Community dental health最新文献

This research aimed to explore factors associated with the satisfaction of children and adolescents with dental services, comparing two satisfaction measurement instruments: a single question and a bidimensional questionnaire. This cross-sectional study included all students (n = 325) aged 9 years or older in a small town in Brazil, who were invited to complete a self-reported questionnaire. The satisfaction with the service used was regressed on age, sex, family income, type of service (public or private), and waiting times. Ordered logistic regression estimated odds ratio (OR). Among the evaluated students, 63%-73% were satisfied with their most recent dental visit. In both the single-question instrument and the dentist dimension of the bidimensional questionnaire, using private dental services was associated with greater satisfaction (OR = 2.24; 95% CI: 1.26-4.02 and OR = 1.79; 95% CI: 1.01-3.19). Lower satisfaction was reported by those who experienced prolonged waiting times (no/yes) (single question: OR = 0.43; 95% CI: 0.24-0.75; dentist dimension: OR = 0.29; 95% CI: 0.17-0.51; ambiance dimension: OR = 0.33; 95% CI: 0.18-0.60). This work showed consistency between the questionnaires in most assessed aspects. While even a short instrument offers essential information about patient satisfaction, the bidimensional tool excels in identifying areas for improvement. The results underscore the need to optimize work processes to reduce waiting times, address issues related to the professional-patient relationship, and enhance treatment effectiveness, particularly in public settings.

Objectives: (1) To assess and develop international expert consensus on the evidence for fluoride-based interventions in Early-year-Education settings (EyE-settings; kindergartens/nursery and primary schools) for reducing Early Childhood Caries (ECC) and (2) to synthesise clear programme-level recommendations to prevent ECC in this setting. Basic research design: Systematic overview of systematic reviews, trials, and observational studies to identify and appraise the available evidence on the effectiveness and cost-effectiveness of fluoride-based interventions in EyE-settings. This was followed by a three-stage modified Delphi exercise. Participants: Delphi panel of 21 experts. Main outcomemeasures: Delphi round 1 online survey: opinions on fluoride-based interventions' safety, effectiveness and feasibility; Delphi round 2, an iterative survey: group opinions and gather feedback on review findings. Consensus developed via in-depth, recorded group discussions during an online workshop. Results: There was high-quality evidence and consensus that supervised toothbrushing in EyE-settings is safe and cost-effective, shows greater benefit to disadvantaged children, and is feasible in high and low/middle-income countries. There was more moderate support for the effectiveness and cost-effectiveness of fluoride varnish application in EyE-settings (especially where supervised toothbrushing with fluoridated toothpaste is in place). It was agreed that policy-makers should prioritise at-risk groups where resources are limited. Conclusion: Supervised toothbrushing with fluoridated toothpaste is the most effective, cost-effective, feasible and safest mechanism of caries prevention for children in EyE-settings. Universal coverage of toothbrushing in EyE-settings is preferred but targeting to need is indicated where resources are limited.

This study investigated the association between oral health examinations and oral health problems among Korean adults, and whether health information literacy mediates this relationship. A cross-sectional analysis using semi-structured interviews was conducted with 5,645 adults aged 19 years and older from the 2023 Korea National Health and Nutrition Examination Survey (KNHANES), which newly included a standardized measure of health literacy. Oral health problems (difficulties with chewing and speaking) and health literacy (10-item self-reported scale) were assessed. Mediation was tested using the Sobel test and PROCESS macro Model 4.Individuals who received oral examinations had significantly higher health information literacy and fewer oral health problems (p < 0.001). Mediation analysis revealed that health information literacy partially mediated this association. In the adjusted model, oral examination was significantly associated with higher health information literacy (β = 0.730, p < .001) and lower oral health problems (β = -0.119, p = 0.011). Health literacy was also significantly associated with oral health problems (β = -0.041, p < .001), confirming the mediation effect. The indirect effect was -0.030 (bootLLCI = -0.044, bootULCI = -0.018). These findings indicate that health information literacy partially mediates the relationship between oral examinations and oral health problems. Promoting preventive dental care and improving health information literacy may help reduce oral health disparities and enhance overall health outcomes.

