Clinicians and researchers have traditionally worked in independent silos, with limited collaboration to rapidly translate discovery into clinical practice. At institutional level, hospitals and universities have also tended to work independently with limited success in leveraging each other's strengths with a view to improving population health. The consequences include fragmentation of clinical services, poor communication between researchers and clinicians, lengthy delays in identification of clinical problems requiring innovative solutions through research and a generation of clinicians who are not well equipped with all the skills to address future health needs. Academic Health Science Systems (AHSS) have been proposed as a mechanism for driving effective collaboration between academia and clinical services. There are examples of well established AHSS and the benefits have been articulated. In Singapore, three AHSS have been established over the past 15 years. National dental specialty centres and one dental school have been embedded in AHSS and have well established multi-disciplinary collaboration across clinical and academic domains. The aim of this commentary is to describe the concept of an AHSS and some of the areas where dentistry in Singapore has been transformed by having key dental institutions embedded in an AHSS.
{"title":"The role of academic health science systems in the transformation of dentistry: The Singapore experience","authors":"Choy Yoke Poon, Tien Yin Wong, Finbarr Allen","doi":"10.1111/cdoe.12929","DOIUrl":"10.1111/cdoe.12929","url":null,"abstract":"<p>Clinicians and researchers have traditionally worked in independent silos, with limited collaboration to rapidly translate discovery into clinical practice. At institutional level, hospitals and universities have also tended to work independently with limited success in leveraging each other's strengths with a view to improving population health. The consequences include fragmentation of clinical services, poor communication between researchers and clinicians, lengthy delays in identification of clinical problems requiring innovative solutions through research and a generation of clinicians who are not well equipped with all the skills to address future health needs. Academic Health Science Systems (AHSS) have been proposed as a mechanism for driving effective collaboration between academia and clinical services. There are examples of well established AHSS and the benefits have been articulated. In Singapore, three AHSS have been established over the past 15 years. National dental specialty centres and one dental school have been embedded in AHSS and have well established multi-disciplinary collaboration across clinical and academic domains. The aim of this commentary is to describe the concept of an AHSS and some of the areas where dentistry in Singapore has been transformed by having key dental institutions embedded in an AHSS.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 3","pages":"265-272"},"PeriodicalIF":2.3,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138175849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Studies to promote regular toothbrushing usually rely on self-reports of toothbrushing frequency (SRF). However, toothbrushing frequency measures may be open to responder bias since twice-daily toothbrushing is a commonly accepted social norm. The validity of SRF measures is unclear, meaning that their use as outcomes in interventional work may be flawed. The study's aim was to compare two different self-reported toothbrushing measures: SRF and the Self-Reported Behavioural Automaticity Index (SRBAI); with measurement of observed toothbrushing frequency tracked over 6 weeks. A secondary aim was to explore the interaction effect of various moderators (age, ethnicity, socioeconomic status (SES), sex, self-efficacy, participant personality and routine preference) upon the correlation between SRBAI and observed toothbrushing frequency.</p> </section> <section> <h3> Methods</h3> <p>One hundred and sixty-four adults were recruited via a number of different community groups and workplaces outside the dental setting. After consent, participants completed a questionnaire which collected demographic and participant characteristics measures (age, ethnicity, SES, sex, self-efficacy, participant personality and routine preference) and self-reported toothbrushing habits. Participants then attached a ‘Brushlink’ device to their toothbrush for 6 weeks to track their observed toothbrushing frequency.</p> </section> <section> <h3> Results</h3> <p>Using the Pearson correlation coefficient, a moderately strong positive linear association (<i>r</i> = 0.65) between SRBAI and observed toothbrushing frequency was found. By comparison, the correlation between SRF and observed toothbrushing frequency was weak (<i>r</i> = 0.39). There was a weak positive association between self-reported behaviour frequency and SRBAI score (<i>r</i> = 0.35). Using multivariable linear regression, no statistically significant interactional effect was demonstrated for any moderator variable upon the correlation coefficient of SRBAI and observed toothbrushing frequency.</p> </section> <section> <h3> Conclusions</h3> <p>The SRBAI provided a stronger association with observed toothbrushing frequency than the SRF measure. A moderately strong relationship between SRBAI and observed toothbrushing frequency was found, compared to a weak positive relationship between self-reported behaviour frequency and SRBAI score. This suggests that the SRBAI score could be a suitable proxy to measure observed toothbrushing behaviour and preferable to SRF in interventional wo
