Lauren Hallewell, Raul Bescos, Zoe Brookes, Robert Witton, Patricia Casas-Agustench
Objectives
This scoping review aimed to identify barriers and facilitators, from both dental clinic staff and caregivers, to effectively providing and implementing dietary assessment and advice (for both oral and/or systemic health) in dental clinics managing paediatric patients.
Methods
A protocol was developed a priori (Open Science Framework- https://osf.io/bp4ts.) and followed the PRISMA-ScR guidelines. Studies published in English from 1990 to December 2024 in MEDLINE, Cochrane Library, Embase and CINAHL databases were searched. Additional journal searches targeted articles on dietary assessment or advice in dental clinics treating paediatric patients (aged ≤ 18 years), exploring barriers and facilitators for caregivers and dental clinic staff.
Results
Of 4736 studies identified, 32 were included, with 5 additional studies included from manual searching. Sixteen studies were quantitative, 13 were qualitative, and 8 mixed methods. Across studies, 77 barriers and 45 facilitators were identified in providing and implementing dietary assessment and advice in the paediatric population attending dental clinics. Results were mapped to the Theoretical Domains Framework. Common barriers for dental staff included time constraints and financial compensation, while caregivers cited controlling children's dietary habits as a major barrier.
Conclusions
Understanding the main barriers and facilitators in providing and implementing dietary assessment and advice in dental clinics treating paediatric patients is crucial to improving preventive healthcare.
{"title":"Exploring Barriers and Facilitators to Dietary Assessment and Advice in the Paediatric Population Attending Dental Clinics: A Scoping Review","authors":"Lauren Hallewell, Raul Bescos, Zoe Brookes, Robert Witton, Patricia Casas-Agustench","doi":"10.1111/cdoe.13046","DOIUrl":"10.1111/cdoe.13046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This scoping review aimed to identify barriers and facilitators, from both dental clinic staff and caregivers, to effectively providing and implementing dietary assessment and advice (for both oral and/or systemic health) in dental clinics managing paediatric patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A protocol was developed a priori (Open Science Framework- https://osf.io/bp4ts.) and followed the PRISMA-ScR guidelines. Studies published in English from 1990 to December 2024 in MEDLINE, Cochrane Library, Embase and CINAHL databases were searched. Additional journal searches targeted articles on dietary assessment or advice in dental clinics treating paediatric patients (aged ≤ 18 years), exploring barriers and facilitators for caregivers and dental clinic staff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 4736 studies identified, 32 were included, with 5 additional studies included from manual searching. Sixteen studies were quantitative, 13 were qualitative, and 8 mixed methods. Across studies, 77 barriers and 45 facilitators were identified in providing and implementing dietary assessment and advice in the paediatric population attending dental clinics. Results were mapped to the Theoretical Domains Framework. Common barriers for dental staff included time constraints and financial compensation, while caregivers cited controlling children's dietary habits as a major barrier.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Understanding the main barriers and facilitators in providing and implementing dietary assessment and advice in dental clinics treating paediatric patients is crucial to improving preventive healthcare.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 5","pages":"500-513"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.13046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157246","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}
Adam A. Rogers, Anne E. M. Halvari, Anne-Kristin Solbakk, Jan-Are K. Johnsen
Background
Increased support for oral health during young adulthood is needed to address trends in oral disease over the life course. Executive functioning (EF) may play a role in supporting oral health but has received little attention. EF represents the capacity to control cognitive information, feelings and behaviour. The current study aimed to explore the association between EF and oral health among young adults and investigate potential mediators.
Methods
Young adults aged 18–30 years were recruited from five universities within Norway to take part in a cross-sectional digital survey. Participants self-reported EF, toothbrushing, flossing, dental fear and anxiety (DFA), and provided ratings on two measures of oral health: self-rated oral health (SROH) and self-reported oral health-related quality of life (OHRQoL). Separate analyses were conducted for each outcome. Linear regression was used to test the association between EF and oral health, and whether toothbrushing, flossing, or DFA mediated this effect.
Results
Data from 344 participants were analysed. Average SROH was quite good (M = 4.13), several participants (60.5%) reported some impact on OHRQoL. In the SROH model, EF difficulties directly predicted oral health (β = −0.26), and DFA mediated the relationship (ab = −0.03, p < 0.05). In the OHRQoL model, EF difficulties again predicted performances impacted (β = 0.27), and DFA mediated the relationship (ab = 0.04, p < 0.05).
Conclusion
EF is related to oral health outcomes among young adults and the relationship is mediated by DFA. Studies are encouraged to continue exploring these relationships, with longitudinal studies needed to provide more insight into the potential role of EF as a protective factor for the development of DFA and oral health problems.