Objective: To describe the existing evidence regarding the training, scope of practice (SOP) and distribution of oral health practitioners (OHPs) in Australia.

Methods: A scoping review was conducted using a reflexive thematic analysis to capture the education and training, workforce characteristics and SOP of Australian OHPs. The literature on the OHP workforce published in peer-reviewed journals as well as in grey literature was included in the scoping review from a range of databases including PubMed, CINAHL, Embase, Web of Science, ABI/INFORM, Analysis & Policy Observatory (APO), Informit, Libraries Australia. Included papers were those published in English only that detailed descriptors of clinical skill sets; practitioner education and training; and practitioner characteristics such as gender, age, practice location, workplace type (e.g., public, private, academia), full-time equivalency, remuneration, and workforce retention. Excluded were studies not published in English, focusing on practitioners outside Australia, non-key outcomes, and publications prior to 1^st July 2010 or after 30^th June 2024.

Results: The training of OHPs in Australia has changed for each of the divisions moving from 2-year diplomas to 3-year bachelors degrees. The OHP workforce was found to possess a range of variation in age, gender, and principal practice settings across the divisions. SOP was not consistently described or measured in the literature for OHPs.

Conclusions: The training pathways and SOP for OHPs in Australia have evolved over time, reflecting changes in educational standards and workforce needs. Geographic and regulatory factors were identified to influence SOP for OHPs. However, there is a lack of consistent measurement and description of SOP in the literature, highlighting the need for further research. Future studies should focus on the service provision and employment characteristics of DHs, DTs, and OHTs to identify potential gaps in care.

Genome-Wide Association Studies (GWAS) are the primary method used to investigate the effects of common genetic variants on health and disease and are increasingly used as an arena for applied epidemiological methods. There are now a growing number of applications of GWAS in oral health research, yielding exciting findings and holding great potential for future discoveries. While exciting, the GWAS approach has inherent limitations, and the success of these experiments depends on achieving adequate statistical power. In the context of dental diseases, where multiple genetic variants have small effects, very large samples are needed to unlock the full potential of GWAS. This article discusses the motivation for undertaking these studies, introduces the GWAS method, and highlights the potential of GWAS to help unravel the complex factors influencing oral health and diseases. Alongside the promises of GWAS, this article also summarizes the key challenges that need to be addressed for this method to be deployed usefully and suggests criteria to consider during the appraisal of a GWAS paper.

Background: Children with special needs face restrictions in dental hygiene due to disabilities. Dental education and preventive measures can significantly improve oral health among children with special needs. This study aims to assess the oral health status of children with Cerebral Palsy, Autism and Down Syndrome and to evaluate the effectiveness of the interventional programs on oral health status in Karnataka, India.

Methods: A quantitative, interventional study with a repeated measures design was conducted among 135 children diagnosed with Cerebral Palsy, Autism, and Down Syndrome. Data were gathered using a Demographic Proforma, the WHO Oral Health Status Questionnaire and WHO Oral Health Assessment Form (2013). The intervention included weekly sessions over 3 months, featuring supervised tooth brushing training, individualised dental counselling for caregivers, interactive educational modules, and distribution of a Pictorial Information Manual in local languages. Data were analysed using SPSS Version 29.0, with a significance level set at p < 0.05.

Results: The study consisting 135 children, oral health status scores as evidenced by statistically significant changes (p < 0.001) indicating improvement in dental health. The Oral health of children shows substantial changes, which were statistically significant (p < 0.001), confirming the positive impact of the intervention.

Conclusions: The study interventions were enriching for caregivers with sufficient information and skill on dental care. The development of the Pictorial Information Manual is a unique manual enriched with of attractive pictures and relevant information on oral health, which was made copyrighted and distributed to caregivers.