{"title":"Does the Self-Reported Behavioural Automaticity Index provide a valid measure of toothbrushing behaviour in adults?","authors":"Heather Raison, Rebecca V. Harris","doi":"10.1111/cdoe.12922","DOIUrl":"10.1111/cdoe.12922","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Studies to promote regular toothbrushing usually rely on self-reports of toothbrushing frequency (SRF). However, toothbrushing frequency measures may be open to responder bias since twice-daily toothbrushing is a commonly accepted social norm. The validity of SRF measures is unclear, meaning that their use as outcomes in interventional work may be flawed. The study's aim was to compare two different self-reported toothbrushing measures: SRF and the Self-Reported Behavioural Automaticity Index (SRBAI); with measurement of observed toothbrushing frequency tracked over 6 weeks. A secondary aim was to explore the interaction effect of various moderators (age, ethnicity, socioeconomic status (SES), sex, self-efficacy, participant personality and routine preference) upon the correlation between SRBAI and observed toothbrushing frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred and sixty-four adults were recruited via a number of different community groups and workplaces outside the dental setting. After consent, participants completed a questionnaire which collected demographic and participant characteristics measures (age, ethnicity, SES, sex, self-efficacy, participant personality and routine preference) and self-reported toothbrushing habits. Participants then attached a ‘Brushlink’ device to their toothbrush for 6 weeks to track their observed toothbrushing frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using the Pearson correlation coefficient, a moderately strong positive linear association (<i>r</i> = 0.65) between SRBAI and observed toothbrushing frequency was found. By comparison, the correlation between SRF and observed toothbrushing frequency was weak (<i>r</i> = 0.39). There was a weak positive association between self-reported behaviour frequency and SRBAI score (<i>r</i> = 0.35). Using multivariable linear regression, no statistically significant interactional effect was demonstrated for any moderator variable upon the correlation coefficient of SRBAI and observed toothbrushing frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The SRBAI provided a stronger association with observed toothbrushing frequency than the SRF measure. A moderately strong relationship between SRBAI and observed toothbrushing frequency was found, compared to a weak positive relationship between self-reported behaviour frequency and SRBAI score. This suggests that the SRBAI score could be a suitable proxy to measure observed toothbrushing behaviour and preferable to SRF in interventional wo","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 4","pages":"381-388"},"PeriodicalIF":1.8,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabriel Keng Yan Lee, Kuan Yee Wong, Wan Zhen Lee, Chai Kiat Chng
Over the last decade, Singapore has grappled with substantial healthcare challenges, chiefly a bourgeoning aging population and a mounting burden of chronic diseases. The oral health landscape has also changed, with the Ministry of Health placing a greater focus on a life-course approach supported by policies that facilitate Singaporeans to receive dental care appropriately and affordably. A pivotal oral health policy is the National Dental Strategy, a comprehensive framework governing dental services in the public sector. This strategy encompasses aspects such as financing, workforce management, and capacity considerations. To facilitate affordability and accessibility to dental services in the public sector, the government extends subsidies to reduce out-of-pocket costs. Those attending private dental clinics also benefit from the Community Health Assist Scheme, introduced in 2012, which alleviates treatment costs for enrolled Singaporeans. Furthermore, additional age-banded subsidies have been introduced for older Singaporeans born before 1960, enhancing financial support when accessing dental services in both private and public sectors. In 2019, a national adult oral health survey was commissioned to gauge the oral health status of Singaporeans aged 21 and above. The findings reported 34.8% having untreated dental caries, and 15.7% and 41.2% experiencing moderate and severe periodontitis, respectively. While over half (53.9%) of respondents visited the dentist at least annually, about 60% of eligible individuals did not utilize their government dental subsidies. In response, the Ministry of Health is committed to strengthening oral disease prevention, integrating oral health into general healthcare services, expanding dental financing schemes to enhance service utilization, improving the quality and transparency of dental care, and leveraging advancements in tele-dentistry and other modes of dental services. It is imperative to adapt Singapore's oral health policies and service delivery models to meet the evolving needs of the population and ensure a sustainable, equitable and resilient oral healthcare system.