{"title":"Testing Dental Anxiety and Self-Care Behaviours as Mediators of the Association Between Executive Functioning and Oral Health Among Young Adults","authors":"Adam A. Rogers, Anne E. M. Halvari, Anne-Kristin Solbakk, Jan-Are K. Johnsen","doi":"10.1111/cdoe.13047","DOIUrl":"10.1111/cdoe.13047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Increased support for oral health during young adulthood is needed to address trends in oral disease over the life course. Executive functioning (EF) may play a role in supporting oral health but has received little attention. EF represents the capacity to control cognitive information, feelings and behaviour. The current study aimed to explore the association between EF and oral health among young adults and investigate potential mediators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Young adults aged 18–30 years were recruited from five universities within Norway to take part in a cross-sectional digital survey. Participants self-reported EF, toothbrushing, flossing, dental fear and anxiety (DFA), and provided ratings on two measures of oral health: self-rated oral health (SROH) and self-reported oral health-related quality of life (OHRQoL). Separate analyses were conducted for each outcome. Linear regression was used to test the association between EF and oral health, and whether toothbrushing, flossing, or DFA mediated this effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 344 participants were analysed. Average SROH was <i>quite good</i> (<i>M</i> = 4.13), several participants (60.5%) reported some impact on OHRQoL. In the SROH model, EF difficulties directly predicted oral health (<i>β</i> = −0.26), and DFA mediated the relationship (<i>ab</i> = −0.03, <i>p</i> < 0.05). In the OHRQoL model, EF difficulties again predicted performances impacted (<i>β</i> = 0.27), and DFA mediated the relationship (<i>ab</i> = 0.04, <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EF is related to oral health outcomes among young adults and the relationship is mediated by DFA. Studies are encouraged to continue exploring these relationships, with longitudinal studies needed to provide more insight into the potential role of EF as a protective factor for the development of DFA and oral health problems.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 5","pages":"533-542"},"PeriodicalIF":2.1,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157247","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}
Kanchan Marcus, Carmen Huckel-Schneider, Anagha Killedar, Madhan Balasubramanian, Arash Rudman, Woosung Sohn, Prithivi Sivaprakash, Sarah Norris, Graeme Liston, Naomi Wilson, Kara Clarke, Andrew Wilson
Objectives
Tooth decay is a leading cause of total disease burden among Australian children. In 2019, the state government of New South Wales, Australia implemented the Primary School Mobile Dental Program (PSMDP) across five local health districts. Understanding stakeholder satisfaction of the PSMDP is an important measure of quality, to determine appropriateness as relevant to the needs of populations. The aim of the study was to explore parent/caregiver and provider attitudes, experiences, and perceptions of the PSMDP.
Methods
This study reports on the qualitative component of a mixed methods study examining parent/caregiver and provider (oral health staff) experiences of the program. Two of the five local health districts were selected for study sampling. Parents/caregivers were recruited using flyers administered via schools and oral health teams. Interviews were conducted between 2022 and 2023. The interviews lasted 20–60 min, were recorded, and transcribed verbatim. A critical realist lens was applied, and thematic analysis was conducted. Data saturation was achieved, and bias was reduced through member checking, researcher reflexivity, and team triangulation of the data.
Results
In total, 79 individuals (58 parents/caregivers and 21 providers) were interviewed. Analysis revealed six key themes: (1) oral healthcare access, (2) informed consent, (3) parental attendance, (4) rewarding experiences, (5) operational barriers, and (6) communication clarity. The PSMDP promoted oral healthcare access while some parents/caregivers reported informed consent challenges. Providers cited rewarding experiences but face operational barriers including time constraints. Stakeholders diverged on parental attendance at school dental appointments, and most importantly, parents/caregivers requested follow-up communication clarity and coordination, particularly in feedback letters.
Conclusions
Qualitative findings identified generally positive attitudes and experiences with the PSMDP, and implications have been identified that would support the scale-up and sustainability of the PSMDP across the state. Study insights could be useful for similar programs, such as extending the attendance time per child, giving greater consideration to parental involvement, and improving communication and follow-up coordination.
