Community dental health最新文献

Objective: We assessed the prevalence of moderate and severe periodontitis and its association with social determinants of health in rural and urban population from the State of Chiapas, in Southern Mexico.

Material and methods: A cross-sectional population-based study was conducted in 2013 comprising people 20 years and older. The determinants were categorized as proximal (age, sex, indigenous origin, diabetes, smoking, diet), intermediate (level of schooling, occupation, medical and dental care), and structural (type of institution of health care provision, residence area). Periodontal status was assessed using the Periodontal Screening and Recording (PSR) Index.

Results: In total, 467 persons (72.4% women; mean age 43.0 years [s.d 14.7]) participated. Of them, 76.5% lived in rural areas and 56.7% were of indigenous origin. Participants with moderate and severe periodontitis had a significantly lower toothbrushing frequency (44.1% and 44.8%, respectively), and poorer oral hygiene (90% and 90.3%, respectively) compared with people without periodontitis (29.4% for toothbrushing frequency and 74.5% for oral hygiene). Moderate periodontitis was associated with poor oral hygiene (OR=2.63) and no schooling (OR=1.86). Severe periodontitis was associated with age (OR=1.05), poor oral hygiene (OR=3.99), no schooling (OR=2.08), and the interaction term of rural area and indigenous origin (RM=5.23).

Conclusions: Social determinants of health play an important role in the development of periodontitis. Preventive oral health programs should thus focus on the specific social, economic, and geographical context of the population.

Objective: Gain insights into how patients with periodontitis perceive the disease and its treatment, thus identifying their potential needs.

Methods: Descriptive qualitative research among 19 patients with periodontitis purposefully sampled for semi-structured interviews. Thematic analysis of the interview data used NVivo 11.0.

Results: The data could be summarized in five themes: 1) restricted physiological function of the oral cavity; 2) psychological frustration; 3) impact on social life; 4) focus on patient comfort; 5) accessibility, convenience, and science of oral health services.

Conclusions: Periodontitis can affect biopsychosocial aspects of patients lives. Some needs remain to be met or improved during treatment. As the paradigm shifts, dental practitioners should also focus on their professional roles and take measures to improve patients' experiences.

Dementia is a major public health challenge, and its impact on oral health and oral healthcare delivery can be drastic. More people are living with dementia, and the proportion of people living longer is growing. This review summarises dementia and its impact on oral health, dental care access and dental services. People living with dementia (PLwD) face a substantial risk of developing oral diseases and experiencing orofacial pain. PLwD face many barriers to dental care. When care is accessed, there can be practical and ethical challenges in receiving person-centred treatment. PLwD with the most complex needs are increasing in number and more are likely to require specialist care. Recommendations are made regarding preventative care, dental care access, domiciliary care, workforce planning and treatment decision-making. Those commissioning and facilitating dental care for PLwD should ensure that suitably trained staff are available in accessible services to plan the necessary care and provide active treatment where appropriate. It is almost inevitable that more care will need to be commissioned to support this growing patient group. This need should be anticipated and planned for at a population and policy level to reduce the detrimental impacts of oral diseases and orofacial pain for PLwD.

Background: A home visiting programme was offered to first-time parents in the south of Sweden to reduce health inequalities among young children and support parents. The programme involved a collaboration between child healthcare nurses and midwives, social workers, and dental hygienists/dental nurses. It is unusual for dental professionals to participate in such programmes.

Objective: To describe the experiences of collaboration between child healthcare nurses and dental professionals and their views on the programme from a dental perspective.

Basic research design: Qualitative semi-structured interview study with content analysis.

Participants: Four child healthcare nurses, three dental hygienists, and two dental nurses.

Results: Analysis identified five themes: contribution of knowledge, reinforced oral health advice, family-based oral health advice, financial considerations, and future role of the dental care.

Conclusions: Participants stressed the importance of dental professionals' knowledge, the need for child healthcare nurses and dental professional to conduct home visits together to deliver family-based and reinforced dental advice. They suggested a follow-up visit and the participation of the public dental service before a private dental care provider since most children will visit a public dentist later. The programme was perceived as worth the costs, but for the best utility, the resources should primarily be for non-native parents. Further research should focus on the effect of the home visiting programme on the children's oral health.

Background: Despite contributing to a reduction in dental caries, improper use of fluoridated toothpaste could add to the burden of dental fluorosis in children.

Aim: To assess the association between tooth-brushing practices such as the type and amount of toothpaste used, frequency of tooth brushing, parental assistance in tooth brushing, timing of tooth brushing and dental fluorosis in school children in Kurunegala district, an endemic area for dental fluorosis in Sri Lanka.

Methods: For this case-control study, a sex-matched sample of 15-year-old school children attending government schools in Kurunegala district and who were lifetime residents of the district was selected. Dental fluorosis was measured using the Thylstrup and Ferjeskov (TF) Index. Those children with a TF⟩1 were considered as cases and those with a TF score of 0 or 1 served as controls. An interview of parents/caregivers of the participants was used to assess risk factors for dental fluorosis. The fluoride concentration in drinking water was measured using spectrophotometry. Data analysis used chi-square tests and conditional logistic regression.

Results: Tooth brushing ≥ twice/day, brushing after breakfast and parent/care giver brushing the child's teeth reduced the likelihood of developing fluorosis.

