Community dental health最新文献

Oral health disparities remain a stark reflection of broader systemic inequities within healthcare. Marginalized and underserved populations consistently experience limited access to dental care, poorer health outcomes, and heightened barriers to achieving equitable care. The dental profession faces a critical, existential moment: it must determine what role it will play in society and how it will respond to pressing issues of health inequity. As stewards of public trust and oral health, dental practitioners and educators must determine how to leverage their influence to address pressing issues of health inequity. This responsibility is particularly significant for dental schools, as they shape the ethical compass, cultural competency, and community engagement capabilities of future practitioners and thus bear a special responsibility in this transformative endeavor. This manuscript thus argues that dental schools should move beyond their traditional role of clinical training to engage more deeply with ethics, social determinants of health (SDOH), and community engagement. By doing so, they can prepare practitioners capable of advancing health equity and reshaping the role of dentistry in society.

Objective: To evaluate the response and validity of a self-reported periodontal questionnaire administered by community health workers (CHWs) for severe periodontitis (SPER) screening.

Methods: CHWs administered the CDC/AAP questionnaire in their communities. Participants underwent a complete periodontal examination. Based on these data, SPER was evaluated considering three definitions: CDC/AAP, EFP/AAP, and the presence of two sextants with probing depth (PD)≥ 6 mm. Questionnaire performance was analysed using the chi-square test and logistic regression with an assessment of sensitivity (SS), specificity (SP) and the receiver operating characteristic (ROC) curve.

Results: In total, 243 individuals completed the questionnaire. The prevalence of SPER was 47.3%. When SPER patients were compared with the controls (using the CDC/AAP criteria), significant differences in the means of interproximal clinical attachment loss and PD values were observed (p < 0.05). Responses to three of the eight questions, "having gum disease" (odds ratio [OR] = 2.6, 95% confidence interval [CI] = 1.5-4.7), "general health of teeth and gums" (OR = 0.5, 95% CI = 0.2-0.9) and "tooth mobility" (OR 2.6, 95% CI = 1.5-4.7) were associated with SPER (p < 0.05). In the regression analysis, the best models to predict SPER were those that included all the self-reported questions and all sociodemographic variables either using CDC/AAP definitions (SS = 69.7%, SP = 80.3, ROC= 0.806) or the presence of two sextants with PD≥ 6 mm (SS = 82.1%, SP = 69.2, ROC = 0.861).

Concluding remarks: The CDC/AAP Self-reported periodontal questionnaire administered by CHWs to screen individuals for severe periodontitis was effectively capable of screening patients with this disease.

Dental students from high-income countries (HIC) engage in volunteer opportunities in a way that reinforces harmful perceptions of saviourism and poverty. This undermines the goal of bringing dentists into the profession with a deep understanding of global health and disease. This paper presents a 2-week course that provided dental students from HIC with practical experience in global oral health service delivery. The course involved four UK dental students participating in a 2-week course run by the University of Puthisastra in Cambodia. Students undertook skills training and competency testing and provided care alongside Cambodian dental personnel in routine mobile dental clinics. They also observed the practices of local dentists in their private clinics, participated in workshops on social determinants of health and systems thinking, and visited local marketplaces to contextualise their learning. The visiting students were exposed to global health concepts and developed skills in oral health service delivery in non-conventional settings. By working with a large number of patients and gained both organisational and clinical skills. The program received positive feedback. Adjusting workshop timing and length, along with pre-learning through online courses, can improve the content and depth of the course.