{"title":"The oral health landscape in Singapore: A commentary on key features, challenges and future policies","authors":"Gabriel Keng Yan Lee, Kuan Yee Wong, Wan Zhen Lee, Chai Kiat Chng","doi":"10.1111/cdoe.12927","DOIUrl":"10.1111/cdoe.12927","url":null,"abstract":"<p>Over the last decade, Singapore has grappled with substantial healthcare challenges, chiefly a bourgeoning aging population and a mounting burden of chronic diseases. The oral health landscape has also changed, with the Ministry of Health placing a greater focus on a life-course approach supported by policies that facilitate Singaporeans to receive dental care appropriately and affordably. A pivotal oral health policy is the National Dental Strategy, a comprehensive framework governing dental services in the public sector. This strategy encompasses aspects such as financing, workforce management, and capacity considerations. To facilitate affordability and accessibility to dental services in the public sector, the government extends subsidies to reduce out-of-pocket costs. Those attending private dental clinics also benefit from the Community Health Assist Scheme, introduced in 2012, which alleviates treatment costs for enrolled Singaporeans. Furthermore, additional age-banded subsidies have been introduced for older Singaporeans born before 1960, enhancing financial support when accessing dental services in both private and public sectors. In 2019, a national adult oral health survey was commissioned to gauge the oral health status of Singaporeans aged 21 and above. The findings reported 34.8% having untreated dental caries, and 15.7% and 41.2% experiencing moderate and severe periodontitis, respectively. While over half (53.9%) of respondents visited the dentist at least annually, about 60% of eligible individuals did not utilize their government dental subsidies. In response, the Ministry of Health is committed to strengthening oral disease prevention, integrating oral health into general healthcare services, expanding dental financing schemes to enhance service utilization, improving the quality and transparency of dental care, and leveraging advancements in tele-dentistry and other modes of dental services. It is imperative to adapt Singapore's oral health policies and service delivery models to meet the evolving needs of the population and ensure a sustainable, equitable and resilient oral healthcare system.</p>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 3","pages":"259-264"},"PeriodicalIF":2.3,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136396686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. N. Bakri, C. A. Ferguson, S. Majeed, W. M. Thomson, K. Oda, S. Bartlett, J. M. Broadbent, M. B. Smith
Background
The workplace is an ideal—and priority—setting for health promotion activities. Developing and implementing workplace health promotion interventions, including oral health promotion activities, can help create health-supporting workplace environments.
Objective
To pilot workplace oral health promotion activities among staff working in the aged care sector, report their impact and explore participants' views on the factors that contribute to participation and effectiveness.
Methods
This study comprised three phases: (i) the development and face validation of the resources, (ii) a 3-h educational session and (iii) five interview sessions with participants 4–6 weeks following the education session. The recorded interviews were transcribed verbatim and analysed thematically.
Results
Eleven community-aged care workforce were invited to five feedback sessions. Ten participants were female and ranged in age from 18 to 64. All participants gave favourable comments about the content and delivery of the training session and accompanying resources. The participants felt that the benefits of WOHP include improved staff knowledge, awareness and oral care routine, the ability to share (and put into practice) the gained knowledge and information with their dependants, a lower risk of having poor oral health that adversely affects their well-being and work tasks, and potentially beneficial impacts on the organization's staff roster. Their attendance in the WOHP was facilitated by being paid to attend and scheduling the sessions during work time. Future WOHP suggestions include the possibility of a one-stop dental check-up at the workplace or staff dental care discounts from local dental practitioners and combining oral health with other health promotion activities.
Conclusions
Planning and implementing WOHP was deemed acceptable and feasible in this study context and successfully achieved short-term impacts among community-aged care workers. Appropriate times and locations, organizational arrangements and a variety of delivery options contributed to successful programme planning and implementation.