Conclusion: Use of fluoridated toothpaste adhering to the recommended guidelines could prevent dental fluorosis in children in this endemic area.

Objectives: Literature on the effectiveness of theory-based oral health education on the oral hygiene of children is limited. We aimed to determine the effectiveness of an health behaviour theory-based school oral health education intervention on 1) oral hygiene and 2) oral health-related knowledge, attitude and practices among 6-12-year-old children in Kerala, India.

Methods: Cluster randomized controlled trial. Sixteen class divisions (clusters) were randomized into intervention and control groups of 225 and 228 children respectively. Primary and secondary outcomes were plaque score as measured using the simplified oral hygiene index (OHI-S) and oral health-related knowledge, attitude and practices respectively. The intervention group received structured oral health education classes for three months and materials including pamphlets. Children in the control group were not given the classes or materials.

Results: Post-intervention OHI-S scores in the intervention group and control groups were 1.65 and 2.17 respectively (difference = -0.52, 95%CI -0.86, -0.18). All the secondary outcomes improved in the intervention group compared to the control group.

Conclusions: The intervention improved the oral hygiene status, oral health-related knowledge, attitude and practices of the children. Longer term follow-up and economic appraisal are needed to help policymakers plan and develop OHEI based on health behaviour theories.

Oral health is finally on the global agenda. The World Health Organisation Global Oral Health Action Plan (OHAP) 2023-2030 (WHO, 2022a) has been completed following a public consultation which took place during August and September 2022. As oral diseases are the most prevalent non-communicable diseases; it is good to see that the OHAP will co-exist alongside the Global Action Plan for the Prevention and Control of Non-communicable Diseases 2013-2030. This editorial summarises the OHAP and highlights the opportunities and challenges discussed during the September 2022 EADPH congress, held co-jointly with the Council of the European Chief Dental Officers (CECDO).

Objectives: To determine the relationship between diabetes and dental caries among US adults participating in the 2011-2018 National Health and Nutrition Examination Survey (NHANES).

Basic research design: The NHANES was a cross-sectional study including clinical assessments, laboratory analysis, and interviews. The sample included 16,635 participants aged 20 years and older that represent 187,596,215 individuals in the US in a probability weighted sample. Outcome variables included overall total caries score (or number of decayed, missing, filled permanent teeth - DMFT index) and the presence of caries. Bivariate analysis, Poisson regression for total caries score, logistic regression for the presence of caries were used for analysis.

Results: Controlling for covariates, multiple Poisson regression revealed that total DMFT scores were associated with diabetes status (adjusted relative risk ratio (RR)controlled diabetes = 1.13, RRuncontrolled diabetes = 1.18; p⟨0.001), no college education, female sex, white race, elderly (≥ 65 years), cigarette smoking, obesity, yearly dental visits, seeing a dentist only for treatment. Similarly, multiple logistic regression shows that the odds of adults with diabetes having dental caries were higher than among those without diabetes (adjusted risk ratio (OR)controlled diabetes = 1.84, ORuncontrolled diabetes = 1.87; p⟨0.05).

Conclusions: Diabetes was associated with a higher caries score and a greater risk for dental caries among US adults.

Background: Cognitive-behavioural interventions may be important for the prevention and treatment of oral diseases. One cognitive factor that has generated considerable interest as a possible mediator is self-efficacy.

Methods: One hundred patients diagnosed with pulpal or periapical pathology that required endodontic therapy were treated. Data were collected at baseline in the waiting room before therapy and then during treatment.

Results: Positive correlations were found between dental fear, pain anticipation and dental avoidance (p⟨0.001). The correlation between dental fear and pain anticipation showed the largest effect sizes. Healthy participants had higher scores in self-efficacy (Mean=32.55; SD=7.15) than those with systemic diseases (n=15; Mean=29.33; SD=4.76, p=0.04). Participants who not taking medication before treatment had lower scores for pain anticipation (Mean=3.63; SD=2.85) than those taking medication. The contribution of pain anticipation to dental avoidance varied at different values of self-efficacy. The indirect effect of dental fear on dental avoidance via dental anxiety was significant in individuals with higher self-efficacy.

Conclusions: Self-efficacy had an essential moderation role between pain anticipation and dental avoidance during endodontic treatment.

Background: Good evidence is available that socioeconomic status (SES) positively correlates with access to orthodontic treatment. There is much less literature, however, on whether socioeconomic inequities affect patients once they are in treatment. SES predicts of treatment outcomes across many health disciplines.

Objectives: To determine whether a similar relationship exists with orthodontic treatment and identify, evaluate and summarise the available evidence.

Methods: Systematic review with searches of multiple databases to identify studies of children and adolescents who underwent orthodontic treatment, in which parental SES was the variable of interest, and treatment duration, treatment outcome or adherence of patients to the treatment plan were the measured outcomes of interest. Quality appraisal used CASP checklists. Data were synthesised narratively and in tables and graphs.

Results: Seventeen studies were included in the final review. The high level of heterogeneity between studies made it hard to draw conclusions from the data as a whole. Many studies also had several quality issues. Some evidence suggested an association between low SES and discontinuation of orthodontic treatment, and between the receipt of state subsidised care and poor appointment attendance.

Conclusion: No strong associations can be concluded. There is a need for more high-quality studies, perhaps incorporating access and uptake variables, to capture how different socioeconomic groups interact with orthodontic care.