| | - Bella Monse
- Regional Fit for School Programme, Gesellschaft für Internationale Zusammenarbeit (GIZ), Manila, Philippines
| | - Denise Duijster
- Department of Social Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Gina Santos Itchon
- Center for Global Health, Xavier University School of Medicine, Cagayan de Oro, Philippines
| | | | - Habib Benzian
- Department of Epidemiology & Health Promotion, WHO Collaborating Center Quality Improvement & Evidence-based Dentistry, College of Dentistry, New York University, New York, New York, USA
| |
Collapse
|
33
|
Bohnhoff JC, Xue L, Hollander MAG, Burgette JM, Cole ES, Ray KN, Donohue J, Roberts ET. Healthcare Utilization Among Children Receiving Permanent Supportive Housing. Pediatrics 2023; 151:e2022059833. [PMID: 36974602 PMCID: PMC10071430 DOI: 10.1542/peds.2022-059833] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Permanent supportive housing (PSH) integrates long-term housing and supports for families and individuals experiencing homelessness. Although PSH is frequently provided to families with children, little is known about the impacts of PSH among children. We examined changes in health care visits among children receiving PSH compared with similar children who did not receive PSH. METHODS We analyzed Pennsylvania Medicaid administrative data for children entering PSH between 2011 and 2016, matching to a comparison cohort with similar demographic and clinical characteristics who received non-PSH housing services. We conducted propensity score-weighted difference-in-differences (DID) analyses to compare changes in health care visits 3 years before and after children entered PSH versus changes in the comparison cohort. RESULTS We matched 705 children receiving PSH to 3141 in the comparison cohort. Over 3 years following PSH entry, dental visits among children entering PSH increased differentially relative to the comparison cohort (DID: 12.70 visits per 1000 person-months, 95% confidence interval: 3.72 to 21.67). We did not find differential changes in preventive medicine visits, hospitalizations, or emergency department (ED) visits overall. When stratified by age, children ≤5 years old at PSH entry experienced a greater decrease in ED visits relative to the comparison cohort (DID: -13.16 visits per 1000 person-months, 95% confidence interval: -26.23 to -0.10). However, emergency visit trends before PSH entry differed between the cohorts. CONCLUSIONS Children in PSH had relatively greater increases in dental visits, and younger children entering PSH may have experienced relative reductions in ED visits. Policymakers should consider benefits to children when evaluating the overall value of PSH.
Collapse
Affiliation(s)
- James C. Bohnhoff
- Schools of Medicine
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lingshu Xue
- Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | | | - Evan S. Cole
- Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kristin N. Ray
- Schools of Medicine
- UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Julie Donohue
- Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eric T. Roberts
- Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
34
|
The effects of a sugar-sweetened beverage tax: moving beyond dental health outcomes and service utilisation. HEALTH ECONOMICS, POLICY, AND LAW 2023; 18:139-153. [PMID: 35916234 DOI: 10.1017/s1744133122000147] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Despite considerable academic and policy interest in the taxation of sugar-sweetened beverages (SSBs), its extra-health implications remain largely unexplored. We investigated the impact of an SSB tax on school absenteeism due to improved dental health, in a framework that accounted for the distribution of the benefit. We designed a quantitative, decision-analytic model that synthesised existing evidence in the areas of dental epidemiology, public health and economics, and simulated causal mechanisms that lead to changes in school attendance in Australian children and adolescents aged 6-17, in a tax vs no tax scenarios. Introducing a 20% sales tax on SSBs would result in a 0.73% (95% confidence interval: 0.38; 1.10), or 4684 (2412; 7071) days per year nationwide, reduction in school absences attributable to dental health reasons. While positive impacts would be seen across the board, the distribution of benefit was favourable towards boys, older teens and those from lower socio-economic status. Our study highlights the need for, and the viability of, quantifying distributions of direct and indirect consequences of public health policy. Despite modest effect size, the equity profile of SSB tax, the long-lasting benefits of educational gains, and potential synergies with other interventions, make it an attractive option for policymakers to consider.