This study aimed to explore the role of social media in influencing patient decisions regarding dental bleaching treatments, examining how online content affects perceptions, attitudes and expectations. This qualitative study involved semi-structured interviews with participants who have either undergone dental bleaching or considered it. Patients were recruited from multiple dental practices in the Netherlands, the researcher's personal network and via social media pages. The individual interviews focused on understanding patient interactions with social media related to dental bleaching. Data were analyzed using conventional content analysis. A total of 16 interviews were conducted, including 10 males and six females. 18 themes were identified across five categories: social media usage, decision factors for dental bleaching, potential risks of dental bleaching, the role of dentists in social media and the credibility of social media as an information source. Social media exposure to dental bleaching advertisements was often passive via algorithms rather than through active searches. Such content was often met with skepticism regarding authenticity and commercial motives. Most participants reported that social media had a minimal influence on their decision-making for dental bleaching, however, many also agreed that social media promote beauty standards that could indirectly influence cosmetic treatment decisions. Dental professionals remained the most trusted source of information. Social media play a complex role in influencing decisions about dental bleaching. Dental professionals have an increasingly important responsibility in providing credible and professionally supported dental health information, allowing patients to make informed decisions about their dental health.

Objectives: This study aimed to evaluate the effects of nutritional guidance on oral and swallowing function, dietary diversity, and body composition in older adults attending regional dental clinics.

Basic research design: A cohort study was conducted following the STROBE guidelines.

Clinical setting: A regional dental clinic in Japan.

Participants: This study included 89 individuals aged 65 years and older (27 males and 62 females, mean age 77.3 ± 6.5 years).

Main outcome measures: Seven oral function tests, number of functional teeth, Repetitive Saliva Swallowing Test (RSST), Dietary Variety Score (DVS), and body composition were assessed. The participants were categorized into three groups based on the DVS: low (0-3 points), middle (4-6 points), and high (7-10 points). The baseline and follow-up measurements were compared.

Results: Significant improvements were observed in oral function tests, specifically in oral diadochokinesis (ODK)/ta/and swallowing ability (RSST), particularly in the low-DVS group. Nutritional guidance led to increased dietary diversity in all groups except the high-DVS group. Despite the improvements in dietary diversity, no significant changes in body composition were observed during the study period. Sex-specific differences were observed, with females showing greater improvements in ODK/ta/ and DVS, whereas males showed significant improvements in RSST.

Conclusions: Nutritional guidance, particularly for patients with a low baseline DVS, may help improve oral function and dietary diversity. Sex-specific approaches can improve nutritional, oral, and swallowing functions.

Objectives: To examine the history of water fluoridation in Scotland, assessing its implementation, cessation, and impact on dental caries, and to evaluate whether water fluoridation should be reconsidered in future public health strategies. Basic research design: A historical review of water fluoridation in Scotland conducted using peer-reviewed studies, government reports, and legal documents. Data was synthesised chronologically on fluoridation's impact, legislative challenges, policy shifts, and public attitudes. Main outcome measures: Dental caries prevalence and treatment costs, public and political attitudes toward fluoridation, and legislative and policy developments affecting the implementation or cessation of fluoridation in Scotland. Results: Scottish fluoridation schemes significantly reduced caries prevalence and treatment costs. Fluoridation was discontinued following legal challenges. Post-cessation studies reported rising caries rates and treatment costs. Recent public attitude surveys indicate majority support for fluoridation. While Childsmile has improved oral health, fluoridation remains the most effective passive intervention. Conclusion: Scotland's fluoridation history highlights the tension between scientific evidence, legal constraints, and public perception. While current policy prioritises individual choice, integrating fluoridation into Childsmile could enhance caries prevention across Scotland. Renewed policy discussions and public engagement are essential for reconsidering fluoridation as part of Scotland's long-term oral health strategy.

Aim: To explore the association between tooth loss and ethnicity and to assess the mediating role of education in this relationship. Methods: Secondary analysis of cross-sectional data from adults aged 16 and over who participated in the Health Survey for England in 1999, 2000, 2001, 2002, and 2005. Key variables included ethnicity, education, socioeconomic status, and occupational class. Logistic regression and interaction analysis assessed associations between ethnicity and edentulousness, adjusted for education. Results: Edentulousness was less prevalent among younger participants, individuals of Asian descent, and those with higher income, education, and managerial occupations. After adjusting for sociodemographic factors, ethnic disparities persisted. Black Caribbean individuals with no education had 37% [95% CI = 1.04-1.80] higher odds, and those with A-levels had 43% [95% CI = 0.34-0.96] lower odds of tooth loss. Conclusion: There is a complex interplay between ethnicity, education and tooth loss. Public health interventions are needed to target oral health education and improve access to care, particularly for ethnic minorities and lower socioeconomic groups.