Background: Dysphagia, or swallowing difficulty, is common among older adults and can pose risks during dental treatments, including aspiration and accidental ingestion. While dysphagia prevalence is well-studied in healthcare and community settings, data from clinical dental settings remain limited. This study aimed to determine the prevalence of swallowing difficulties in older adults visiting a dental clinic.

Methods: A cross-sectional survey was conducted at Nong Khai General Hospital, Thailand, from November 2023 to April 2024, using completed demographic questionnaires and the Thai version of the Eating Assessment Tool (EAT-10). Swallowing difficulties were defined as an EAT-10 score ≥3. Associations with demographic and clinical factors were examined using Chi-square tests, Fisher's exact tests, and logistic regression.

Results: Among 327 participants (mean age 69.2 ± 6.6 years; 52.3% female), 12.5% were screened as positive for swallowing difficulties. Significant predictors included female sex, dietary texture modification, and underlying conditions such as stroke and neuromuscular disorders. Self-reported choking or coughing during dental treatment were also associated with increased risk.

Conclusions: This is the first study to investigate swallowing difficulties in older adults within a dental clinic setting. The findings underscore the need for dental professionals to screen for dysphagia and consider appropriate precautions to reduce procedural complications.

Dissemination and implementation sciences provide oral health professionals with an opportunity to understand which determinants promote the adoption of evidence-based innovations and interventions. Within this dynamic field, de-implementation provides the other side of the coin, that is, finding the ways to halt or modify practices that may be harmful to patients, do not hold sufficient scientific backing, or are simply not cost-efficient; conjointly known as low-value care. Scrutinizing low-value care procedures in oral health is essential, as identifying such practices creates opportunities to replace, update, or enhance them with approaches that offer greater benefits to patients, practitioners, and healthcare systems. Effective de-implementation begins with a clear understanding of which low-value practices persist. Only then can we conceptualize strategies to overcome barriers and promote more efficient, evidence-based care within the field. Furthermore, de-implementation can serve as a way to target oral health equity, as shifting away from low value care practices can lead to the better use of human and economic resources in those places where it is needed most. This commentary serves as a conceptualization of de-implementation within oral health, as well as, an invitation for the broader community to reflect on the importance of adequately mobilizing towards the delivery of more equitable care using the vigorous elements that dissemination and implementation science offer.

Background: The interplay between oral health and chronic kidney disease (CKD) is not fully understood, but both conditions may influence each other through chronic inflammatory states. This systematic review and meta-analysis aim to investigate the association between CKD and oral health.

Methods: The review included observational studies (cross-sectional, case-control, and cohort) involving adults (≥18 years) comparing individuals with and without CKD regarding the number of missing teeth, edentulism, or the decayed, missing, and filled teeth (DMFT) index, a recognized indicator of oral health. The databases PubMed, Scopus, and Web of Science, together with references, were searched up to October 10, 2024. The results were synthesized using meta-analysis in RevMan software.

Results: Eight case-control studies from Portugal, Turkey, Japan, Brazil, and Thailand were included, with sample sizes ranging from 30 to 204 participants. CKD patients had significantly more missing teeth (mean difference +3.17; 95% CI 2.07-4.28), fewer filled teeth (mean difference -1.23; 95% CI -1.82; -0.64), and higher DMFT scores (mean difference +2.60; 95% CI 1.34; 3.86) compared to controls. No significant difference was found in the number of decayed teeth (mean difference 0.31; 95% CI -0.15; 0.76). The methodological quality of studies ranged from 4 to 7 stars.

Conclusions: Patients with CKD, especially those on hemodialysis, experience more tooth loss and higher DMFT scores, highlighting a gap in oral health care within dialysis units. Although the findings highlight the importance of addressing oral health in CKD patients, further studies are needed in developed countries to better understand the interplay between both conditions.