Community dental health最新文献

This narrative review describes the impetus for health screening for non-communicable diseases in dental settings and highlights important considerations for evaluating such interventions. Real world cases are presented that showcase health screening interventions implemented in the UK. Non-communicable diseases including diabetes and cardiovascular disease are a global public health challenge. They are largely preventable by implementing lifestyle changes such as healthy eating and participation in physical activity, regular health screening for disease prevention, and/or early initiation of treatment. Hypertension case finding and control is one of the key five areas of focus for adult health, and oral health and diabetes are two of five key clinical areas for children and young people where efforts should be focused to intervene, improve outcomes and reduce inequalities. Links between oral and chronic diseases have been discussed in recent years. Therefore, screening for diabetes and cardiovascular disease has become of greater relevance to the dental profession. There is emerging evidence indicating that screening for the risk factors of cardiovascular diseases and diabetes in dental settings shows promise for improving health outcomes and may offer a cost-effective preventive approach for the detection of diabetes. Real-world services implementing health screening in dental settings have highlighted possibilities for the future and highlight the potential for the role of the dental team in detecting chronic diseases.

Objective: Early Childhood Caries (ECC) is prevalent among preschool children. The aim was to assess the effectiveness of an intervention to modify family-level determinants of caries (i.e. maternal parenting style, oral health-related self-efficacy and oral health-related knowledge) via preschool teachers, to improve the child level determinants of ECC (dietary sugar consumption, oral hygiene pattern, dental attendance pattern).

Basic research design: Quasi-experimental study.

Setting: Preschools in Gampaha District, Sri Lanka.

Participants: Preschoolers and their mothers/caregivers.

Interventions: Delivered via preschool teachers to 200 children and their caregivers.

Main outcome measures: Maternal parenting style, oral health related self-efficacy and oral health related knowledge, parentally reported dietary sugar consumption, oral hygiene pattern, dental attendance pattern and ECC.

Results: Maternal oral health related knowledge, authoritative parenting, authoritarian parenting and oral health related self-efficacy, maternally reported sugar consumption, sweetened drink consumption, tooth brushing frequency, dental visiting during the past six months and receipt of treatment better in the intervention group than the control group post-intervention.

Conclusions: The intervention shows potential in modifying family level determinants of ECC.

Objectives: To describe the oral health-related quality of life (OHRQoL) and its potential influencing factors within the Myanmar population.

Methods: Data were from the first national oral health survey, involving 3,513 participants aged 15-18 years, 35-44 years, and 60-74 years from 21 selected townships in Myanmar. Self-administered questionnaire-based surveys, conducted from December 2016 to January 2017, included socio-demographics, behavioral factors, self-reported oral conditions (number of teeth present, teeth and gingival conditions), and inquiries regarding OHRQoL (a set of 12 questions with 5 response options) using the recommended questions from WHO Oral Health Surveys.

Results: The most prevalent oral health issues were difficulties in chewing (32.2%) and biting foods (30.8%). In bivariate analysis, older individuals, rural residents, and participants with higher educational levels were associated with OHRQoL. In multiple regression analysis, self-reported number of teeth, teeth and gingival conditions were strong predictors of OHRQoL in all age groups.

Conclusion: Self-rated oral health conditions predicted quality of life due to oral problems. The development of national oral health policies and strategies is imperative to facilitate early detection of oral health problems and promote the awareness of oral health importance.

Objectives: To compare parent/carer proxy-reported dental caries experience of their 5-year-old child with epidemiological survey clinician examination of caries experience in the same children. To determine any differences in the accuracy by area-based socioeconomic group.

Methods: A cross-sectional data linkage study linked data from the Growing Up in Scotland (GUS) study and the National Dental Inspection Programme (NDIP) school epidemiology survey. Parent/carer proxy-reported caries experience was compared with clinician-measured caries experience on n=3008 children, and data were stratified by home-residential area-based socioeconomic deprivation levels (Scottish Index of Multiple Deprivation (SIMD)). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated overall and stratified by SIMD.

