Journal of public health dentistry最新文献_第7页

Effectiveness of silver diamine fluoride in arresting dental caries in residents living in nursing homes: A randomized controlled trial 氟化二胺银在疗养院居民中预防龋齿的效果：一项随机对照试验。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-06-12 DOI: 10.1111/jphd.12578

Hala Shakir BDS, MPH, DPH, Rochisha Singh Marwaha BDS, MPH, Pankil Shah MD, MSPH, Suman Challa BDS, MSPH

Objective

The primary objective of this randomized controlled trial was to determine the effectiveness of a single application of 38% silver diamine fluoride (SDF) solution in arresting and controlling active accessible caries compared to no treatment among adults aged 18 years and older residing in nursing homes or long-term care facilities. Many patients cannot receive standard-of-care dental treatment due to their medical conditions and inability to undergo anesthesia. All teeth in the control group will be treated with SDF at the conclusion of the study.

Methods

This study enrolled 39 adults aged 18 or older with 188 active lesions from nine San Antonio, Texas, nursing home facilities. Teeth were randomized and divided into two treatment and control groups. Each treatment tooth was paired with a control in the same oral cavity. Accessible carious lesions were treated with a single application of 38% SDF solution. Teeth were re-evaluated at 3 weeks where control groups also received SDF treatment.

Results

The treatment group demonstrated caries arrest in 77 (81.9%) teeth compared to 0 in the control group (0%). Notably, within the treatment group 14 of the 17 teeth with no caries arrest were posterior teeth (82.4%).

Conclusions

Our results suggest that a single application of 38% SDF solution is an effective measure for arresting and controlling caries compared to standard oral hygiene maintenance. Our research team recommends the regular use of a single application of SDF solution in marginalized populations given the possible public health, oral health, social, and economic benefits.

目的：本随机对照试验的主要目的是确定在18岁成年人中，与不治疗相比，单次应用38%氟化二胺银溶液在阻止和控制活动性可及龋齿方面的有效性居住在疗养院或长期护理机构的岁及以上老人。许多患者由于身体状况和无法进行麻醉而无法接受标准的牙科护理。对照组的所有牙齿将在研究结束时接受SDF治疗。方法：这项研究招募了39名18岁或以上的成年人，他们来自德克萨斯州圣安东尼奥市的9家疗养院，有188处活动性病变。将牙齿随机分为治疗组和对照组。每个治疗牙齿与同一口腔中的对照牙齿配对。可触及的龋性病变用38%SDF溶液进行治疗。3岁时对牙齿进行了重新评估其中对照组也接受SDF治疗。结果：治疗组77颗（81.9%）牙齿龋齿停止，而对照组为0颗（0%）。值得注意的是，在治疗组中，17颗没有龋齿阻止的牙齿中有14颗是后牙（82.4%）。结论：我们的研究结果表明，与标准口腔卫生维护相比，单次使用38%SDF溶液是阻止和控制龋齿的有效措施。鉴于可能带来的公共卫生、口腔健康、社会和经济效益，我们的研究团队建议在边缘化人群中定期使用SDF解决方案。

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引用次数: 1

Social support and oral health among working-age and older adults in the United States 美国工作年龄和老年人的社会支持和口腔健康。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-06-11 DOI: 10.1111/jphd.12573

Nadia Laniado DDS, MPH, MS, Megan Cloidt DDS, MPH, Parth Shah DDS, MPH

Objectives

The purpose of this study was to examine the association of social support with untreated dental caries and severe tooth loss in adults in the United States.

Methods

This cross-sectional study was conducted by analyzing data obtained from 5,447 individuals, 40 years of age and older, in the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2008 who had both a complete dental examination and social support index measures. Sample characteristics, overall and by social support level, were examined through descriptive statistical analyses. Logistic regression analyses were performed to estimate the association of social support with untreated dental caries and severe tooth loss.

