RESUMEN
Background: The prevalence of early childhood caries (ECC) among 36-47 months-old children in Lima, Peru, is 65.5%. Dentists have no easy access to see infants but nurses do. If nurses will be trained on oral health behaviours and early recognition of signs of ECC in infants, they could assist parents in keeping infant teeth healthy, during their regular well-child visits, using an oral health advisory and control cards and by referring infants to the health centre dentist earlier. Aims: The primary aim of the study is to reduce the prevalence of ECC. Nurses will be trained in educating mothers on oral health behaviour and in detecting signs of ECC in infants. They will assist parents in keeping infant teeth healthy with assistance of an oral health advisory card during regular well-child controls and referring infants with ECC risk to the health centre dentist. Study Design: The study is a three-arm randomized clinical trial. (A) Active intervention group: nurses will receive training in oral health education and in detecting carious lesions, supported by validated oral health advisory and control cards. (B) Passive intervention group: nurses will receive the oral health advisory and control cards together with written instructions, while nurses in the (C) control group will be lectured once on good oral health behaviours. In the three groups, knowledge of nurses will be evaluated, using a validated questionnaire, pre- and post-training. The pattern of referrals and treatments will be obtained from records available in the office of the health centre dentist. The ECC status among three year olds will be assessed at baseline and after three years, as will the quality of life of the infants. Place and Duration of the Study: The study will be carried out in three districts in Lima, Peru between September 2014 and September 2017.
RESUMEN
Background: To assess the approach of GPDs in Upper Egypt regarding preventive and restorative treatments for various stages of carious lesion development. Methods: A 42-item questionnaire was constructed for obtaining the GPD’s opinions. Factor analyses (with Varimax rotation) were conducted to identify scales (clusters) of variables. Logistic regression analyses, with continuing professional development as dependent variable, were conducted to test for the effect of single and scaled factors regarding indications to perform preventive or restorative treatments Results: All 70 participants returned the questionnaire. Three scale factors, i.e., treatment strategies, were identified as: ‘operative-minded dentists’ (who make >10 amalgam and resin composite restorations per week); ‘problem solvers’ (who have >10 years of experience, see >60 patients and make >10 temporary restorations per week); and ‘thinkers’ (who spend >50 hours / year on continuing professional development but also make >10 restorations per week). Logistic regression analyses found only one statistically significant relationship (p=0.03): ‘operative-minded dentists’ indicated provision of significantly less caries-preventive measures. Most patient visits were pain-induced. Conclusion: It was concluded that most GPDs in Upper Egypt have an operative-minded treatment philosophy, and spend less time on preventive measures. Amalgam is the most common restorative material used.
RESUMEN
Background: In the Kenya primary health care (PHC) setting where most patients, including nearly 1.4 million HIV-infected people, seek medical care, PHC providers are expected to identify and manage HIV-related oral diseases during general consultations. This study aimed to assess the current knowledge of clinical officers and nurses in Nairobi East district of Kenya regarding HIV-related oral diseases and conditions. Design and Methods: A 40-item questionnaire was used in interviewing all 57 PHC providers in 2 administrative divisions in the district in a cross-sectional survey. Assessed categories were: knowledge about HIV-related oral lesions, clinical appearance of HIV-suspected conditions, knowledge about oro-pharyngeal candidiasis (OPC), general dental knowledge, common appearances of OPC, knowledge about periodontitis, causes of dental caries, frequency of general oral examinations and past training in oral health topics. The first 4 categories were confirmed as sub domains, with Cronbach’s alpha of 0.57, 0.54, 0.59 and 0.45 respectively. Results: All 57 PHC providers (15 clinical officers and 42 nurses) completed the questionnaire (response rate 100%). PHC providers did not routinely perform oral examinations. Their knowledge about HIV-related oral health topics and general oral health was found to be generally inadequate. Recommendations: A training module on HIV-related oro-facial lesions for Nairobi PHC providers, incorporating a practical session covering oral examinations, is recommended; especially in this high HIV-prevalence environment.