Collapse
|
35
|
Conte NR. A Public Health Update:: The Oral Health of Delaware's Kindergarten and Third Grade Children in 2022. Dela J Public Health 2023; 9:8-12. [PMID: 37122349 PMCID: PMC10132360 DOI: 10.32481/djph.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Affiliation(s)
- Nicholas R Conte
- Dental Director, Bureau of Oral Health and Dental Services, Division of Public Health, Delaware Department of Health and Social Services; Prosthodontist, Private Practice
| |
Collapse
|
36
|
Slavkin HC, Dubois PA, Kleinman DV, Fuccillo R. Science-Informed Health Policies for Oral and Systemic Health. J Healthc Leadersh 2023; 15:43-57. [PMID: 36960302 PMCID: PMC10028303 DOI: 10.2147/jhl.s363657] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/21/2023] [Indexed: 03/18/2023] Open
Abstract
Oral, dental and craniofacial (ODC) health has a profound impact on general health and welfare throughout life, yet US dentists and physicians operate across misaligned silos. This protracted division limits access to optimal health, supports fee for services, and exacerbates health disparities. Early in the 20th century, the most frequent dental therapy was tooth extraction: removed infected teeth were substituted by prosthetic appliances - commonly, dentures or nothing. Most adults assumed becoming edentulous was a normal corollary of aging. With the discovery of penicillin and other antibiotics, healthcare professionals and policy makers predicted infectious diseases would become irrelevant. However, given numerous health threats, including SARS-CoV-2, HIV, multidrug-resistant bacteria, Zika virus, Ebola virus, and now monkeypox, public and professional awareness of transmissible infectious diseases has never been more evident. Ironically, little attention has been paid to unmet transmissible, infectious, common oral diseases - dental caries and periodontal diseases. Therefore, these persist within "the silent and invisible epidemic". The preventable death of a young boy in 2007 from an infected untreated tooth that produced bacterial meningitis is a profound reminder that our nation has vast inequities in education, health, and welfare. The impact of oral infections on hospital-acquired pneumonia, post-operative infection in cardiac valve surgery, and even academic performances of disadvantaged children displayed through sociodemographic characteristics and access to care determinants also are profound! This paper asserts that current and emerging ODC health knowledge and science will inform health policies and advance equity in access to care, affordable costs, and optimal healthcare outcomes. We recommend that legal and regulatory systems and public health programs be required to ensure health equity. A fair healthcare system that addresses holistic healthcare must be transparent, accessible, integrated and provide a standard of oral healthcare based upon scientific evidence for all people across the lifespan.
Collapse
Affiliation(s)
- Harold C Slavkin
- Ostrow School of Dentistry, University of Southern California, Los Angeles, California, USA
| | - Peter A Dubois
- California Dental Association, California Dental Association Holding Company, Inc., Sacramento, California, USA
| | | | - Ralph Fuccillo
- Cambridge Concord Associates, Stoneham, Massachusetts, USA
| |
Collapse
|
37
|
Das H, Janakiram C, Ramanarayanan V, Karuveettil V, Kumar V, Balachandran P, Varma B, John D. Effectiveness of an oral health curriculum in reducing dental caries increment and improving oral hygiene behaviour among schoolchildren of Ernakulam district in Kerala, India: study protocol for a cluster randomised trial. BMJ Open 2023; 13:e069877. [PMID: 36806129 PMCID: PMC9944638 DOI: 10.1136/bmjopen-2022-069877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
INTRODUCTION Children's learning abilities suffer when their oral health is compromised. Inadequate oral health can harm children's quality of life, academic performance, and future success and achievements. Oral health problems may result in appetite loss, depression, increased inattentiveness, and distractibility from play and schoolwork, all of which can lower self-esteem and contribute to academic failure. An oral health curriculum, in addition to the standard school curriculum, may instil preventive oral hygiene behaviour in school students, enabling them to retain good oral health for the rest of their lives. Because most children attend school, the school setting is the most effective for promoting behavioural change in children. A 'health-promoting school' actively promotes health by enhancing its ability to serve as a healthy place to live, learn and work, bringing health and education together. Making every school a health-promoting school is one of the joint objectives of the WHO and UNICEF. The primary objective of this proposed study is to assess the effectiveness of an oral health curriculum intervention in reducing dental caries incidence and improving oral hygiene behaviour among high school children in grades 8-10 of the Ernakulam district in Kerala, India. If found to be effective in changing children's behaviour in a positive way, an oral health curriculum may eventually be incorporated into the school health curriculum in the future. Classroom interventions can serve as a cost-effective tool to increase children's oral health awareness. METHODS AND ANALYSIS This protocol presents a cluster randomised trial design. It is a parallel-group comparative trial with two arms having a 1:1 distribution-groups A and B with oral health curriculum intervention from a dental professional and a schoolteacher, respectively. High schools (grades 8-10) will be selected as clusters for the trial. The minimum cluster size is 20 students per school. The total sample size is 2000 high school children. Data will be collected at three time points, including baseline, after 1 year (mid-term) and 2 years (final), respectively. The outcome measures are Decayed, Missing and Filled Teeth Index; Oral Hygiene Index-Simplified; and knowledge, attitude and behaviour. Data collection will be done by clinical oral examination and questionnaire involving oral health-related knowledge, attitude and behaviour items. ETHICS AND DISSEMINATION Ethical approval was obtained from the Institutional Ethics Committee of Amrita Institute of Medical Sciences and Research Centre (dated 19 July 2022, no: IEC-AIMS-2022-ASD-179). TRIAL REGISTRATION NUMBER Clinical Trial Registry of India (CTRI/2022/09/045410).
