Evaluation of caries risk reduction following preventive programs in orthodontic patients, using Cariogram computer model: A quasi-experimental trial

ABSTRACT Objective: This study evaluated the effectiveness of preventive strategies on caries risk reduction in patients undergoing orthodontic treatment, using the Cariogram program. Methods: In this quasi-experimental study, samples were selected using a convenience quota sampling technique, in a public dental school. At first, caries risk profile was determined for each subject using the Cariogram before brackets bonding. The sample size consisted of 36 patients. The intervention group (n = 18) received preventive programs, and the control group (n = 18) was trained based on the routine oral health education by means of pamphlets. Then, Cariogram parameters were calculated for patients in both groups after six months. Results: The age range of participants was from 12 to 29 years. The mean percentage of the "Actual chance of avoiding new cavities" section in the intervention group increased from 45.72 ± 21.64 to 62.50 ± 17.64. However, the mean percentage of other parameters - such as "Diet", "Bacteria" and "Susceptibility" - decreased after six months (p< 0.001). Besides, the differences in the mean percentage between intervention and control group at the end of the study period (T1) related to the Cariogram parameters were statistically significant (p< 0.001). Accordingly, the mean percentage of 'Actual chance of avoiding new cavities'' parameter in the intervention group (62.50) was statistically higher than in the control group (42.44) (p< 0.001). Conclusion: Implementing different preventive approaches is able to reduce the caries risk in patients undergoing fixed orthodontic treatment, which can be clearly demonstrated using Cariogram program.

RESUMO Objetivo: O presente estudo usou o software Cariogram para avaliar a eficácia de estratégias preventivas para redução do risco de cáries em pacientes sob tratamento ortodôntico. Métodos: Nesse estudo quase-experimental, as amostras foram selecionadas por meio de uma técnica de amostragem por cota de conveniência, em uma faculdade pública de Odontologia. Inicialmente, o perfil de risco de cárie foi determinado para cada indivíduo usando o Cariogram antes da colagem dos braquetes. A amostra consistiu de 36 pacientes: o grupo experimental (n = 18) recebeu programas preventivos, e o grupo controle (n = 18) recebeu orientações sobre a saúde bucal por meio de folhetos. Após seis meses, os parâmetros obtidos por meio do Cariogram foram calculados novamente para os pacientes de ambos os grupos. Resultados: A faixa etária dos participantes foi de 12 a 29 anos. A porcentagem média da seção "Probabilidade real de prevenir novas cáries" no grupo experimental aumentou de 45,72 ± 21,64 para 62,50 ± 17,64. Por outro lado, a porcentagem média de outros parâmetros - como "Dieta", "Bactérias" e "Suscetibilidade" - diminuiu após seis meses (p< 0,001). Além disso, as diferenças nas porcentagens médias entre o grupo experimental e o grupo controle ao fim do estudo (T1), relacionadas aos parâmetros do Cariogram, foram estatisticamente significativas (p< 0,001). Assim, a porcentagem média do parâmetro "Probabilidade real de prevenir novas cáries" no grupo experimental (62,50) foi estatisticamente maior do que no grupo controle (42,44) (p< 0,001). Conclusão: A implementação de diferentes abordagens preventivas pode reduzir o risco de cárie em pacientes sob tratamento ortodôntico com aparelhos fixos, o que pode ser observado claramente por meio do software Cariogram.

Non-clinical Expectations of Patients in an Oral Healthcare Setup: A Qualitative Research.

Aims: Patients’ expectations are essential part of healthcare delivery system. This would definitely relate to patient satisfaction and consequently would provide a guideline for promotion of community health level. This study illustrates the non-clinical expectations of patients referred to a dental school clinic. Study Design: This is a Qualitative study. Place and Duration of Study: This study was performed in dental school of Shahid Beheshti University of Medical Sciences, for a period of three months from May to July 2015. Methodology: In this qualitative study, seventeen patients aged 18 years and older were interviewed. These patients were selected by convenient sampling method from a dental school in Tehran, Iran. The data was gathered based upon semi-structured, face-to-face, and an in-depth interview. The transcribed interview texts were analyzed according to the principals of qualitative content analysis. Results: The responses were interpreted into two main themes: “met” and “unmet” expectations. “Met expectations” included four subthemes consisting “students and staff behaviors”, “infection control”, “fees”, and “trust” in dental school clinics. “Unmet expectations” included seven subthemes consisting “length of reception process”, “waiting time”, “accessibility”, “explanation about treatment procedures”, “facilities and equipment”, “working hours of the clinic” and “insurance coverage”. Conclusion: The results highlight that there are many concerns to the eyes of healthcare receivers which should be regarded by healthcare providers and administrators. Meeting these expectations would consequently improve the oral health level of a related community.