Results

In this nationally representative sample (mean age 56.5 years) the prevalence of low social support was 27.5%. The prevalence of individuals with moderate-to-high social support increased with higher levels of educational attainment and income level. In fully adjusted models, relative to those who had moderate-high social support levels, individuals with low social support had 1.49 higher odds of untreated dental caries (95% CI, 1.17-1.90, p=0.002) and 1.23 higher odds of severe tooth loss (95% CI, 1.05-1.44, p=0.011).

Conclusions

Higher odds of untreated dental caries and severe tooth loss were found among U.S. adults with low levels of social support compared to those with moderate-to-high levels of social support. Additional studies are warranted to provide a more current perspective on the impact of social support on oral health so that programs may be developed and tailored to reach these populations.

目的：本研究的目的是检验社会支持与美国成年人未经治疗的龋齿和严重牙齿缺失的关系 2005年至2008年，在国家健康和营养检查调查（NHANES）中，年龄在岁及以上的人同时进行了完整的牙科检查和社会支持指数测量。通过描述性统计分析，对样本的总体特征和社会支持水平进行了检验。进行Logistic回归分析，以评估社会支持与未经治疗的龋齿和严重牙齿缺失的关系。结果：在这个具有全国代表性的样本中（平均年龄56.5岁）年）低社会支持的患病率为27.5%。具有中等至高社会支持的个体的患病率随着教育程度和收入水平的提高而增加。在完全调整的模型中，相对于那些具有中等高社会支持水平的人，社会支持水平低的人患未经治疗的龋齿的几率高1.49（95%CI，1.17-1.90，p=0.002），患严重牙齿缺失的几率高1.23（95%CI，1.05-1.44，p=0.011）。有必要进行更多的研究，以提供关于社会支持对口腔健康影响的最新观点，从而制定和调整计划，以惠及这些人群。

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引用次数: 0

Stressful life events, oral health, and barriers to dental care during pregnancy 压力重重的生活事件、口腔健康以及怀孕期间牙科护理的障碍。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-06-09 DOI: 10.1111/jphd.12576

Alexander Testa PhD, Dylan B. Jackson PhD, Lisa Simon MD, DMD, Kyle T. Ganson PhD, MSW, Jason M. Nagata MD, MSc

Objectives

Poor oral health during pregnancy poses risks to maternal and infant well-being. However, limited research has documented how proximate stressful life events (SLEs) during the prenatal period are associated with oral health and patterns of dental care utilization.

Methods

Data come from 13 states that included questions on SLEs, oral health, and dental care utilization in the Pregnancy Risk Assessment Monitoring System for the years 2016–2020 (n = 48,658). Multiple logistic regression analyses were used to assess the association between levels of SLE (0, 1–2, 3–5, or 6+) and a range of (1) oral health experiences and (2) barriers to dental care during pregnancy while controlling for socio-demographic and pregnancy-related characteristics.

Results

Women with more SLEs in the 12 months before birth—especially six or more—reported worse oral health experiences, including not having dental insurance, not having a dental cleaning, not knowing the importance of caring for teeth and gums, needing to see a dentist for a problem, going to see a dentist for a problem, and unmet dental care needs. Higher levels of SLEs were also associated with elevated odds of reporting barriers to dental care.

Conclusions

SLEs are an essential but often understudied risk factor for poor oral health, unmet dental care needs, and barriers to dental care services. Future research is needed to understand better the mechanisms linking SLEs and oral health.

目的：孕期口腔健康状况不佳对母婴健康构成威胁。然而，有限的研究记录了产前期间的近期压力生活事件（SLE）与口腔健康和牙科护理利用模式之间的关系。方法：数据来自13个州，包括2016-2020年妊娠风险评估监测系统中关于睡眠呼吸暂停、口腔健康和牙科护理利用的问题（n = 48658）。使用多元逻辑回归分析来评估SLE水平（0、1-2、3-5或6+）与一系列（1）口腔健康经历和（2）妊娠期牙科护理障碍之间的关系，同时控制社会人口统计学和妊娠相关特征。结果：12岁中SLE较多的女性出生前几个月，尤其是六个月或六个月以上，报告了更糟糕的口腔健康经历，包括没有牙科保险，没有进行牙科清洁，不知道照顾牙齿和牙龈的重要性，需要看牙医治疗问题，去看牙医治疗问题，以及未满足的牙科护理需求。SLEs水平越高，报告牙科护理障碍的几率也越高。结论：SLEs是口腔健康状况不佳、牙科护理需求未得到满足和牙科护理服务障碍的一个重要但研究不足的风险因素。未来的研究需要更好地了解SLEs与口腔健康之间的联系机制。