{"title":"Workplace oral health promotion activities among community-aged care workers: A qualitative exploration","authors":"N. N. Bakri, C. A. Ferguson, S. Majeed, W. M. Thomson, K. Oda, S. Bartlett, J. M. Broadbent, M. B. Smith","doi":"10.1111/cdoe.12924","DOIUrl":"10.1111/cdoe.12924","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The workplace is an ideal—and priority—setting for health promotion activities. Developing and implementing workplace health promotion interventions, including oral health promotion activities, can help create health-supporting workplace environments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To pilot workplace oral health promotion activities among staff working in the aged care sector, report their impact and explore participants' views on the factors that contribute to participation and effectiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study comprised three phases: (i) the development and face validation of the resources, (ii) a 3-h educational session and (iii) five interview sessions with participants 4–6 weeks following the education session. The recorded interviews were transcribed verbatim and analysed thematically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eleven community-aged care workforce were invited to five feedback sessions. Ten participants were female and ranged in age from 18 to 64. All participants gave favourable comments about the content and delivery of the training session and accompanying resources. The participants felt that the benefits of WOHP include improved staff knowledge, awareness and oral care routine, the ability to share (and put into practice) the gained knowledge and information with their dependants, a lower risk of having poor oral health that adversely affects their well-being and work tasks, and potentially beneficial impacts on the organization's staff roster. Their attendance in the WOHP was facilitated by being paid to attend and scheduling the sessions during work time. Future WOHP suggestions include the possibility of a one-stop dental check-up at the workplace or staff dental care discounts from local dental practitioners and combining oral health with other health promotion activities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Planning and implementing WOHP was deemed acceptable and feasible in this study context and successfully achieved short-term impacts among community-aged care workers. Appropriate times and locations, organizational arrangements and a variety of delivery options contributed to successful programme planning and implementation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 4","pages":"389-397"},"PeriodicalIF":1.8,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72208777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
With the increasing number of family caregivers due to the ageing population, physical and mental health problems among caregivers are of concern. However, few studies have evaluated their oral health. This study aimed to evaluate the association between being a family caregiver and recent dental visits for dental symptoms in Japan, with consideration of gender.
Methods
A cross-sectional study was conducted using the 2016 Comprehensive Survey of Living Conditions (CSLC) in Japan. Participants with dental symptoms were included in this study. The primary outcome was recent dental visits. The exposure variable of interest was being a primary caregiver for a family member requiring long-term care. A logistic regression analysis was conducted adjusting for contributing factors such as age, gender, marital status, working hours per week, education, household expenditure per month, self-rated health and the interaction between gender and caregiving. A stratified analysis by gender was also performed.
Results
Of the 5100 eligible participants, 233 (4.6%) were family caregivers. Of all participants, 2746 (53.8%) reported dental visits. The adjusted odds ratio (aOR) of family caregivers having recent dental visits was 0.83 (95% confidence interval [CI], 0.64–1.09). In a gender stratified analysis, family caregivers were less likely to visit dental clinics than were non-family caregivers in the male subsample (aOR: 0.56, 95% CI: 0.34–0.92) but not in the female subsample (aOR: 0.99, 95% CI: 0.72–1.38).
Conclusions
The findings indicate that family caregivers, especially male caregivers, had fewer dental visits than non-family caregivers. These findings suggest the need to improve the accessibility of dental clinics to family caregivers with dental symptoms.