Collapse
Affiliation(s)
- Hindol Das
- Department of Public Health Dentistry, Armita School of Dentistry, Ernakulam, Kerala, India
| | | | | | - Vineetha Karuveettil
- Department of Public Health Dentistry, Armita School of Dentistry, Ernakulam, Kerala, India
| | - Vijay Kumar
- Department of Public Health Dentistry, Armita School of Dentistry, Ernakulam, Kerala, India
| | - Parvathy Balachandran
- Department of Public Health Dentistry, Armita School of Dentistry, Ernakulam, Kerala, India
| | - Balagopal Varma
- Department of Pediatric Dentistry, Armita School of Dentistry, Amrita Vishwa Vidyapeetham, Ernakulam, India
| | - Denny John
- Department of Public Health, Ramaiah University of Applied Sciences, Bengaluru, Karnataka, India
- Department of Public Health, Amrita Vishwa Vidyapeetham, Ernakulam, India
| |
Collapse
|
38
|
The Impact of Dental Care Programs on Individuals and Their Families: A Scoping Review. Dent J (Basel) 2023; 11:dj11020033. [PMID: 36826178 PMCID: PMC9954911 DOI: 10.3390/dj11020033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/12/2023] [Accepted: 01/20/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Despite significant global improvements in oral health, inequities persist. Targeted dental care programs are perceived as a viable approach to both improving oral health and to address inequities. However, the impacts of dental care programs on individual and family oral health outcomes remain unclear. OBJECTIVES The purpose of this scoping review is to map the evidence on impacts of existing dental programs, specifically on individual and family level outcomes. METHODS We systematically searched four scientific databases, MEDLINE, EMBASE, CINAHL, and Sociological Abstracts for studies published in the English language between December 1999 and November 2021. Search terms were kept broad to capture a range of programs. Four reviewers (AG, VD, AE, and KKP) independently screened the abstracts and reviewed full-text articles and extracted the data. Cohen's kappa inter-rater reliability score was 0.875, indicating excellent agreement between the reviewers. Data were summarized according to the PRISMA statement. RESULTS The search yielded 65,887 studies, of which 76 were included in the data synthesis. All but one study assessed various individual-level outcomes (n = 75) and only five investigated family outcomes. The most common program interventions are diagnostic and preventive (n = 35, 46%) care, targeted children (n = 42, 55%), and delivered in school-based settings (n = 28, 37%). The majority of studies (n = 43, 57%) reported a significant improvement in one or more of their reported outcomes; the most assessed outcome was change in dental decay (n = 35). CONCLUSIONS Dental care programs demonstrated effectiveness in addressing individual oral health outcomes. However, evidence to show the impact on family-related outcomes remains limited and requires attention in future research.
Collapse
|
39
|
Zerden LDS, Morris M, Burgess-Flowers J. Oral Health and Social Work Integration: Advancing Social Workers' Roles in Dental Education. HEALTH & SOCIAL WORK 2023; 48:43-53. [PMID: 36511330 DOI: 10.1093/hsw/hlac038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/22/2021] [Accepted: 12/21/2021] [Indexed: 06/17/2023]
Abstract
Oral health remains underutilized within both integrated service delivery and educational settings. Advancing social workers' roles in the education of oral health providers is one strategic way to expand oral health and social work integration. Although the involvement of social workers in dental education is not new, fewer than 18 percent of the country's 68 accredited dental schools have active social work departments or services. This exploratory study sought to determine how, as of 2021, social work has been integrated into U.S. dental education programs (N = 13). Findings offer an overview of current social work programs in existence, roles social workers have in addressing social and behavioral health needs in dental education settings, and barriers to and facilitators in developing and sustaining integrated partnerships. This article discusses ways social work and oral health educational settings can mutually benefit from developing and/or strengthening their integrated collaborations. It also addresses a comparison of educational missions, clinical learning opportunities across both professions, and how patient care can be improved by expanding oral health and social work integration.