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引用次数: 1

Impact of the COVID-19 pandemic on pediatric Medicaid dental claims in Arizona 新冠肺炎大流行对亚利桑那州儿科医疗补助牙科索赔的影响。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-04-12 DOI: 10.1111/jphd.12572

Katherine Mommaerts PhD, MSW, Indrakshi Roy PhD, Denise Muesch Helm RDH, MS, EdD

Objectives

To examine the role COVID-19 had on access to dental services among children in Arizona by comparing paid pediatric dental claims made before and during the pandemic.

Methods

In a retrospective descriptive study, we examined Medicaid paid claims for dental services among pediatric patients from March through December 2019 and during the outbreak in 2020. Using dental claims data obtained from the Centers for Health Information and Research at Arizona State University (ASU), we analyzed Medicaid (Arizona Health Care Cost Containment System [AHCCCS]) reimbursed dental services.

Results

During the COVID-19 pandemic, paid preventive dental claims for children aged birth to 21 years decreased in 2020 compared to the same time period in 2019. Pediatric patients in Arizona utilized fewer dental services and had less access to credentialed Medicaid dental providers during the pandemic. Further, rural counties had statistically significant fewer preventive, minor restorative, major restorative, and endodontic claims compared to urban counties. Arizona rural counties also had fewer providers who were paid $10,000 or more per year during 2020 than in 2019.

Conclusions

COVID-19 has had a detrimental impact on pediatric dental service utilization. While dental services were provided during the COVID-19 pandemic, preventive and restorative dental claims dropped for rural Arizona children aged birth to 21 years. This reveals potential negative impacts on oral health. Further research should examine the direct and indirect impact the COVID-19 pandemic has had on dental service utilization and oral health for the general pediatric population.

目的：通过比较大流行前和大流行期间的付费儿科牙科索赔，研究新冠肺炎对亚利桑那州儿童获得牙科服务的作用。方法：在一项回顾性描述性研究中，我们调查了2019年3月至12月以及2020年疫情期间儿科患者的医疗补助支付牙科服务索赔。使用从亚利桑那州立大学健康信息与研究中心获得的牙科索赔数据，我们分析了Medicaid（亚利桑那州医疗保健成本控制系统[AHCCCS]）报销的牙科服务。结果：在新冠肺炎大流行期间，与2019年同期相比，2020年出生至21岁儿童的付费预防性牙科索赔有所下降。在疫情期间，亚利桑那州的儿科患者使用的牙科服务较少，获得有资格的医疗补助牙科服务的机会也较少。此外，与城市县相比，农村县的预防性、次要恢复性、主要恢复性和牙髓病索赔在统计上显著减少。与2019年相比，亚利桑那州农村县2020年每年获得10000美元或以上报酬的提供者更少。结论：新冠肺炎对儿科牙科服务的利用产生了不利影响。虽然在新冠肺炎大流行期间提供了牙科服务，但亚利桑那州农村出生至21岁儿童的预防性和恢复性牙科索赔有所下降。这揭示了对口腔健康的潜在负面影响。进一步的研究应检查新冠肺炎大流行对普通儿科人群牙科服务利用和口腔健康的直接和间接影响。

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引用次数: 0

A certain protective effect of vitamin D against dental caries in US children and youth: A cross-sectional study 维生素D对美国儿童和青少年龋齿的一定保护作用：一项横断面研究。

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-04-02 DOI: 10.1111/jphd.12571

Rui Pu MD, Mengdie Fu MSc, Na Li MSc, Zhiwei Jiang PhD

Objectives

Recent studies reported that evidence of the association between caries and vitamin D was inconclusive. We investigated the relationship between dental caries and serum vitamin D levels in US children and youth aged 5–19 years through the National Health and Nutrition Examination Survey (NHANES). The purpose of this study was to analyze the relations between serum 25-hydroxyvitamin-D [25(OH)D] level and dental caries in children and youth.