{"title":"Recent dental visits and family caregiving among individuals with dental symptoms: A nationwide cross-sectional study in Japan","authors":"Miho Ishimaru, Takashi Zaitsu, Shiho Kino, Yuko Inoue, Kento Taira, Hideto Takahashi, Nanako Tamiya","doi":"10.1111/cdoe.12926","DOIUrl":"10.1111/cdoe.12926","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>With the increasing number of family caregivers due to the ageing population, physical and mental health problems among caregivers are of concern. However, few studies have evaluated their oral health. This study aimed to evaluate the association between being a family caregiver and recent dental visits for dental symptoms in Japan, with consideration of gender.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was conducted using the 2016 Comprehensive Survey of Living Conditions (CSLC) in Japan. Participants with dental symptoms were included in this study. The primary outcome was recent dental visits. The exposure variable of interest was being a primary caregiver for a family member requiring long-term care. A logistic regression analysis was conducted adjusting for contributing factors such as age, gender, marital status, working hours per week, education, household expenditure per month, self-rated health and the interaction between gender and caregiving. A stratified analysis by gender was also performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 5100 eligible participants, 233 (4.6%) were family caregivers. Of all participants, 2746 (53.8%) reported dental visits. The adjusted odds ratio (aOR) of family caregivers having recent dental visits was 0.83 (95% confidence interval [CI], 0.64–1.09). In a gender stratified analysis, family caregivers were less likely to visit dental clinics than were non-family caregivers in the male subsample (aOR: 0.56, 95% CI: 0.34–0.92) but not in the female subsample (aOR: 0.99, 95% CI: 0.72–1.38).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings indicate that family caregivers, especially male caregivers, had fewer dental visits than non-family caregivers. These findings suggest the need to improve the accessibility of dental clinics to family caregivers with dental symptoms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 4","pages":"406-412"},"PeriodicalIF":1.8,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The objective of the study was to identify the prevalence of periodontal disease in pregnant women in the Colombian population and its association with social determinants and medical history based on data from the Fourth National Oral Health Survey (ENSAB IV).
Methods
A total of 1012 pregnant women from different areas of Colombia were evaluated. A periodontal evaluation was performed using a North Carolina periodontal probe. The following data were recorded: number of teeth, probing depth (PD), the position of the gingival margin (GM) and clinical attachment level (CAL). An ordinal logistic regression analysis was performed for the association between social determinants and the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) classification and logistic regression between social determinants and the European Federation of Periodontology (EFP) classification.
Results
The prevalence of periodontitis was 37.1% using the CDC/AAP criteria and 41.2% according to the criteria of EFP distributed in sensitive (40.2%) and specific cases (0.9%). Age, belonging to a subsidized regime, living in a rural area, having an intermittent water supply and bleeding in medical records were found to be positively associated with periodontitis (mild, moderate, severe).
Conclusions
The findings of this national study of pregnant women show a high prevalence of periodontitis—using the CDC/AAP and EFP criteria—associated with age, living in rural areas, subsidized regime, intermittent water supply and bleeding in medical records.
{"title":"Prevalence and social determinants of periodontal disease in Colombian pregnant women","authors":"Juliana Velosa-Porras, Nelcy Rodríguez Malagón","doi":"10.1111/cdoe.12916","DOIUrl":"10.1111/cdoe.12916","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective of the study was to identify the prevalence of periodontal disease in pregnant women in the Colombian population and its association with social determinants and medical history based on data from the Fourth National Oral Health Survey (ENSAB IV).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 1012 pregnant women from different areas of Colombia were evaluated. A periodontal evaluation was performed using a North Carolina periodontal probe. The following data were recorded: number of teeth, probing depth (PD), the position of the gingival margin (GM) and clinical attachment level (CAL). An ordinal logistic regression analysis was performed for the association between social determinants and the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC/AAP) classification and logistic regression between social determinants and the European Federation of Periodontology (EFP) classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of periodontitis was 37.1% using the CDC/AAP criteria and 41.2% according to the criteria of EFP distributed in sensitive (40.2%) and specific cases (0.9%). Age, belonging to a subsidized regime, living in a rural area, having an intermittent water supply and bleeding in medical records were found to be positively associated with periodontitis (mild, moderate, severe).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings of this national study of pregnant women show a high prevalence of periodontitis—using the CDC/AAP and EFP criteria—associated with age, living in rural areas, subsidized regime, intermittent water supply and bleeding in medical records.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 2","pages":"207-216"},"PeriodicalIF":2.3,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12916","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nan Jiang, Jonas Minet Kinge, Irene Skau, Jostein Grytten
Objective
An important part of Norwegian welfare policy is to provide subsidized orthodontic treatment for children and adolescents. The objective of this policy is that dental services should be allocated according to children's need for treatment, and not according to parents' ability to pay. The probability of receiving orthodontic treatment independent of parent's household income was examined.