Collapse
Affiliation(s)
- Lisa de Saxe Zerden
- is former senior associate dean for MSW education and associate professor, School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, Chapel Hill, NC 27599-3550, USA
| | - Melanie Morris
- is a doctoral student, School of Social Work, Boston University, Boston, MA, USA
| | - Jamie Burgess-Flowers
- is clinical assistant professor, School of Social Work and Adams School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
40
|
Weigel MM, Armijos RX. Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors. Public Health Nutr 2023; 26:23-32. [PMID: 36172927 PMCID: PMC11077448 DOI: 10.1017/s1368980022002166] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 08/15/2022] [Accepted: 09/23/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The main objective was to investigate the association of household food insecurity (HFI) with child oral health. A secondary objective was to explore potential dietary and non-dietary mediators of the HFI-child oral health relationship. DESIGN Cross-sectional data from the nationally representative Ecuadorian National Health and Nutrition Survey (2018) were analysed. The data included self-reported child oral health, HFI (Food Insecurity Experience Scale), diet (FFQ) and oral care behaviours (toothbrushing frequency, toothpaste use). The association of HFI with the reported number of oral health problems was examined with stereotype logistic regression. Parallel mediation analysis was used to explore potential dietary (highly fermentable carbohydrate foods, plain water) and non-dietary (toothbrushing) mediators of the HFI-oral health relationship. Bias-corrected standard errors and 95 % CI were obtained using non-parametric bootstrapping (10 000 repetitions). Effect size was measured by percent mediation (PM). SETTING Ecuador. PARTICIPANTS 5-17-year-old children (n 23 261). RESULTS HFI affected 23 % of child households. 38·5 % of children have at least one oral health problem. HFI was associated with a greater number of oral health problems: 1-2 problems (adjusted odds ratio (AOR) = 1·37; 95 % CI (1·15, 1·58); P = 0·0001), 3-4 problems (AOR = 2·21; 95 % CI (1·98, 2·44); P = 0·0001), 5-6 problems (AOR = 2·57; 95 % CI (2·27, 2·88); P = 0·0001). The HFI-oral health relationship was partially mediated by highly fermentable carbohydrate foods (PM = 4·3 %), plain water (PM = 1·8 %) and toothbrushing frequency (PM = 3·3 %). CONCLUSIONS HFI was associated with poorer child oral health. The HFI-oral health relationship was partially mediated by dietary and non-dietary factors. Longitudinal studies are needed to replicate our findings and investigate the role of other potential mediators.
Collapse
Affiliation(s)
- M Margaret Weigel
- Department of Environmental & Occupational Health, Indiana University, School of Public Health, 1025 E. 7th Street, Bloomington, IN47403, USA
- Global Environmental Health Research Laboratory, School of Public Health-Bloomington, Bloomington, IN, USA
- Center for Latin American & Caribbean Studies, Indiana University, Bloomington, IN, USA
- IU Center for Global Health, Indianapolis, IN, USA
| | - Rodrigo X Armijos
- Department of Environmental & Occupational Health, Indiana University, School of Public Health, 1025 E. 7th Street, Bloomington, IN47403, USA
- Global Environmental Health Research Laboratory, School of Public Health-Bloomington, Bloomington, IN, USA
- Center for Latin American & Caribbean Studies, Indiana University, Bloomington, IN, USA
- IU Center for Global Health, Indianapolis, IN, USA
| |
Collapse
|
41
|
Costa ACS, Paulo DME, Vidigal MTC, Vieira WDA, Cardenas AFM, Paranhos LR. Perception of malocclusion and school performance in adolescents: a systematic review. Braz Oral Res 2023; 37:e033. [PMID: 37132722 DOI: 10.1590/1807-3107bor-2023.vol37.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 10/17/2022] [Indexed: 05/04/2023] Open
Abstract
This study aimed to assess the potential association between perception malocclusion and school performance in children and adolescents. An electronic search was performed in ten databases. Based on the PECO acronym (Population, Exposition, Comparator, and Outcome), the eligibility criteria included observational studies that compared the school performance of children and adolescents with and without the perception of malocclusion. There were no restrictions on the language or year of publication. Two reviewers selected the studies, extracted the data, and assessed the risk of bias by using the Joanna Briggs Institute tool for cross-sectional studies. School performance was measured by analyzing student grades; levels of absenteeism; and child or adolescent self-perception and/or the perception of parents, guardians, close friends, and teachers regarding the impact of malocclusion on school performance. The data were described narratively/descriptively. The search resulted in 3,581 registers, of which eight were included in the qualitative synthesis. These studies were published between 2007 and 2021. Two studies concluded that there was no significant association between school performance and perception of malocclusion, five studies found that only some of the children with malocclusion had their school performance affected, and one study concluded that there was a significant association between perception of malocclusion and low school performance. Considering all variables and the very low certainty of evidence, the perception of malocclusion seems to negatively impact school performance when associated with external and subjective factors. Further studies using additional measurement standards are required.