{"title":"Stakeholder Attitudes, Experiences and Perceptions of the New South Wales Primary School Mobile Dental Program","authors":"Kanchan Marcus, Carmen Huckel-Schneider, Anagha Killedar, Madhan Balasubramanian, Arash Rudman, Woosung Sohn, Prithivi Sivaprakash, Sarah Norris, Graeme Liston, Naomi Wilson, Kara Clarke, Andrew Wilson","doi":"10.1111/cdoe.13044","DOIUrl":"10.1111/cdoe.13044","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Tooth decay is a leading cause of total disease burden among Australian children. In 2019, the state government of New South Wales, Australia implemented the Primary School Mobile Dental Program (PSMDP) across five local health districts. Understanding stakeholder satisfaction of the PSMDP is an important measure of quality, to determine appropriateness as relevant to the needs of populations. The aim of the study was to explore parent/caregiver and provider attitudes, experiences, and perceptions of the PSMDP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study reports on the qualitative component of a mixed methods study examining parent/caregiver and provider (oral health staff) experiences of the program. Two of the five local health districts were selected for study sampling. Parents/caregivers were recruited using flyers administered via schools and oral health teams. Interviews were conducted between 2022 and 2023. The interviews lasted 20–60 min, were recorded, and transcribed verbatim. A critical realist lens was applied, and thematic analysis was conducted. Data saturation was achieved, and bias was reduced through member checking, researcher reflexivity, and team triangulation of the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 79 individuals (58 parents/caregivers and 21 providers) were interviewed. Analysis revealed six key themes: (1) oral healthcare access, (2) informed consent, (3) parental attendance, (4) rewarding experiences, (5) operational barriers, and (6) communication clarity. The PSMDP promoted oral healthcare access while some parents/caregivers reported informed consent challenges. Providers cited rewarding experiences but face operational barriers including time constraints. Stakeholders diverged on parental attendance at school dental appointments, and most importantly, parents/caregivers requested follow-up communication clarity and coordination, particularly in feedback letters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Qualitative findings identified generally positive attitudes and experiences with the PSMDP, and implications have been identified that would support the scale-up and sustainability of the PSMDP across the state. Study insights could be useful for similar programs, such as extending the attendance time per child, giving greater consideration to parental involvement, and improving communication and follow-up coordination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"424-441"},"PeriodicalIF":1.8,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.13044","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109830","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}
<div> <section> <h3> Background</h3> <p><b>T</b>he oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world with varying degrees of success.</p> </section> <section> <h3> Aim</h3> <p>The aim of this systematic review is to analyse the health promotion strategies used in oral health promotion interventions in RACF settings and map the behaviour change techniques (BCTs) used in interventions to the Behaviour Change Techniques Taxonomy Version 1 (BCTTV1). This will help us identify the BCTs that are used and how effective they are in improving oral health outcomes for residents and the knowledge, attitudes and skills of caregivers in providing mouth care assistance to residents of RACFs.</p> </section> <section> <h3> Methods</h3> <p>A database search was conducted in MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), EMBASE, PsycINFO, CINAHL and Web of Sciences databases to screen for articles relevant to the topic of the review; after full-text review a total of 31 articles comprising both randomised controlled trials and non-randomised intervention studies were included in this review. Risks of bias in randomised studies were assessed using the ROB2 tool and ROBINS-I was used to evaluate non-randomised studies. The description of intervention content in each study was coded for the presence of BCTs by two independent review authors trained in coding BCTs according to BCTTv1.</p> </section> <section> <h3> Results</h3> <p>The most commonly used BCTs were ‘demonstration of behaviour’, ‘instruction on how to perform behaviour’ and ‘credible source’. These BCTs were effective in improving oral health outcomes and knowledge of caregivers on short-term follow-up. A higher number of BCTs were coded in studies that showed significant improvement in oral health outcomes of residents on long-term follow-up with rarely used BCTs related to ‘monitoring and feedback’ being coded in majority of studies that showed consistent improvement in oral health outcomes of residents.</p> </section> <section> <h3> Conclusion</h3> <p>This review identified the most commonly used BCTs used in health promotion interventions to improve oral health among older people in RACFs and found that majority of interventions were targeted towards ‘knowledge transfer’ and were inconsistent in improving oral health outcome
背景：居住在住宅养老机构的老年人口腔健康状况很差。许多促进口腔健康的干预措施已在世界各地的RACF环境中进行了测试，取得了不同程度的成功。目的：本系统综述的目的是分析RACF环境中口腔健康促进干预措施中使用的健康促进策略，并将干预措施中使用的行为改变技术（bct）映射到行为改变技术分类法第1版（BCTTV1）。这将有助于我们确定所使用的bct，以及它们在改善居民口腔健康结果方面的效果，以及护理人员在向社区住客提供口腔护理援助方面的知识、态度和技能。方法：检索MEDLINE、Cochrane CENTRAL、Cochrane系统评价数据库（CDSR）、EMBASE、PsycINFO、CINAHL和Web of Sciences数据库，筛选与综述主题相关的文章；全文综述后，本综述共纳入31篇文章，包括随机对照试验和非随机干预研究。使用ROB2工具评估随机研究的偏倚风险，使用ROBINS-I评估非随机研究。每项研究的干预内容描述均由两名接受过bct编码培训的独立综述作者根据BCTTv1编码bct。结果：最常用的btc是“行为示范”、“如何执行行为的指导”和“可靠来源”。这些bct在短期随访中有效地改善了口腔健康结果和护理人员的知识。在长期随访中显示居民口腔健康结果显著改善的研究中，编码了更多的bct，而在大多数显示居民口腔健康结果持续改善的研究中，编码了与“监测和反馈”相关的很少使用的bct。结论：本综述确定了健康促进干预措施中最常用的bct，以改善racf老年人的口腔健康，并发现大多数干预措施以“知识转移”为目标，并且在长期改善居民口腔健康结果方面不一致。需要使用理论行为改变框架进行良好的研究，以制定促进口腔健康的干预措施，因为目前使用的大多数策略在改善口腔健康结果方面没有表现出一致的有效性。
{"title":"Oral Health Promotion Interventions in Residential Aged Care Facilities – A Systematic Review of Behaviour Change Techniques Used in Interventions","authors":"Nesa Aurlene, Sindhu Ravichandran, Melanie Bish, Santosh Kumar Tadakamadla","doi":"10.1111/cdoe.13042","DOIUrl":"10.1111/cdoe.13042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p><b>T</b>he oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world with varying degrees of success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this systematic review is to analyse the health promotion strategies used in oral health promotion interventions in RACF settings and map the behaviour change techniques (BCTs) used in interventions to the Behaviour Change Techniques Taxonomy Version 1 (BCTTV1). This will help us identify the BCTs that are used and how effective they are in improving oral health outcomes for residents and the knowledge, attitudes and skills of caregivers in providing mouth care assistance to residents of RACFs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A database search was conducted in MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), EMBASE, PsycINFO, CINAHL and Web of Sciences databases to screen for articles relevant to the topic of the review; after full-text review a total of 31 articles comprising both randomised controlled trials and non-randomised intervention studies were included in this review. Risks of bias in randomised studies were assessed using the ROB2 tool and ROBINS-I was used to evaluate non-randomised studies. The description of intervention content in each study was coded for the presence of BCTs by two independent review authors trained in coding BCTs according to BCTTv1.