Methods

Data were collected from the NHANES dataset performed in 2011–2018. A total of 8896 subjects completed the examination was enrolled. Serum 25(OH)D was determined by high-performance liquid chromatography–tandem mass spectrometry (HPLC–MS/MS). All teeth examined and caries assessment was conducted by licensed dentists. Statistical analyses included complex samples Chi-square tests, analysis of variance, logistic regression analyses, and restricted cubic splines conducted by R software.

Results

There was a nonlinear relation between dental caries and age in youth. Vitamin D showed a relatively stable protective effect when the concentration exceeded 60 nmol/L. There was a dose–effect relation that a 10 nmol/L increase in serum 25(OH)D concentrations was associated with a decreased caries odd by 10%.

Conclusions

Our findings suggested that vitamin D sufficiency may be a protective factor for dental caries.

目的：最近的研究报告称，龋齿和维生素D之间的联系没有定论。我们调查了美国5至19岁儿童和青少年的龋齿与血清维生素D水平的关系国家健康和营养检查调查（NHANES）。本研究旨在分析儿童和青少年血清25-羟基维生素D[25（OH）D]水平与龋齿的关系。方法：数据收集自2011-2018年进行的NHANES数据集。共有8896名受试者完成了考试。采用高效液相色谱-串联质谱法（HPLC-MS/MS）测定血清25（OH）D。所有的牙齿检查和龋齿评估都是由有执照的牙医进行的。统计分析包括复样本卡方检验、方差分析、逻辑回归分析和R软件进行的限制三次样条。结果：青少年龋齿与年龄呈非线性关系。当浓度超过60时，维生素D显示出相对稳定的保护作用 nmol/L。10 nmol/L血清25（OH）D浓度的增加与龋齿奇数减少10%有关。结论：我们的研究结果表明，维生素D的充足可能是龋齿的一个保护因素。

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引用次数: 1

Building effective public dental care programs: The critical role of implementation evaluation 建立有效的公共牙科保健计划:实施评估的关键作用

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-03-23 DOI: 10.1111/jphd.12569

Anna Durbin PhD, Ariel Root MSc, Herenia P. Lawrence DDS, MSc, PhD, Sara Werb DDS, Stephen Abrams DDS, Janet Durbin PhD

There are significant income-related inequities in oral health and access to oral health care. Public dental programs generally aim to increase access to oral health care for individuals with financial barriers through government payments for appointments. Low engagement from both oral health care providers and intended patients are common challenges in delivery of public dental programs, and are impediments to program impact and outcomes. Still, these programs rarely address the systemic issues that affect the experiences of intended users. This accentuates the importance of monitoring of program delivery to refine or adapt programs to better meet needs of service providers and users. As such, specifying program goals and developing a related monitoring strategy are critical as Canada begins to implement a national public dental program. Drawing on an example of a pediatric public dental program for children from low-income families or with severe disabilities in Ontario, Canada, this article illustrates how an implementation and evaluation framework could be applied to measure implementation and impact of the national program. The RE-AIM framework measures performance across five domains: (1) Reach, (2) Effectiveness (patient level), (3) Adoption, (4) Implementation (provider, setting, and policy levels), and (5) Maintenance (all levels). Given the disparities in oral disease and access to oral health care, the results can be used most effectively to adapt programs if relevant stakeholders participate in reviewing data, investigating quality gaps, and developing improvement strategies.