Collapse
Affiliation(s)
- Ana Carla Souza Costa
- Universidade Ceuma, School of Dentistry, Post-Graduate Program in Dentistry, São Luiz, MA, Brazil
| | - Djessyca Miranda E Paulo
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Post-Graduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Maria Tereza Campos Vidigal
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Post-Graduate Program in Dentistry, Uberlândia, MG, Brazil
| | - Walbert de Andrade Vieira
- Universidade Estadual de Campinas - Unicamp, School of Dentistry of Piracicaba, Department of Restorative Dentistry, Piracicaba, SP, Brazil
| | | | - Luiz Renato Paranhos
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Preventive and Community Dentistry, Uberlândia, MG, Brazil
| |
Collapse
|
42
|
Kebede N, Wondiye H, Melkamu L, Anagaw TF, Assefa E, Bogale EK, Hailu G, Mohammed Y, Adane B. Application of the integrated behavioral model to identify the predictors of toothbrushing practices among primary school children at Bahir Dar city, Ethiopia. BMC Oral Health 2022; 22:638. [PMID: 36566198 PMCID: PMC9789586 DOI: 10.1186/s12903-022-02676-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 12/16/2022] [Indexed: 12/25/2022] Open
Abstract
Knowing the level of behavioral intention and tooth-brushing practices is crucial for the implementation of the intervention. However, such studies are too limited in Ethiopia. The current study employed a health behavior model to identify predictors that can serve to support primary school children's attitudes, intentions, knowledge, environmental constraints, and practices of tooth brushing. Thus, this study aimed to assess tooth brushing practices and their predictors among primary school children in Bahir Dar city, Ethiopia. An Institutional based cross-sectional study was conducted among primary school children in Bahir Dar city. A multi-stage sampling technique was used to select 610 participants. Data were collected using pre-tested interviewer-administered questionnaires. Questionnaires adapted from items' previous literature were used for integrated behavioral model constructs incorporated with elicitation study results. Data were entered into Epi data and then analyzed by Stata. Descriptive statistics were done. Confirmatory factor analysis was performed to check the convergent validity of the measurement. The Internal reliability of the items was also checked using composite reliability. Multivariable logistic regression was used to predict the role of independent variables in toothbrushing practices. Moreover, path analysis was performed to check the causal effect of integrated behavioral model constructs on toothbrushing practices. The goodness of fit of the final model was checked using the Hosmer and Lemeshow test of best fit with a large p value = 0.97 and Area under receiver operating characteristics curve = 0.98. The overall prevalence of the current practice of toothbrushing among the respondents was 45.4%. The prevalence of brushing frequency was 243 (89.01%), 27 (9.89%), and 3 (1.09%) brushed once a day, twice a day, and more than twice a day respectively. Female child's [AOR 3.23, 95% CI 1.48-7.02], mothers' education [AOR 4.6; 95% CI 1.22-17.44], past experience of toothbrushing [AOR 0.042; CI 0.018-0.101], knowledge about tooth brushing practices [AOR 1.3; 95% CI 1.09-1.60], behavioral intention [AOR 2.01; 95% CI 1.74-2.32], experiential attitude [AOR 1.09; 95% CI 1.01-1.17],instrumental attitude [AOR 1.02; 95% CI 1.01-1.03], and descriptive norm [AOR 1.07; 95% CI 1.01-1.14] were predictors of toothbrushing practices. The findings indicate that the practice of toothbrushing practices among primary school students was low. Sex, mother's education, knowledge, intention, experience, experiential attitude, instrumental attitude, and descriptive norm, have significant effects on toothbrushing practices; indicating that the integrated behavioral model showed adequate utility in predicting toothbrushing practices in the study area. School-based toothbrushing practices change interventions such as communication strategy.