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most commonly used BCTs were ‘demonstration of behaviour’, ‘instruction on how to perform behaviour’ and ‘credible source’. These BCTs were effective in improving oral health outcomes and knowledge of caregivers on short-term follow-up. A higher number of BCTs were coded in studies that showed significant improvement in oral health outcomes of residents on long-term follow-up with rarely used BCTs related to ‘monitoring and feedback’ being coded in majority of studies that showed consistent improvement in oral health outcomes of residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review identified the most commonly used BCTs used in health promotion interventions to improve oral health among older people in RACFs and found that majority of interventions were targeted towards ‘knowledge transfer’ and were inconsistent in improving oral health outcome","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 5","pages":"465-499"},"PeriodicalIF":2.1,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.13042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977251","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}
<div> <section> <h3> Objectives</h3> <p>To develop the International Association for Disability and Oral Health Universal Case Mix Tool (iADH UCMT) that rates case complexity in the delivery of oral healthcare.</p> </section> <section> <h3> Methods</h3> <p>A modified e-Delphi survey sought consensus on the content of a universal Case Mix Tool to rate the degree of adaptation over and above that required for the general population, with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The survey consisted of candidate domains, ratings and descriptors, following a scoping review of the literature. The consensus threshold was set a priori at ≥ 75% agreement. Expert agreement was sought on both content and wording, and free text comments were subsequently used to refine the exact wording of each domain and descriptor. A consensus meeting followed to rate descriptors for cultural acceptability and clarity, using 5-point Likert scales. Terms were aligned linguistically to ensure consistency across domains, scores and descriptors, and a glossary of definitions was refined.</p> </section> <section> <h3> Results</h3> <p>From the 70 registrants, 40 completed the survey (participation rate 59.7%). Respondents demonstrated a high level of agreement regarding the appropriateness of the seven domains, with agreement ranging from 90% to 100%. Consensus for rating descriptors was also high (85%–95%). Twenty-seven panellists and five development team members attended the consensus meeting, where cultural acceptability (means ranged from 4.6 to 4.8) and clarity (means ranged from 4.2 to 4.7) were demonstrated across domains. This consensus process produced an iADH Universal Case Mix Tool consisting of seven domains: <i>Communication; Dental behaviour support; Medical status; Risk factors for oral disease and dysfunction; Autonomy; Legal and ethical barriers;</i> and, <i>Access to adapted care at the services, systems and policies level</i>. Each Domain has four possible ratings to reflect the degree of adaptation required with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The domains, ratings and descriptors were found to be appropriate, clear and culturally acceptable.</p> </section> <section> <h3> Conclusions</h3> <p>An international panel developed a Universal Case Mix Tool to rate complexity in the delivery of oral health care. Acceptable content validity was confirmed, and further psychometric testing is planned.</p> </section>
{"title":"Development and Content Validity of the International Association for Disability and Oral Health Universal Case Mix Tool: A Consensus Study","authors":"Caoimhin Mac Giolla Phadraig, Denise Faulks, Colman McGrath, Alison Dougall, Gustavo Molina","doi":"10.1111/cdoe.13041","DOIUrl":"10.1111/cdoe.13041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To develop the International Association for Disability and Oral Health Universal Case Mix Tool (iADH UCMT) that rates case complexity in the delivery of oral healthcare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A modified e-Delphi survey sought consensus on the content of a universal Case Mix Tool to rate the degree of adaptation over and above that required for the general population, with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The survey consisted of candidate domains, ratings and descriptors, following a scoping review of the literature. The consensus threshold was set a priori at ≥ 75% agreement. Expert agreement was sought on both content and wording, and free text comments were subsequently used to refine the exact wording of each domain and descriptor. A consensus meeting followed to rate descriptors for cultural acceptability and clarity, using 5-point Likert scales. Terms were aligned linguistically to ensure consistency across domains, scores and descriptors, and a glossary of definitions was refined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From the 70 registrants, 40 completed the survey (participation rate 59.7%). Respondents demonstrated a high level of agreement regarding the appropriateness of the seven domains, with agreement ranging from 90% to 100%. Consensus for rating descriptors was also high (85%–95%). Twenty-seven panellists and five development team members attended the consensus meeting, where cultural acceptability (means ranged from 4.6 to 4.8) and clarity (means ranged from 4.2 to 4.7) were demonstrated across domains. This consensus process produced an iADH Universal Case Mix Tool consisting of seven domains: <i>Communication; Dental behaviour support; Medical status; Risk factors for oral disease and dysfunction; Autonomy; Legal and ethical barriers;</i> and, <i>Access to adapted care at the services, systems and policies level</i>. Each Domain has four possible ratings to reflect the degree of adaptation required with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The domains, ratings and descriptors were found to be appropriate, clear and culturally acceptable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>An international panel developed a Universal Case Mix Tool to rate complexity in the delivery of oral health care. Acceptable content validity was confirmed, and further psychometric testing is planned.</p>\u0000 </section>\u0000 ","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"402-412"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.13041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976424","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}
T. L. Finlayson, K. Moss, J. A. Jones, J. S. Preisser, J. A. Weintraub
Objective
Psychosocial factors can affect health. Patterns of psychosocial stressors and resources among older adults were examined for oral health status.