Methods
The study population encompassed children and adolescents aged 10–18 years in 2019 (n = 354 439). Information about whether they had started orthodontic treatment was obtained from the Norwegian Health Economics Administration. The key independent variable was net equalized household income. Inequalities were measured using concentration indices, which were estimated according to the severity of the malocclusion (very great need, great need, obvious need and no need). Two indices were used to measure relative inequality: the unstandardized concentration index and the partial concentration index. Absolute inequality was measured using the corrected concentration index. Relevant control variables were included in some of the analyses.
Results
The unstandardized indices were in the range 0.04 (very great need) to 0.05 (obvious need). For all three groups of severity, the 95% confidence intervals overlapped. The values of the partial indices were significantly lower than the values of the unstandardized indices. The partial indices were in the range 0.008 (very great need) to 0.03 (obvious need). The 95% confidence intervals for the partial indices did not overlap with the 95% confidence intervals of the unstandardized indices. For all three groups of severity, the indices that measured absolute inequality were close to zero.
Conclusions
It is possible to achieve the egalitarian aim of equality in service provision by subsidizing orthodontic treatment. This is possible within a system where the cost of orthodontic treatment is reimbursed according to the criteria of need. These criteria function in such a way that patients with the greatest need for orthodontic treatment are given the highest priority.
{"title":"Does subsidized orthodontic treatment reduce inequalities in access? Evidence from Norway based on population register data","authors":"Nan Jiang, Jonas Minet Kinge, Irene Skau, Jostein Grytten","doi":"10.1111/cdoe.12918","DOIUrl":"10.1111/cdoe.12918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>An important part of Norwegian welfare policy is to provide subsidized orthodontic treatment for children and adolescents. The objective of this policy is that dental services should be allocated according to children's need for treatment, and not according to parents' ability to pay. The probability of receiving orthodontic treatment independent of parent's household income was examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study population encompassed children and adolescents aged 10–18 years in 2019 (<i>n</i> = 354 439). Information about whether they had started orthodontic treatment was obtained from the Norwegian Health Economics Administration. The key independent variable was net equalized household income. Inequalities were measured using concentration indices, which were estimated according to the severity of the malocclusion (very great need, great need, obvious need and no need). Two indices were used to measure relative inequality: the unstandardized concentration index and the partial concentration index. Absolute inequality was measured using the corrected concentration index. Relevant control variables were included in some of the analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The unstandardized indices were in the range 0.04 (very great need) to 0.05 (obvious need). For all three groups of severity, the 95% confidence intervals overlapped. The values of the partial indices were significantly lower than the values of the unstandardized indices. The partial indices were in the range 0.008 (very great need) to 0.03 (obvious need). The 95% confidence intervals for the partial indices did not overlap with the 95% confidence intervals of the unstandardized indices. For all three groups of severity, the indices that measured absolute inequality were close to zero.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>It is possible to achieve the egalitarian aim of equality in service provision by subsidizing orthodontic treatment. This is possible within a system where the cost of orthodontic treatment is reimbursed according to the criteria of need. These criteria function in such a way that patients with the greatest need for orthodontic treatment are given the highest priority.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 2","pages":"232-238"},"PeriodicalIF":2.3,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.12918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryan Richard Ruff, Tamarinda Barry Godín, Richard Niederman
Background
The sustainability of school-based oral health programs depends on the utilization of effective, efficient treatments and the availability of a trained clinical workforce. The objective of this study was to determine whether registered nurses are comparable to dental hygienists in the application and effectiveness of silver diamine fluoride (SDF) and fluoride varnish (FV) for the prevention of dental caries.
Methods
CariedAway was a school-based study of SDF and FV versus dental sealants and atraumatic restorations. Within the SDF + FV arm, participants were treated by either a licensed dental hygienist or a registered nurse, both under the supervision of a paediatric dentist. Although initial treatment assignment in CariedAway was randomized, assignment to provider was not. The proportion of children who remained caries free after 2 years was assessed for non-inferiority using two-group proportion tests, adjusting for the clustering effect of schools.