在口腔健康和获得口腔保健方面存在着与收入有关的重大不平等。公共牙科计划通常旨在通过政府支付预约费用来增加经济困难的个人获得口腔保健的机会。口腔卫生保健提供者和预期患者的低参与度是公共牙科项目实施中常见的挑战，也是项目影响和结果的障碍。然而，这些程序很少解决影响目标用户体验的系统性问题。这强调了监测项目交付的重要性，以改进或调整项目，更好地满足服务提供者和用户的需求。因此，当加拿大开始实施国家公共牙科计划时，明确计划目标和制定相关的监测策略至关重要。本文以加拿大安大略省针对低收入家庭儿童或严重残疾儿童的儿科公共牙科项目为例，说明了如何应用实施和评估框架来衡量国家项目的实施和影响。RE-AIM框架跨五个领域衡量绩效:(1)覆盖范围，(2)有效性(患者层面)，(3)采用，(4)实施(提供者、设置和政策层面)，以及(5)维护(所有层面)。考虑到口腔疾病和获得口腔卫生保健的差异，如果相关利益相关者参与审查数据、调查质量差距和制定改进策略，研究结果可以最有效地用于调整规划。

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引用次数: 0

Association between oral health knowledge, perceived oral health related quality of life, perceived oral health status and emergency department and/or urgent care visit: Results from the multi-site oral health literacy study 口腔健康知识、感知口腔健康相关生活质量、感知口腔健康状况与急诊科和/或紧急护理就诊之间的关系:来自多站点口腔健康素养研究的结果

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-03-20 DOI: 10.1111/jphd.12567

Folasayo Adunola DDS, MPH, Mark D. Macek DDS, DrPH, Kathryn Atchison DDS, MPH, Aderonke Akinkugbe BDS, MPH, PHD

Objectives

To assess the link between oral health knowledge (OHK), self-perceived oral health, and emergency room (ER)/urgent care utilization for a dental problem.

Methods

Data were analyzed from a convenience sample of 790 adult participants who presented to two US dental schools and completed an interviewer-administered survey. Key independent variables were OHK assessed with the Comprehensive Measure of Oral Health Knowledge (CMOHK) instrument, self-perceived oral health status and quality of life determined using the General Oral Health Assessment Index (GOHAI) scores. The dependent variable was ER and/or urgent care utilization for a dental problem. Select sociodemographic variables such as age and gender were adjusted for in logistic regression models using SAS.

Results

15.7% of the participants had ever visited an ER and/or urgent care for a dental problem. CMOHK scores were not significantly associated with visits to the ER and/or urgent care. In adjusted analysis, participants with unfavorable GOHAI scores were about three times as likely to have had an ER and/or urgent care visit (OR = 2.60, 95% CI: 1.66–4.09). Similarly, participants who were unsatisfied with their oral health were about twice as likely to have had an ER and/or urgent care visit (OR = 1.91, 95% CI: 1.21–3.00) as compared to those satisfied with their oral health status.

Conclusion

Individuals unsatisfied with their oral health and those with unfavorable perceived oral health related quality of life could benefit from a greater awareness of dental service availability and extended hours including weekend hours at public dental clinics.

目的评估口腔健康知识(OHK)、自我感知口腔健康和急诊室/紧急护理对口腔问题的利用之间的联系。方法对790名成人参与者进行数据分析，这些参与者曾在两所美国牙科学校就读，并完成了一项访谈管理的调查。主要自变量为口腔健康知识综合测量仪(CMOHK)评估口腔健康状况，一般口腔健康评估指数(GOHAI)评分评估自我感知口腔健康状况和生活质量。因变量是急诊和/或牙科问题的紧急护理利用率。选择社会人口变量，如年龄和性别，在使用SAS的逻辑回归模型中进行调整。结果15.7%的参与者曾因牙齿问题去过急诊室和/或紧急护理。CMOHK评分与急诊室就诊和/或紧急护理无显著相关。在调整后的分析中，GOHAI评分不理想的参与者去急诊室和/或急诊就诊的可能性约为三倍(or = 2.60, 95% CI: 1.66-4.09)。同样，与对口腔健康状况满意的参与者相比，对口腔健康不满意的参与者去急诊室和/或紧急护理的可能性大约是其两倍(or = 1.91, 95% CI: 1.21-3.00)。结论对口腔健康不满意的人群和认为口腔健康与生活质量相关的人群可以通过提高公共牙科诊所牙科服务的可获得性和延长服务时间(包括周末)来获益。