Methods
The Health and Retirement Study (HRS) is a representative sample of US adults > 50 years. Participants completed the 2018 HRS CORE survey and the Psychosocial and Lifestyle Questionnaire–Panel A “Leave Behind” survey (HRS-LB) (N = 4703). All measures were self-reported and stratified into outcome groups: (1) edentulous/dentate, (2) with/without a recent dental visit in the last 2 years. Psychosocial measures covered three domains: well-being, beliefs, and lifestyle. Specifically, loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors were included in this analysis. Latent class analysis (LCA) identified profiles of adults based on the distribution of psychological and social stressors and resources. Associations between latent classes and being edentulous and a recent dental visit were examined in logistic regression models.
Results
About 30% reported no recent dental visit; 14% were edentulous. Three latent classes were identified; profiles had different distributions of psychosocial factors. About half (47%) were in Class A: “Satisfied/Connected” (n = 2230), 28% in Class B: “Satisfied/Lonely” (n = 1293), and 25% in Class C: “Unsatisfied/Lonely” (n = 1180). “Satisfied/Connected” adults had the fewest psychosocial risk factors, most resources, were dentate, and had a recent dental visit. “Unsatisfied/Lonely” adults exhibited the most psychosocial risk factors and fewest resources and lacked a recent dental visit. “Satisfied/Lonely” adults exhibited characteristics between Classes A and C. In fully adjusted regression models, Class B adults had 1.29 (1.03–1.62) times greater odds than Class A to be edentulous and 1.26 (1.07–1.50) times greater odds to not have a recent dental visit. Class C adults had 1.22 (0.97–1.53) times greater odds than Class A to be edentulous and 1.31 (1.10–1.57) times greater odds to not have a recent dental visit.
Conclusion
Adverse psychosocial factors are associated with edentulism and lack of routine dental visits. Exposure to psychosocial risk and resource factors can affect oral health. Health providers should assess older adults for loneliness and other psychosocial risk factors, and policies and programmes that support older adults' psychosocial needs should be expanded.
{"title":"Psychosocial Profiles of Older Adults by Dentition Status and Dental Utilisation History","authors":"T. L. Finlayson, K. Moss, J. A. Jones, J. S. Preisser, J. A. Weintraub","doi":"10.1111/cdoe.13040","DOIUrl":"10.1111/cdoe.13040","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Psychosocial factors can affect health. Patterns of psychosocial stressors and resources among older adults were examined for oral health status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Health and Retirement Study (HRS) is a representative sample of US adults > 50 years. Participants completed the 2018 HRS CORE survey and the Psychosocial and Lifestyle Questionnaire–Panel A “Leave Behind” survey (HRS-LB) (<i>N</i> = 4703). All measures were self-reported and stratified into outcome groups: (1) edentulous/dentate, (2) with/without a recent dental visit in the last 2 years. Psychosocial measures covered three domains: well-being, beliefs, and lifestyle. Specifically, loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors were included in this analysis. Latent class analysis (LCA) identified profiles of adults based on the distribution of psychological and social stressors and resources. Associations between latent classes and being edentulous and a recent dental visit were examined in logistic regression models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>About 30% reported no recent dental visit; 14% were edentulous. Three latent classes were identified; profiles had different distributions of psychosocial factors. About half (47%) were in Class A: “Satisfied/Connected” (<i>n</i> = 2230), 28% in Class B: “Satisfied/Lonely” (<i>n</i> = 1293), and 25% in Class C: “Unsatisfied/Lonely” (<i>n</i> = 1180). “Satisfied/Connected” adults had the fewest psychosocial risk factors, most resources, were dentate, and had a recent dental visit. “Unsatisfied/Lonely” adults exhibited the most psychosocial risk factors and fewest resources and lacked a recent dental visit. “Satisfied/Lonely” adults exhibited characteristics between Classes A and C. In fully adjusted regression models, Class B adults had 1.29 (1.03–1.62) times greater odds than Class A to be edentulous and 1.26 (1.07–1.50) times greater odds to not have a recent dental visit. Class C adults had 1.22 (0.97–1.53) times greater odds than Class A to be edentulous and 1.31 (1.10–1.57) times greater odds to not have a recent dental visit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adverse psychosocial factors are associated with edentulism and lack of routine dental visits. Exposure to psychosocial risk and resource factors can affect oral health. Health providers should assess older adults for loneliness and other psychosocial risk factors, and policies and programmes that support older adults' psychosocial needs should be expanded.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"389-401"},"PeriodicalIF":1.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955676","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}
Casey D. Wright, Arif Salman, Raul I. Garcia, Daniel W. McNeil, Brenda Heaton
Background
The Periodontal Disease Self Report (PDSR) measure was originally created and psychometrically validated using a nationwide sample via online data collection. No clinical parameters were included in the prior validation of the PDSR. Thus, this study evaluated potential evidence for the clinical validity of the measure by examining associations between the PDSR scores and various clinical parameters obtained from a new sample of participants in which full-mouth periodontal examinations were conducted.