Collapse
Affiliation(s)
- Natnael Kebede
- grid.467130.70000 0004 0515 5212Department of Health Promotion, School of Public Health, College of Medicine Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtamu Wondiye
- grid.442845.b0000 0004 0439 5951Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Lidiya Melkamu
- grid.442845.b0000 0004 0439 5951Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Tadele Fentabil Anagaw
- grid.442845.b0000 0004 0439 5951Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Elias Assefa
- Department of Health Promotion, College of Medicine Health Sciences, Mizan Tipi University, Tepi, Ethiopia
| | - Eyob Ketema Bogale
- grid.442845.b0000 0004 0439 5951Department of Health Promotion, College of Medicine Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gebremedhin Hailu
- Department of Health Promotion, College of Medicine Health Sciences, Arsi University, Assela, Ethiopia
| | - Yirgalem Mohammed
- grid.467130.70000 0004 0515 5212Department of Health System and Policy, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- grid.467130.70000 0004 0515 5212Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine Health Sciences, Wollo University, Dessie, Ethiopia
| |
Collapse
|
43
|
Ghoneim A, Ebnahmady A, D'Souza V, Parbhakar KK, He H, Gerbig M, Singhal S, Quiñonez C. The impact of dental care programs on healthcare system and societal outcomes: a scoping review. BMC Health Serv Res 2022; 22:1574. [PMID: 36564768 PMCID: PMC9780625 DOI: 10.1186/s12913-022-08951-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dental diseases have detrimental effects on healthcare systems and societies at large. Providing access to dental care can arguably improve health outcomes, reduce healthcare utilization costs, and improve several societal outcomes. OBJECTIVES Our objective was to review the literature to assess the impacts of dental care programs on healthcare and societal outcomes. Specifically, to identify the nature of such programs, including the type of services delivered, who was targeted, where services were delivered, and how access to dental care was enabled. Also, what kind of societal and healthcare outcomes have been attempted to be addressed through these programs were identified. METHODS We conducted a scoping review by searching four databases, MEDLINE, EMBASE, CINAHL, and Sociological Abstracts. Relevant articles published in English language from January 2000 to February 2022 were screened by four reviewers to determine eligibility for inclusion. RESULTS The search resulted in 29,468 original articles, of which 25 were included in the data synthesis. We found minimal evidence that answers our proposed research question. The majority of identified programs have demonstrated effectiveness in reducing medical and dental healthcare utilization (especially for non-preventive services) and avert more invasive treatments, and to a lesser degree, resulting in cost-savings. Moreover, some promising but limited evidence about program impacts on societal outcomes such as reducing homelessness and improving employability was reported. CONCLUSION Despite the well-known societal and economic consequences of dental problem, there is a paucity of studies that address the impacts of dental care programs from the societal and healthcare system perspectives. MESH TERMS Delivery of Health Care, Dental Care, Outcome assessment, Patient acceptance of Health Care.
Collapse
Affiliation(s)
| | - Arezoo Ebnahmady
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Violet D'Souza
- Faculty of Dentistry, Dalhousie University, Halifax, NS, Canada
| | | | - Helen He
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Madeline Gerbig
- Faculty of Arts and Science, University of Toronto, Toronto, ON, Canada
| | - Sonica Singhal
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada.,Public Health Ontario, Toronto, ON, Canada
| | - Carlos Quiñonez
- Schulich School of Medicine and Dentistry, London, ON, Canada
| |
Collapse
|
44
|
Tahani B, Asgari I, Golkar S, Ghorani A, Hasan Zadeh Tehrani N, Arezoo Moghadam F. Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran. BMC Oral Health 2022; 22:599. [PMID: 36510207 PMCID: PMC9744048 DOI: 10.1186/s12903-022-02644-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran. METHODS This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05). RESULTS The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4). CONCLUSION It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.
Collapse
Affiliation(s)
- Bahareh Tahani
- grid.411036.10000 0001 1498 685XDepartment of Oral Public Health, Dental Research Center, Dental research Institute,School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Imaneh Asgari
- grid.411036.10000 0001 1498 685XDepartment of Oral Public Health, Dental Material Research Center, Dental Research Institute,School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shayan Golkar
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amir Ghorani
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nooshin Hasan Zadeh Tehrani
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Arezoo Moghadam
- grid.411036.10000 0001 1498 685XDental Students Research Commiittee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
45
|
Kranz AM, Opper IM, Stein BD, Ruder T, Gahlon G, Sorbero M, Dick AW. Medicaid Payment and Fluoride Varnish Application During Pediatric Medical Visits. Med Care Res Rev 2022; 79:834-843. [PMID: 35130771 PMCID: PMC9357861 DOI: 10.1177/10775587221074766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
All Medicaid programs pay for fluoride varnish applications during medical visits for infants and toddlers, but receipt of care varies considerably across states. Using 2006-2014 Medicaid data from 22 states, this study examined the association between Medicaid payment and receipt of fluoride varnish during pediatric medical visits. Among 3,393,638 medical visits, fewer than one in 10 visits included fluoride varnish. Higher Medicaid payment was positively associated with receipt of fluoride varnish during pediatric medical visits. As policymakers consider strategies for increasing young children's access to preventive oral health services, as well as consider strategies for balancing budgets, attention should be paid to the effects of provider payment on access to pediatric oral health services.