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引用次数: 2

The association between adverse childhood experiences and oral health: A systematic review 儿童期不良经历与口腔健康之间的关系:一项系统综述

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-03-14 DOI: 10.1111/jphd.12564

Lina Bahanan BDS, DScD, Solafa Ayoub BDS, DScD, MSc

Objective

It is well established that adverse childhood experiences (ACEs) negatively affect health and are associated with health-risk behaviors. This study aimed to provide a systematic review of the studies that examine the relationship between ACE exposure and oral health among adults aged 18 years and older.

Methods

The following electronic databases were searched in January 2022: MEDLINE, Cochrane, Web of Science, CINAHL via EBSCOhost, ProQuest, ScienceDirect, and Google Scholar. Data were extracted independently by two reviewers. The quality of the studies was assessed using the Newcastle-Ottawa Scale.

Results

Among the 292 articles identified, four met the eligibility criteria. All included studies were cross-sectional and of satisfactory quality. The dental outcomes included: last dental visit, last dental cleaning, number of filled teeth, number of extracted teeth, and number of remaining teeth. The studies showed that exposure to ACE was negatively associated with oral health. The relationship between ACE score and oral health outcome measures was found to be directly proportional.

Conclusion

There is an association between ACE and poor oral health. Moreover, the association was proven to have a dose–response relationship. Given that the studies in the literature were cross-sectional, causality cannot be determined with certainty, therefore interpretation of the results should be cautious. Longitudinal follow-up studies are needed to understand how ACEs contribute to oral diseases later in life.

目的不良童年经历对健康有负面影响，并与健康危险行为相关。本研究旨在对18岁及以上成人ACE暴露与口腔健康之间关系的研究进行系统回顾。方法通过EBSCOhost、ProQuest、ScienceDirect和谷歌Scholar检索2022年1月的MEDLINE、Cochrane、Web of Science、CINAHL等电子数据库。数据由两位审稿人独立提取。研究的质量采用纽卡斯尔-渥太华量表进行评估。结果在292篇文献中，有4篇符合入选标准。所有纳入的研究均为横断面研究，质量令人满意。结果包括:最后一次看牙、最后一次洗牙、补牙数、拔牙数和剩余牙数。研究表明，接触ACE与口腔健康呈负相关。ACE评分与口腔健康结果测量之间的关系被发现成正比。结论ACE与口腔健康状况不佳有关。此外，该关联已被证明具有剂量-反应关系。由于文献中的研究是横断面的，不能确定因果关系，因此对结果的解释应谨慎。需要进行纵向随访研究，以了解ace对以后生活中口腔疾病的影响。

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引用次数: 1

Dental opioid prescription patterns in academic and community settings 牙科阿片类药物处方模式在学术和社区设置

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-03-11 DOI: 10.1111/jphd.12568

Douglas R. Oyler PharmD, Marcia V. Rojas-Ramirez DDS, MS, MPH, Aisaku Nakamura PhD, Dana Quesinberry JD, DrPH, Craig S. Miller DMD, MS

Objectives

Reports of interventions to improve dental opioid prescribing have come primarily from academic settings, but most opioid prescriptions are written by community dentists. This analysis compares prescription characteristics between these two groups to inform interventions to improve dental opioid prescribing in community settings.

Methods

State prescription drug monitoring program data from 2013 to 2020 were used to compare opioid prescriptions from dentists at academic institutions (PDAI) to prescriptions from dentists in non-academic settings (PDNS). Linear regression was used to assess daily morphine milligram equivalents (MME), total MME, and days' supply, adjusting for year, age, sex, and rurality.