Methods
Adults from a community sample (n = 114) provided demographic information, responded to the PDSR measure and received a full-mouth clinical periodontal examination. Individual self-report items, subscale scores and total scores obtained from the PDSR were evaluated against clinical parameters of periodontitis. Regression models and receiver operating characteristic statistics were also utilised to test the ability of the PDSR to predict clinical outcomes.
Results
PDSR total scores were positively correlated with mean probing depth (r = 0.50, p < 0.01) and mean clinical attachment loss (r = 0.52, p < 0.01). After accounting for common risk factors in periodontal disease, the PDSR predicted mean probing depth (β = 0.45, 95% CI: 0.02–0.04; ΔR2 = 0.19). The area under the curve for the PDSR scores distinguishing between CDC/AAP no/mild periodontitis and moderate/severe periodontitis categories was 0.71 (95% CI: 0.62–0.81).
Conclusions
Clinical data support the use of the PDSR measure as a screening tool for periodontal disease. Additionally, the PDSR may offer added utility compared to other measures due to less reliance on information obtained via clinical encounters.
{"title":"Cross-Sectional Clinical Validation of the Periodontal Disease Self-Report Measure","authors":"Casey D. Wright, Arif Salman, Raul I. Garcia, Daniel W. McNeil, Brenda Heaton","doi":"10.1111/cdoe.13038","DOIUrl":"10.1111/cdoe.13038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Periodontal Disease Self Report (PDSR) measure was originally created and psychometrically validated using a nationwide sample via online data collection. No clinical parameters were included in the prior validation of the PDSR. Thus, this study evaluated potential evidence for the clinical validity of the measure by examining associations between the PDSR scores and various clinical parameters obtained from a new sample of participants in which full-mouth periodontal examinations were conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adults from a community sample (<i>n</i> = 114) provided demographic information, responded to the PDSR measure and received a full-mouth clinical periodontal examination. Individual self-report items, subscale scores and total scores obtained from the PDSR were evaluated against clinical parameters of periodontitis. Regression models and receiver operating characteristic statistics were also utilised to test the ability of the PDSR to predict clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PDSR total scores were positively correlated with mean probing depth (<i>r</i> = 0.50, <i>p</i> < 0.01) and mean clinical attachment loss (<i>r</i> = 0.52, <i>p</i> < 0.01). After accounting for common risk factors in periodontal disease, the PDSR predicted mean probing depth (<i>β</i> = 0.45, 95% CI: 0.02–0.04; Δ<i>R</i><sup><i>2</i></sup> = 0.19). The area under the curve for the PDSR scores distinguishing between CDC/AAP no/mild periodontitis and moderate/severe periodontitis categories was 0.71 (95% CI: 0.62–0.81).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Clinical data support the use of the PDSR measure as a screening tool for periodontal disease. Additionally, the PDSR may offer added utility compared to other measures due to less reliance on information obtained via clinical encounters.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"373-381"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794909","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}
Katri Palo, Mimmi Tolvanen, Auli Suominen, Hasse Karlsson, Linnea Karlsson, Satu Lahti
Objectives
The aim was to evaluate the association between public oral healthcare procedures and change in oral health-related quality of life (OHRQoL) over 4 years among parents in the FinnBrain Cohort Study, comparing those who did not visit public oral healthcare.
Methods
The study used data on parents of young children from the FinnBrain Birth Cohort Study (www.finnbrain.fi) and healthcare centers' national patient data register. OHRQoL was measured with the 14-item Oral Health Impact Profile (OHIP-14). Of those who had answered the OHIP-14 questionnaire at gestational week (gw) 34 and 4-year time points (n = 1552), 589 had visited a public oral healthcare service. OHIP-14 severity score, two thresholds of prevalence and their changes were evaluated according to gender and public oral healthcare visits (Mann–Whitney U test, ꭓ2 test, and Wilcoxon signed ranks test). Correlations between treatment procedures and OHRQoL were evaluated among those who had visited public oral healthcare service. The association between OHRQoL and its change with different treatment procedures was evaluated by using Spearman correlation coefficients.