Collapse
|
46
|
Quadri MFA, Alwadani MA, Talbi KM, Hazzazi RAA, Eshaq RHA, Alabdali FHJ, Wadani MHM, Tartaglia G, Ahmad B. Exploring associations between oral health measures and oral health-impacted daily performances in 12–14-year-old schoolchildren. BMC Oral Health 2022; 22:304. [PMID: 35870965 PMCID: PMC9308186 DOI: 10.1186/s12903-022-02341-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Oral health-related quality of life, a prominent topic in dentistry, has been studied extensively. However, the comparison between various self-perceived and clinical oral health measures still needs to be explored. The purpose of the current study is; first, to report the self-perceived and clinically examined oral health measures that are associated with the oral impacts on daily performances. Second, to identify the oral health measure that best predicts greater oral impact scores. Third, to investigate the difference in findings related to the disease experience measures and the treatment measures.
Methods
A cross-sectional study was carried out on children aged 12–14 years. The prevalence, frequency, and oral impact scores of each daily performance were calculated. Thirteen self-perceived OH conditions were assessed. Clinically examined oral health measures included gingival health, oral hygiene status, DMFT, DT, MT, and FT scores and, one or more decay (1 + D), missing (1 + M) and filled (1 + F) teeth. Simple linear and multiple linear regressions were carried out to report the associations.
Results
At least one oral health impacted daily performance was reported by 40% of the total sample of schoolchildren (N = 700). Based on the magnitude and precision of adjusted regression coefficients (RC), decay severity (DT) was identified as a better predictor of a greater oral impact score with regression coefficient values ranging between 0.3 (social contact) and 2.4 (1 + performance). Contrariwise, MT and FT components of DMFT were associated with lower oral impact scores. The self-perceived measures were also associated with oral impact scores and presented similar findings to that of the clinical oral health measures.
Conclusions
Untreated decay significantly impacted daily performances, especially eating, sleeping, studying, and social contact. The findings are of importance to public health practitioners for reporting, treating, and preventing oral health problems in children, and eventually contributing to better oral health-related quality of life.
Collapse
|
47
|
Lin P, Huang Y, Chen H, Wang J, Chen S, Chang H, Chi L. Decline in dental caries experience among schoolchildren in Taiwan, 2012–2020. Community Dent Oral Epidemiol 2022; 51:519-526. [DOI: 10.1111/cdoe.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/08/2022] [Accepted: 11/18/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Po‐Yen Lin
- Department of Dentistry, School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan
- Association of Family Dentistry Taipei Taiwan
| | - Yao‐Hui Huang
- Association of Family Dentistry Taipei Taiwan
- School of Oral Hygiene, College of Oral Medicine Taipei Medical University Taipei Taiwan
- School of Dentistry National Defense Medical Center Taipei Taiwan
| | - Hsiu‐Hsien Chen
- Department of Dentistry, School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan
| | - Jui Wang
- Institute of Epidemiology and Preventive Medicine, College of Public Health National Taiwan University Taipei Taiwan
| | - Shao‐Ching Chen
- Department of Oral Health Ministry of Health and Welfare Taipei Taiwan
| | - Hong‐Ji Chang
- Association of Family Dentistry Taipei Taiwan
- Department of Dentistry Cheng Hsin General Hospital Taipei Taiwan
| | - Lin‐Yang Chi
- Department of Dentistry, School of Dentistry National Yang Ming Chiao Tung University Taipei Taiwan
- Association of Family Dentistry Taipei Taiwan
- Department of Stomatology Kaohsiung Veteran General Hospital Kaohsiung Taiwan
| |
Collapse
|
48
|
Statistical Study on the Motivation of Patients in the Pediatric Dentistry. CHILDREN 2022; 9:children9111782. [DOI: 10.3390/children9111782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022]
Abstract
Our statistical study included 344 participants selected from the patients of the Pedodontics–Orthodontics Discipline of the Tîrgu-Mureş University of Medicine and Pharmacy. The patients’ age was between 6 and 18 years, with an average of 13.70 and a standard deviation of 4.62. The study participants were informed and agreed to complete two questionnaires of our conception regarding their health status, oral hygiene, and motivation for pedodontics or orthodontic treatment. The results of the two questionnaires were interpreted according to the gender and age of the patients. Data processing was performed with NCSS/PASS Dawson Edition statistical software, using the CHI2 test, considering a p of less than 0.05 as significant for comparative results. Results showed that girls were more motivated than boys in addressing pedodontic services due to dental, periodontal, and articular problems. Children, aged between 11 and 14 years, were less intrinsically motivated to solve oral health problems due to their low frequency. The intrinsic motivation for a more beautiful dentition was very strong, regardless of age and sex. Girls were more intrinsically motivated for orthodontic treatment than boys. There was a linear increase together in the age of those who wanted to improve their smile and facial appearance. Children between 11 and 14 years had the best self-perception of the appearance of their teeth, mouth, smile, and facial harmony. The strongest extrinsic motivation for orthodontic treatment came from parents or another doctor. The most important reason for orthodontics was dental malpositions, the last one was the improvement of masticatory efficiency. The extrinsic motivation from parents for orthodontics decreases linearly with age, along with the increase in motivation from the person with whom the participants relate emotionally and from the group of friends.