Results
A total of 417 children with no untreated caries at baseline were analysed including 298 treated by hygienists and 119 by nurses. The proportion of children who remained caries free after 2 years was 0.81 and 0.80 for those treated by hygienists and nurses, respectively, for a difference of 0.01 (95% CI = −0.07, 0.098) and within the pre-determined non-inferiority margin.
Conclusions
Nurses may be effective in treating children with silver diamine fluoride and other fluoride varnishes in school-based oral health programs.
{"title":"The effectiveness of medical nurses in treating children with silver diamine fluoride in a school-based caries prevention program","authors":"Ryan Richard Ruff, Tamarinda Barry Godín, Richard Niederman","doi":"10.1111/cdoe.12925","DOIUrl":"10.1111/cdoe.12925","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The sustainability of school-based oral health programs depends on the utilization of effective, efficient treatments and the availability of a trained clinical workforce. The objective of this study was to determine whether registered nurses are comparable to dental hygienists in the application and effectiveness of silver diamine fluoride (SDF) and fluoride varnish (FV) for the prevention of dental caries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CariedAway was a school-based study of SDF and FV versus dental sealants and atraumatic restorations. Within the SDF + FV arm, participants were treated by either a licensed dental hygienist or a registered nurse, both under the supervision of a paediatric dentist. Although initial treatment assignment in CariedAway was randomized, assignment to provider was not. The proportion of children who remained caries free after 2 years was assessed for non-inferiority using two-group proportion tests, adjusting for the clustering effect of schools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 417 children with no untreated caries at baseline were analysed including 298 treated by hygienists and 119 by nurses. The proportion of children who remained caries free after 2 years was 0.81 and 0.80 for those treated by hygienists and nurses, respectively, for a difference of 0.01 (95% CI = −0.07, 0.098) and within the pre-determined non-inferiority margin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nurses may be effective in treating children with silver diamine fluoride and other fluoride varnishes in school-based oral health programs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 4","pages":"398-405"},"PeriodicalIF":1.8,"publicationDate":"2023-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49689072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karen Glazer Peres, Huihua Li, Melissa Tan, Wanyi Lim, Yim Heng Wong, Bien Lai, Oy Chu Eu, Marco Aurelio Peres
Objectives
This study aimed to describe caries prevalence and experience trends of permanent teeth among Singapore schoolchildren between 2007 and 2019.
Methods
Anonymized records of all 6-year-old Primary 1 (P1), 11-year-old Primary 6 (P6) and 14-year-old Secondary 3 (S3) before the start of each school year were extracted from the Integrated Dental Electronic Assessment System (IDEAS) by school level, ethnicity and sex. Prais–Winsten regression was used to assess trends of mean decayed, missing and filled teeth (DMFT) and caries prevalence (% DMFT > 0) among the schoolchildren by school level, with reported Average Annual Percentage Change (AAPC) together with respective 95% confidence interval (CI).
Results
In total, 519 471 P1, 566 573 P6 and 548 138 S3 were included during the above period, and the majority were comprised of Chinese children (P1: 67.2%, P6: 68.8% and S3: 71.0%, respectively). Overall, the prevalence of caries dropped from 6.9% in 2007 to 3.5% in 2019 among P1, from 34.5% in 2009 to 20.3% in 2019 among P6 and from 41.5% in 2007 to 33.5% in 2019 among S3 schoolchildren. The mean DMFT reduced from 0.11 to 0.05 among P1, 0.72 to 0.35 among P6 and 1.05 to 0.76 among S3 schoolchildren during the same period. Caries prevalence and mean DMFT were consistently higher among girls. On average, caries prevalence decreased 5% per year in P1 (AAPC −5.0 [95% CI: −6.1, −3.9]) and P6 (AAPC −4.9 [95% CI: −5.7, −4.1]) and 2% among S3 (AAPC −2.0 [95% CI: −3.5, −0.4]) schoolchildren. Caries prevalence decreased approximately 4% ~ 5% annually among P1 and P6 schoolchildren regardless of ethnicity. The average decrease in caries prevalence was lower (about 2%) among all ethnicities at S3 school level.