Results
OHRQoL did not change for the majority of parents, regardless of visiting public oral healthcare services, or if they received oral healthcare treatment or only preventive procedures. Change in OHRQoL and treatment procedures showed a weak association. OHRQoL worsened most for those receiving treatment in four or more procedure groups. Changes in OHRQoL were not clinically meaningful.
Conclusions
Oral healthcare procedures seem to have a limited impact on OHRQoL changes among parents of young children.
{"title":"Changes in Oral Health-Related Quality of Life According to Public Oral Health Procedures in Parents of Young Children From the FinnBrain Birth Cohort Study","authors":"Katri Palo, Mimmi Tolvanen, Auli Suominen, Hasse Karlsson, Linnea Karlsson, Satu Lahti","doi":"10.1111/cdoe.13039","DOIUrl":"10.1111/cdoe.13039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The aim was to evaluate the association between public oral healthcare procedures and change in oral health-related quality of life (OHRQoL) over 4 years among parents in the FinnBrain Cohort Study, comparing those who did not visit public oral healthcare.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study used data on parents of young children from the FinnBrain Birth Cohort Study (www.finnbrain.fi) and healthcare centers' national patient data register. OHRQoL was measured with the 14-item Oral Health Impact Profile (OHIP-14). Of those who had answered the OHIP-14 questionnaire at gestational week (gw) 34 and 4-year time points (<i>n</i> = 1552), 589 had visited a public oral healthcare service. OHIP-14 severity score, two thresholds of prevalence and their changes were evaluated according to gender and public oral healthcare visits (Mann–Whitney <i>U</i> test, <i>ꭓ</i><sup>2</sup> test, and Wilcoxon signed ranks test). Correlations between treatment procedures and OHRQoL were evaluated among those who had visited public oral healthcare service. The association between OHRQoL and its change with different treatment procedures was evaluated by using Spearman correlation coefficients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>OHRQoL did not change for the majority of parents, regardless of visiting public oral healthcare services, or if they received oral healthcare treatment or only preventive procedures. Change in OHRQoL and treatment procedures showed a weak association. OHRQoL worsened most for those receiving treatment in four or more procedure groups. Changes in OHRQoL were not clinically meaningful.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Oral healthcare procedures seem to have a limited impact on OHRQoL changes among parents of young children.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"382-388"},"PeriodicalIF":1.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779357","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}
Lan Nguyen, Luke B. Connelly, Stephen Birch, Ha Trong Nguyen
Objectives
In Australia, although there have been some improvements, child oral health continues to be a major public health issue. The Australian Government introduced the means-tested Child Dental Benefits Schedule (CDBS) in 2014 to support access to dental services for children and adolescents aged 0–17 years from low-income families. There is a lack of evidence documenting whether the CDBS improved the dental attendance rate. This study aimed to evaluate the impact of the CDBS on dental visits among eligible children and adolescents in Australia.
Methods
The study analysed the data set from the birth cohort (B cohort) in the Longitudinal Study of Australian Children (LSAC). This is a nationally representative cohort survey collected biennially since 2004. The information on dental visits in the last 12 months was reported by the parents. A difference-in-differences analysis was used to examine 22,985 observations in the period 2008–2018. A propensity score matching (PSM) method was employed as a robustness check for the main findings.
Results
The proportion of children and adolescents eligible for CDBS in the six biennial surveys from 2008 to 2018 was 62.0%, 54.4%, 47%, 41.2%, 35.5%, and 28.9%, while the proportion of eligible individuals visiting dentists was 38.0%, 45.6%, 53.0%, 58.8%, 64.5%, and 71.1%, respectively. The analyses showed that the CDBS policy had a statistically significant and positive impact on dental visits among eligible children and adolescents. There was a 6.1–6.4 percentage point increase (p-value < 0.001) in dental visits across different specifications after the introduction of the CDBS policy.
Conclusion
The removal of financial barriers was beneficial to improve dental visits; however, the target group still faces the other remaining barriers, especially those related to inequalities in the social determinants of health, impeding the uptake of free dental services.