Background: Oral pathology (e.g. caries, periodontal disease, edentulism) contributes to poor overall health and negatively impacts quality of life. Ageing increases susceptibility to oral diseases and poor oral health is common among older adults. In contrast, dental attendance is low among this group. This descriptive study aims to examine dental utilisation patterns among older adults in Flanders, Belgium. Methods: The study included all members from the two largest Belgian healthcare insurance funds aged 65 and older, residing in Flanders (Belgium). Descriptive and bivariate analyses were performed with dental utilisation patterns as main outcome and socio-demographic data, care dependency and oral status as covariates. Statistical analysis was performed using chi-square tests, with effect sizes calculated using Cramér's V. Results: Data from 911,159 older adults were analysed. Between 2020 and 2022, preventive care was regularly received by 36.8% of the participants, 37.0% had no contact with an oral health professional and 21.9% only received curative care. Lower utilisation of preventive care was observed in the following groups: the oldest-old (Cramér's V = 0.136), individuals having an increased reimbursement (Cramér's V = 0.171), residents of long-term care facilities (Cramér's V = 0.090), recipients of domiciliary nursing care (Cramér's V = 0.121), and edentulous older adults (Cramér's V = 0.362). Conclusion: A significant proportion of older adults did not attend a dentist or only received curative care. Further research is needed to investigate whether health promotion campaigns and enhanced collaboration among health professionals can motivate these older adults to engage in preventive oral care.

Objectives: Oral and maxillofacial trauma (OMFT) presents significant public health challenges, impacting individuals' functional, aesthetic, and psychological well-being. While clinical and sociodemographic factors are well-documented, environmental influences remain underexplored. This review explores how social, physical, and familial factors are associated with the prevalence and severity of OMFT. Methods: A comprehensive literature search was performed across MEDLINE (PubMed), Scopus, Web of Science, Cochrane Library, Google Scholar, and Embase (Ovid), with no restrictions on publication date and limited to English-language articles. Study quality was assessed using the JBI tool for prevalence studies, categorising studies as high (≥70%), moderate (50-69%), or low quality (≤49%) based on the proportion of affirmative responses. Findings were synthesized using a narrative approach. Results: A total of 25 observational studies from 10 countries, published between 1982 and 2024, with sample sizes ranging from 731 to 55,858 participants, were included. The findings indicate that physical environments-particularly schools and homes-are common injury sites, while lower socioeconomic conditions of the area is associated with a higher prevalence of trauma. Additionally, supportive family environments correlate with reduced injury risk. All studies were rated as having a low risk of bias according to the JBI tool. Conclusions: By classifying environmental influences into physical, socioeconomic, and familial domains, this review highlights key areas where targeted interventions and preventive strategies can be most effective in the context of OMFT. Prevention and intervention strategies should focus on high-risk settings and vulnerable populations. Future research should further examine how social determinants mediate injury outcomes.

ObjectivesThis review aims to understand the effectiveness and/or economic benefit of non-dental health professionals providing fluoride varnish for the management of dental caries.MethodsThe population included all ages, countries and settings. Included studies were published between January 2000 and October 2024. Risk of study bias was conducted using the JBI Critical Appraisal Tools. Outcomes were reported following the narrative synthesis in systematic reviews framework.ResultsAfter screening 555 unique records, 16 papers met the study selection criteria. The majority of studies were from the United States (n = 15; 94%) and targeted children under 6 years old (n = 15; 94%). Most studies were rated as higher quality studies (n = 13; 81%). Most studies (n = 9/13) reported positive effects on dental caries related outcomes. Six studies reported positive effects on changing oral health behaviour. Three economic evaluation studies reported fluoride varnish interventions were more costly and more effective compared to 'no intervention', while cost-effectiveness was uncertain.ConclusionsFluoride varnish interventions provided by non-dental health professionals are effective, but whether they are cost-effective remains unclear. Trained non-dental professionals applying fluoride varnish can play a critical role in dental caries prevention.