Conclusion
Dental caries in permanent dentition of Singaporean schoolchildren had decreased from 2007 to 2019. However, the decrease observed among primary school students was more than double that among secondary schoolchildren.
{"title":"Prevalence and experience of dental caries among Singaporean schoolchildren: A time-trend analysis from 2007 to 2019","authors":"Karen Glazer Peres, Huihua Li, Melissa Tan, Wanyi Lim, Yim Heng Wong, Bien Lai, Oy Chu Eu, Marco Aurelio Peres","doi":"10.1111/cdoe.12919","DOIUrl":"10.1111/cdoe.12919","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to describe caries prevalence and experience trends of permanent teeth among Singapore schoolchildren between 2007 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Anonymized records of all 6-year-old Primary 1 (P1), 11-year-old Primary 6 (P6) and 14-year-old Secondary 3 (S3) before the start of each school year were extracted from the Integrated Dental Electronic Assessment System (IDEAS) by school level, ethnicity and sex. Prais–Winsten regression was used to assess trends of mean decayed, missing and filled teeth (DMFT) and caries prevalence (% DMFT > 0) among the schoolchildren by school level, with reported Average Annual Percentage Change (AAPC) together with respective 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 519 471 P1, 566 573 P6 and 548 138 S3 were included during the above period, and the majority were comprised of Chinese children (P1: 67.2%, P6: 68.8% and S3: 71.0%, respectively). Overall, the prevalence of caries dropped from 6.9% in 2007 to 3.5% in 2019 among P1, from 34.5% in 2009 to 20.3% in 2019 among P6 and from 41.5% in 2007 to 33.5% in 2019 among S3 schoolchildren. The mean DMFT reduced from 0.11 to 0.05 among P1, 0.72 to 0.35 among P6 and 1.05 to 0.76 among S3 schoolchildren during the same period. Caries prevalence and mean DMFT were consistently higher among girls. On average, caries prevalence decreased 5% per year in P1 (AAPC −5.0 [95% CI: −6.1, −3.9]) and P6 (AAPC −4.9 [95% CI: −5.7, −4.1]) and 2% among S3 (AAPC −2.0 [95% CI: −3.5, −0.4]) schoolchildren. Caries prevalence decreased approximately 4% ~ 5% annually among P1 and P6 schoolchildren regardless of ethnicity. The average decrease in caries prevalence was lower (about 2%) among all ethnicities at S3 school level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dental caries in permanent dentition of Singaporean schoolchildren had decreased from 2007 to 2019. However, the decrease observed among primary school students was more than double that among secondary schoolchildren.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 3","pages":"273-280"},"PeriodicalIF":2.3,"publicationDate":"2023-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49689071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thais Freitas Formozo Tillmann, Maria Beatriz Junqueira de Camargo, Andréia Morales Cascaes, Aluísio J. D. Barros, Iná S. Santos, Marcos Britto Corrêa, Alicia Matijasevich, Otávio Pereira D'Ávila, Alexandre Emidio Ribeiro Silva
Objective
To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12–13 years and associated factors.
Methods
Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables ‘previous history of dental pain’, ‘self-rated oral health’, clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI).
Results
At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14–1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15–1.39), the presence of dental caries (PR 1.27; 95% CI 1.20–1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05–1.25).
Conclusions
The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.
{"title":"Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort","authors":"Thais Freitas Formozo Tillmann, Maria Beatriz Junqueira de Camargo, Andréia Morales Cascaes, Aluísio J. D. Barros, Iná S. Santos, Marcos Britto Corrêa, Alicia Matijasevich, Otávio Pereira D'Ávila, Alexandre Emidio Ribeiro Silva","doi":"10.1111/cdoe.12915","DOIUrl":"10.1111/cdoe.12915","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12–13 years and associated factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables ‘previous history of dental pain’, ‘self-rated oral health’, clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14–1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15–1.39), the presence of dental caries (PR 1.27; 95% CI 1.20–1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05–1.25).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"52 2","pages":"217-223"},"PeriodicalIF":2.3,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49675215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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