Collapse
|
49
|
Burns LE, Gencerliler N, Terlizzi K, Wu Y, Solis-Roman C, Gold HT. A comparative analysis of outcomes of root canal therapy for pediatric medicaid beneficiaries from New York State. FRONTIERS IN ORAL HEALTH 2022; 3:1031443. [PMID: 36479449 PMCID: PMC9720667 DOI: 10.3389/froh.2022.1031443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/28/2022] [Indexed: 08/03/2023] Open
Abstract
Objectives This study investigated differences in the provision of root canal therapy and outcomes in a publicly insured cohort of children and adolescents. Methods New York State Medicaid administrative claims from 2006 to 2018 were analyzed. Enrollees aged 6-18 were included in the study if they had initial non-surgical root canal therapy (NSRCT), in the permanent dentition, that allowed for at least 1 year of post-treatment follow-up. Descriptive analyses, multivariable logistic regression, and multivariable Cox proportional hazard models were used to examine the association between demographic variables (gender, age, race/ethnicity, and area-based factors) and dental treatment provision and outcomes. Results Male gender was associated with having more than one initial NSRCT (adjusted odds ratio (aOR) = 1.06; 95% confidence interval (CI) = 1.02-1.10), as was rurality (aOR = 1.15; 95% CI = 1.06-1.24). Black/African American (AA) and Hispanic children were less likely than non-Hispanic white children to have multiple NSRCTs (aOR = 0.88; 95% CI = 0.83-0.93 and aOR = 0.78; 95% CI = 0.74-0.83). Being older or female conferred a lower hazard of an untoward event (aHR = 0.93; 95% CI = 0.92-0.94 and aHR = 0.86; 95% CI = 0.81-0.91). Compared to non-Hispanic white children, Hispanic and Black/AA children had a higher risk of untoward event (aHR = 1.31; 95% CI = 1.21-1.41 and aHR = 1.55; 95% CI = 1.43-1.67) while children of Asian descent had a lower incidence after initial NSRCT (aHR = 0.79; 95% CI = 0.71-0.88). Conclusion Race/ethnicity was the strongest demographic predictor of provision of initial non-surgical root canal therapy, subsequent placement of a permanent restoration and the occurrence of an untoward event after NSRCT in this cohort.
Collapse
Affiliation(s)
- Lorel E. Burns
- Department of Endodontics, New York University College of Dentistry, New York, NY, United States
| | - Nihan Gencerliler
- Department of Endodontics, New York University College of Dentistry, New York, NY, United States
| | - Kelly Terlizzi
- Health Evaluation and Analytics Lab, New York University, New York, NY, United States
| | - Yinxiang Wu
- Department of Population Health, New York University Langone Health, New York, NY, United States
| | - Claudia Solis-Roman
- Health Evaluation and Analytics Lab, New York University, New York, NY, United States
| | - Heather T. Gold
- Department of Population Health, New York University Langone Health, New York, NY, United States
| |
Collapse
|
50
|
Ria N, Simaremare SA, Manurung NK. Education of Dental Health Maintenance Using Paint Application. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND: Education of dental health maintenance is important for children, because the lack of knowledge of children in maintaining dental health will affect the development of dental health in adulthood. The success of education is influenced, among others, by the media or tools used.
AIM: This study aims to determine the effect of education using paint application media on the risk factors for caries.
METHODOLOGY: This type of research was a quasi-experimental design with pre-test and post-test designs. To find out changes in knowledge, a questionnaire was administered. The sample was elementary school students, aged 8-10 years and the number of samples were 60 people. Data analysis using paired t test.
RESULTS: This study showed that there was a significant effect on the average value obtained from students' knowledge before and after the intervention using the paint application. The results of this study can be used as a basis for the use of paint applications as a medium for education media of dental health maintenance
CONCLUSION: Education using paint application media has increased students' knowledge. It was stated that education using paint applications had an effect on increasing students' knowledge in maintaining dental health. It is hoped that the use of the Paint Application media will be an alternative in the selection of dental health maintenance educational aids.
Collapse
|