Results

Prescriptions from dentists at the academic institution accounted for less than 2% of over 2.3 million dental opioid prescriptions analyzed. Over 80% of prescriptions in both groups were written for <50 MME per day and for ≤3 days' supply. On average, in the adjusted models, prescriptions from the academic institution were written for about 75 additional MME per prescription and nearly a full day longer duration. Compared to adults, adolescents were the only age group who received both higher daily doses and longer days' supply.

Conclusions

Prescriptions from dentists at academic institutions accounted for small percentage of opioid prescriptions, but prescription characteristics were clinically comparable between groups. Interventional targets to reduce opioid prescribing in academic institutions could be applied to community settings.

改善牙科阿片类药物处方的干预措施报告主要来自学术机构，但大多数阿片类药物处方是由社区牙医撰写的。该分析比较了这两组之间的处方特征，以告知干预措施，以改善社区环境中的牙科阿片类药物处方。方法采用2013 - 2020年国家处方药监测项目数据，比较学术机构(PDAI)和非学术机构(PDNS)牙医开具的阿片类药物处方。采用线性回归评估每日吗啡毫克当量(MME)、总MME和天数供应，并根据年份、年龄、性别和农村情况进行调整。结果该学术机构牙医的处方占分析的230多万牙科阿片类药物处方的不到2%。两组中超过80%的处方为每天50 MME且≤3天的供应。平均而言，在调整后的模型中，来自学术机构的处方每份处方的撰写时间增加了约75个MME，持续时间几乎延长了一整天。与成年人相比，青少年是唯一一个每日剂量更高、供应时间更长的年龄组。结论来自学术机构牙医的处方占阿片类药物处方的比例很小，但处方特征在临床组间具有可比性。减少学术机构阿片类药物处方的干预目标可以应用于社区环境。

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引用次数: 0

Auxiliary delivered school based oral health promotion among 12–14-year-old children from a low resource setting–A cluster randomized trial 低资源环境下12 - 14岁儿童口腔健康促进辅助服务的整群随机试验

IF 2.3 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of public health dentistry

Pub Date : 2023-03-10 DOI: 10.1111/jphd.12565

Vivek Narayan MDS, Susan Thomas MDS, Mary shimi S. Gomez MDS, Bindu V. Bhaskar MDS, Arun Krishna Rao MDS

Objectives

This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12–14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India.

Methods

The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3 months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self-administered KAP questionnaire were evaluated at baseline and 1-year follow-up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance.

Results

The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001).

Conclusions

Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.

目的:本社区干预研究比较了印度农村地区12 - 14岁儿童在接受辅助机构提供的以学校为基础的口腔健康促进后，口腔健康知识、态度、实践(KAP)和口腔健康指标的变化。方法采用以学校为基础的整群随机试验，采用学校教师和学校保健护士进行干预。提供口腔健康教育(3个月1次)、每周课堂氟化钠漱口和每年两次口腔健康筛查/转诊，为期1年。对照组没有接受这些干预。在基线和1年随访时评估口腔健康指标和自行填写的KAP问卷。口腔健康指标包括简化口腔卫生指数、DMFT/DMFS净龋增量、预防比例、牙龈出血部位数量、护理指数、修复指数、治疗指数的变化和牙科就诊情况。结果干预组患者KAP总分、口腔卫生、牙龈出血改善程度较对照组明显(p < 0.05)。DMFT和DMFS对净龋增长的预防率分别为23.33%和20.51%。干预组学生的牙科就诊率较高(OR 2.92, p < 0.001)。干预组治疗指数、恢复指数和护理指数的变化显著高于干预组(p < 0.001)。结论在资源匮乏的农村地区，将学校保健护士和教师等初级保健辅助人员纳入口腔健康促进是一种新颖、有效和可持续的策略，可改善口腔健康指标和利用率。

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引用次数: 0