Results: Overall, parent/carer proxy-reporting had low sensitivity (42.3% 95%CI: 39.0, 45.7) that decreased with decreasing deprivation (SIMD-1(most deprived): 49.4% to SIMD-5 (least deprived): 37.2%). Specificity remained consistently high overall and across area-based socioeconomic deprivation levels (overall=96.2%, 95%CI: 95.3, 97.0; SIMD-1: 94.4% SIMD-5: 97.8%). In children whose parents/carers reported them to have caries experience (GUS) a high percentage were found to have caries experience (NDIP) (PPV=81.8%, 95%CI: 78.2, 84.9).

Conclusion: Parent/carer proxy-reporting of caries experience in 5-year-old children had very low sensitivity and was lowest in children from the least deprived areas. In contrast, parents/carers who reported their child had caries experience did so reasonably accurately. This study concludes that proxy reporting caries experience is not sufficiently sensitive to replace clinician examination in assessing dental caries experience in surveys of child populations and highlights the importance of data linkage to routine datasets.

Background: Despite concerns such as allergic dermatitis and bans recommended by health authorities, latex gloves are used by dental professionals in many countries. There are published reports of the prevalence of latex allergy in health professionals including dental professionals; however, no systematic review and meta-analysis is available.

Objectives: To determine the prevalence of latex allergy in dental professionals.

Method: Two researchers independently searched articles using appropriate keyword combinations in three search engines; PubMed, Cochrane Library, and Google Scholar for observational studies on latex allergy in dental professionals reported in English or where complete translations in English were included. Percentage prevalence of latex allergy was the variable of interest. The risk of bias was assessed using the Hoy et al. (2012) tool and publication bias using a funnel plot.

Results: From 435 possible sources, a total of 14 studies were included in the review and meta-analysis. The prevalence of latex allergy, based on 6302 participants was 10.37% (95% CI: 7.31 to 13.88). Heterogeneity (I2) was high (94.13%); hence, REM was used. There was moderate risk of bias across studies and minimal publication bias. GRADE analysis indicated that the evidence was uncertain.

Conclusions: The prevalence of latex allergy in dental professionals is about 10.37%. Evidence is of low quality due to high heterogeneity.

Objective: To explore ethnic inequalities in oral health-related quality of life (OHRQoL) and the role of nativity status on them.

Methods: Data from 1868 adults (16-65 years) of 9 ethnic groups participating in a community-based health survey in East London. Participants completed a supervised questionnaire including the Oral Health Impact Profile (OHIP-14) to calculate prevalence, extent and severity of oral impacts. Associations between ethnicity and nativity status (individually and combined) with OHRQoL were assessed in regression models, crude and adjusted for socio-demographic factors and clinical oral health indicators.

Results: Black others showed higher prevalence (OR: 1.91; 95%CI 1.05-3.46), severity (IRR: 2.87, 95%CI 1.63-5.06) and extent of oral impacts (IRR: 1.86, 95%CI 1. 35-2.59). Oral impacts were more severe among Black Caribbeans (IRR: 2.85, 95%CI 1.31-6.18) and Bangladeshis (IRR: 3.08, 95%CI .07-8.91); whereas impacts were more extensive among Pakistanis (IRR: 1.54, 95%CI 1.05-2.25) and Bangladeshis (IRR: 1.87, 95%CI 1.16-3.00). Nativity status individually showed no association with OHRQoL, although when combined with ethnicity resulted in many minority groups showing worse OHRQoL than White British participants.

Conclusion: Ethnicity and nativity status have a combined and important role in OHRQoL: ethnic minority groups showed worse OHRQoL even when controlling for clinical oral status.