{"title":"Change in Dental Visits Among Eligible Children Under the Impact of the Child Dental Benefits Schedule in Australia","authors":"Lan Nguyen, Luke B. Connelly, Stephen Birch, Ha Trong Nguyen","doi":"10.1111/cdoe.13036","DOIUrl":"10.1111/cdoe.13036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>In Australia, although there have been some improvements, child oral health continues to be a major public health issue. The Australian Government introduced the means-tested Child Dental Benefits Schedule (CDBS) in 2014 to support access to dental services for children and adolescents aged 0–17 years from low-income families. There is a lack of evidence documenting whether the CDBS improved the dental attendance rate. This study aimed to evaluate the impact of the CDBS on dental visits among eligible children and adolescents in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study analysed the data set from the birth cohort (B cohort) in the Longitudinal Study of Australian Children (LSAC). This is a nationally representative cohort survey collected biennially since 2004. The information on dental visits in the last 12 months was reported by the parents. A difference-in-differences analysis was used to examine 22,985 observations in the period 2008–2018. A propensity score matching (PSM) method was employed as a robustness check for the main findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proportion of children and adolescents eligible for CDBS in the six biennial surveys from 2008 to 2018 was 62.0%, 54.4%, 47%, 41.2%, 35.5%, and 28.9%, while the proportion of eligible individuals visiting dentists was 38.0%, 45.6%, 53.0%, 58.8%, 64.5%, and 71.1%, respectively. The analyses showed that the CDBS policy had a statistically significant and positive impact on dental visits among eligible children and adolescents. There was a 6.1–6.4 percentage point increase (<i>p</i>-value < 0.001) in dental visits across different specifications after the introduction of the CDBS policy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The removal of financial barriers was beneficial to improve dental visits; however, the target group still faces the other remaining barriers, especially those related to inequalities in the social determinants of health, impeding the uptake of free dental services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"362-372"},"PeriodicalIF":1.8,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.13036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623924","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}
Jonathan Bowman-Newmark, Amin Vahdati, Anup Karki, Linda Young, Gerry Cleary, Wendy Thompson
Objectives
To evaluate and compare the rates of antibiotic prescribing by dental practitioners across the constituent countries of the United Kingdom between March 2020 and August 2023 and to estimate the total ‘excess’ prescribing that occurred during this interval beyond the rates predicted based upon trends between March 2016 and February 2020.
Methods
Retrospective pharmacoepidemiological study of dental practitioners' antibiotic prescribing, by secondary analysis of population-level National Health Service dispensing data from England, Scotland, Wales and Health and Social Care dispensing data from Northern Ireland.
Results
Effective August 2023, the antibiotic items dispensed rate for each country remained in excess of that predicted based upon pre-pandemic trends. Between March 2020 and August 2023, those rates were 175.6, 227.2, 195.0 and 321.8 antibiotic items per 1000 population for England, Scotland, Wales and Northern Ireland, respectively. Those represented estimated total ‘excesses’ of 27.7% (95% confidence limit [CL], 14.8, 43.7), 43.3% (95% CL, 29.9, 60.0), 33.2% (95% CL, 20.4, 49.0) and 42.9% (95% CL, 27.6, 62.3). Pairwise comparisons showed statistically significant differences between England and Scotland, England and Northern Ireland, and Wales and Northern Ireland (p < 0.001), Scotland and Wales (p = 0.001), and Scotland and Northern Ireland (p = 0.009). There was no statistically significant difference between England and Wales.
Conclusions
With shared prescribing guidelines and a single professional regulatory framework, it was unsurprising that similar antibiotic prescribing trends were found across the United Kingdom. Further research is required to investigate the reasons for the differences.
{"title":"Impact of the COVID-19 Pandemic on Antibiotic Prescribing by Dental Practitioners Across the United Kingdom's Four Countries: A Pharmacoepidemiological Study of Population-Level Dispensing Data, 2016–2023","authors":"Jonathan Bowman-Newmark, Amin Vahdati, Anup Karki, Linda Young, Gerry Cleary, Wendy Thompson","doi":"10.1111/cdoe.13037","DOIUrl":"10.1111/cdoe.13037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate and compare the rates of antibiotic prescribing by dental practitioners across the constituent countries of the United Kingdom between March 2020 and August 2023 and to estimate the total ‘excess’ prescribing that occurred during this interval beyond the rates predicted based upon trends between March 2016 and February 2020.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective pharmacoepidemiological study of dental practitioners' antibiotic prescribing, by secondary analysis of population-level National Health Service dispensing data from England, Scotland, Wales and Health and Social Care dispensing data from Northern Ireland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Effective August 2023, the antibiotic items dispensed rate for each country remained in excess of that predicted based upon pre-pandemic trends. Between March 2020 and August 2023, those rates were 175.6, 227.2, 195.0 and 321.8 antibiotic items per 1000 population for England, Scotland, Wales and Northern Ireland, respectively. Those represented estimated total ‘excesses’ of 27.7% (95% confidence limit [CL], 14.8, 43.7), 43.3% (95% CL, 29.9, 60.0), 33.2% (95% CL, 20.4, 49.0) and 42.9% (95% CL, 27.6, 62.3). Pairwise comparisons showed statistically significant differences between England and Scotland, England and Northern Ireland, and Wales and Northern Ireland (<i>p</i> < 0.001), Scotland and Wales (<i>p</i> = 0.001), and Scotland and Northern Ireland (<i>p</i> = 0.009). There was no statistically significant difference between England and Wales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>With shared prescribing guidelines and a single professional regulatory framework, it was unsurprising that similar antibiotic prescribing trends were found across the United Kingdom. Further research is required to investigate the reasons for the differences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10580,"journal":{"name":"Community dentistry and oral epidemiology","volume":"53 4","pages":"354-361"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cdoe.13037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596477","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}
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