The pressure on academics to publish is greater than ever. Sharing knew knowledge has always been satisfying and is necessary for career development. There are also ethical imperatives to avoid withholding knowledge and to prevent colleagues duplicating research unnecessarily, which would waste their time and burden participants. On top of these long-standing drivers, academic institutions must now manage their resources carefully and want to see a return on their investment in you, which will be measured in terms of quality and quantity of research outputs. As the need for publications has increased, so has the number of submissions and consequently, the competition to publish in the best-known journals. In some years CDH receives ten times more manuscripts than we can fit in the journal. Academics must publish more often, and their submissions must be of the highest quality to stand a chance of publication.

This paper reviews the associations between sugars consumption and non-communicable diseases. Systematic reviews demonstrate associations between sugars intake and dental caries, weight gain, type 2 diabetes and cardiovascular diseases. Children consuming more sugar-sweetened beverages (SSBs) are 1.55 times more likely to be overweight. In adults, higher consumption of SSBs is associated with a 27% higher relative risk of developing type 2 diabetes. In adults, greater free sugar consumption was positively associated with total CVD (HR 1.07; 95% CI: 1.03-1.10), ischaemic heart disease (HR 1.06; 95%CI: 1.02,1.10), and stroke (HR 1.10, 95% CI: 1.04, 1.17). Those consuming sugars higher than the recommended level of 10% of total energy are more likely to develop dental caries; 42 out of 50 studies involving children and 5 out of 5 in adults reported at least one positive association between sugars and caries. Reduction in sugars consumption requires a myriad of interventions to reduce supply and demand at national and global levels, fiscal policies, alongside high-quality research and promoting environments to reduce the burden of NCDs.

Objective: To determine the effectiveness of preventive interventions in children who have undergone caries-related dental extractions.

Methods: Rapid review across five databases (CENTRAL, Ovid Medline, Embase, Web of Science and Scopus). Quality was assessed using the Risk of Bias 2 tool.

Results: Five studies were included, all randomised controlled trials involving pre-and/or post-extractions activity. Three studies involved oral health education (computer game, motivational interviewing, visual aids), one delivered clinical prevention (fissure sealants), and one an enhanced prevention programme combining additional health education and a clinical intervention (fluoride varnish). Retention was mixed (55%-80% in the intervention groups). Of the three studies measuring caries, all reported less caries development in the test group. However, only a study involving a dental nurse-delivered structured conversation, informed by motivational interviewing, showed an improvement in oral health. Two studies reporting on plaque and gingival bleeding had conflicting results. A study reporting on subsequent dental attendance did not demonstrate a clear improvement.

Conclusion: Few published studies have explored prevention-based interventions in high caries-risk children requiring dental extractions. Whilst evidence of clinical benefit of preventive interventions in this population is limited, the potential use of contemporary behaviour change techniques appears promising. There is an urgent need for more high-quality longer-term trials using contemporary methodologies.

Objective: Observational studies have suggested an association between chronic periodontitis (CP) and chronic obstructive pulmonary disease (COPD). This study aimed to determine whether there is a causal relationship between CP and COPD incidence.

Design: Two‑sample Mendelian Randomization (MR) analysis using summary statistics from two genome‑wide association studies (GWASs) of European ancestry. Single nucleotide polymorphisms (SNPs) associated with COPD were obtained from the FinnGen database, which included 16,380,382 SNPs. The diagnosis of COPD was based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD 2023). We also obtained SNPs associated with CP from the FinnGen database, which included 16,380,378 SNPs.

Results: Sixteen eligible SNPs were extracted to analyze the causal effect of CP on COPD incidence. There was no causal correlation between CP and COPD using the inverse variance-weighted method (IVW) (OR=0.97, 95%CI= 0.91-1.05; p=0.482). Seven eligible SNPs were extracted to analyze the causal effect of COPD on CP incidence. Again, there was also no causal correlation between using IVW (OR=1.09, 95%CI=0.93-1.28; p=0.279).

Conclusion: We did not demonstrate a causal relationship between genetically predicted CP and COPD, or between genetically predicted COPD and CP.