Current status of probiotic and related health benefits

This review is aimed to explore the health beneficial effects of probiotics which are live microorganisms that provide a positive health influence on humans when taken in sufficient quantity. Lactic acid bacteria, bifidobacteria, and yeast are frequently used as probiotics. These health-beneficial bacteria could compete with pathogens and modulate the gut microbiota, and exhibit immunomodulatory, anti-obesity, anti-diabetic, and anti-cancer activities which are discussed in this review. Moreover, recent studies showed that probiotics could neutralize COVID-19 infections. Hence, probiotics have become an alternative to several drugs including antibiotics. In addition, probiotic efficacy also depends on the delivery system as the delivery agents help the bacteria to survive in the harsh environment of the human gut. Considering these health benefits of probiotics, now it has been applied to different food materials which are designated as functional food. This review explored a portrait of the beneficial effects of probiotics on human health.Copyright © 2022 The Author(s)

Structure of Patients and Outcome of the Triage Process for the Dental Treatment in General Anesthesia

Introduction: Aim of the study was to analyse the structure of patients referred for dental treatment in general anaesthesia (GA) and to analyse the triage outcomes. Material(s) and Method(s): Retrospective chart analysis of patients referred between January 1st 2018 and July 7th 2022 was performed. Following data were registered: age, sex, diagnosis/ reason for referral for GA, indication for dental treatment in GA, trisage outcome and waiting time for the GA procedure. Result(s): Charts of 193 referred in the aforementioned period were analysed. Most common reason for the referral was autism (65/33.7%), cerebral paralysis (29/15%) and mental retardation (27/14%). Indication for dental treatment in GA was found in 156(80.8%) patients while in 37(19.2%) patients no indication for dental treatment in GA was found. Out of the 156 patients who were indicated for dental treatment in GA, 98(62.8%) patients were managed through day-care surgery and 8(5.2%) patients were admitted to hospital. Twenty patients (12.8%) were still waiting for their GA appointment in the time of analysis, 29(18.6%) were lost to follow up and in one (0.6%) patient the anaesthesiologist recommended ambulatory treatment due to increased risk. Out of the 37 patients in whom no indication for the treatment in GA was found, 13(35.2%) had no caries, 16/ (43.2%) were referred to paediatric dentist and 8(21.6%) were managed on the initial exam. Median time of waiting for the procedure was 120(10-365) days. Before the COVID- 19 pandemics median waiting time was 90(15-300) days, and after the COVID-19 pandemics median waiting time was 135(10-365) days. Conclusion(s): In the majority of the patients referred for dental treatment in GA, indication for the procedure was established. Majority of the referred patients can be managed through a day-care surgery. COVID-19 pandemics is probably one of the reasons for the increased GA procedure waiting time.

The effect of COVID-19 on the blood supply to the gums and the appearance of caries

The biological system of the oral cavity provides a number of protective mechanisms that fight pathogenic factors that arise due to a decrease in local immunity. This problem is found in patients after Covid-19. There is a violation of the blood supply to all organs and systems, including the mucous membrane of the oral cavity. As a result, patients have an increased risk of ulcers, plaques, fungal infections of the oral cavity, cracks, and spot hemorrhages. Due to a decrease in immune reactions in the oral cavity, the risk of caries in all groups of teeth increases, the permeability of enamel increases, and mineral substances exit from the hard tissues of the tooth.

The Relationship between Wearing Protective Masks and Poor Oral Health

Since the beginning of the COVID-19 pandemic, the number of people wearing masks in everyday life has increased. At the same time, there has been a noticeable rise in the amount of patients with bad breath (foe-tor ex ore), gingivitis, caries, and xerostomia. The appearance of these symptoms and diseases caused by wearing a mask is designated by the term mask mouth. The aim of this article is to establish the link between wearing protective masks and deteriorating oral health. From the conducted research, it has been es-tablished that wearing a surgical mask over a long period of time leads to reduced air exchange in the mask and "recycling" of exhaled air. This leads to inhalation of air with increased CO2 content and increase in pCO2 in the blood, which is subsequently compensated by rapid and deep breathing in most cases through the mouth. The goal is to exhale the accumulated CO2. As the mask reduces air exchange, the level of CO2 in the mask remains relatively high. Prolonged breathing through the mouth often leads to xerostomia. Saliva is known to have protective functions against the development of bacteria in the oral cavity through its an-tibacterial properties. Xerostomia can be a prerequisite for the development of various diseases of bacterial origin, such as gingivitis. Furthermore, oral respiration leads to an increase in temperature and CO2 in the air in the mask and a decrease in pH in the oral cavity, which are optimal conditions for biofilm formation, plaque buildup, development of most bacteria, e.g., S. mutans, which is the main cause of caries.Copyright © 2022, Bulgarian-American Center. All rights reserved.

Gabor Filter-Based Caries Image Feature Analysis Using Machine Learning

Dental caries sufferers in Indonesia demonstrate a higher frequency than other dental diseases even before the Covid-19 pandemic. The high risk of spreading the virus during the pandemic hinders handling dental care patients. Teledentistry is suggested as the main alternative to reduce the risk of spreading the virus. This study aims to establish a system for classifying the level of dental caries based on texture applicable for clinical implementation. Dental caries images were extracted using the Gabor Filter method and classified using the Support Vector Machine (SVM) and K-Nearest Neighbor (K-NN). A downsampling technique was applied to this system to reduce the large number of features affecting the classification time. System testing revealed that the Cubic SVM model generated the best result: Accuracy of 90.5%, precision of 89.75%, recall of 89.25%, specificity of 91.75%, and f-score of 88.5%. © 2022 IEEE.

Acceptability of e-training to support dentists to discuss tooth-kind behaviours with parents: Presenter(s): Sarah Peters, University of Manchester, United Kingdom

Tooth decay is preventable, through health behaviours (e.g. tooth brushing and limiting sugar consumption). However, in the UK, the most common reason for hospital admission in young children is to have decayed teeth removed under general anaesthetic. Dentists report finding behaviour change conversations challenging, and often use approaches known to be ineffective in changing behaviours (e.g. information giving, fear tactics). The study aim was to investigate the acceptability of a health psychology-informed behaviour change communication toolkit. A brief, interactive online training course was developed and made available to a sample of 117 dentists, trainees and allied practitioners. At baseline and post-training, participants completed questionnaires of knowledge, motivation, and confidence in holding behaviour change conversations. In-depth interviews were conducted with a purposive sample of 16 practitioners to investigate how the intervention could be developed in the context of COVID-19, which has severely disrupted routine dental services. Participants valued the training, which they described as novel and provided them with new strategies to enhance behaviour change conversations. Post-training questionnaires indicated participants felt more confident after training, with increased knowledge around planning and initiating behaviour change conversations with families. Early years practitioners working in a variety of non-dental settings (e.g. nurseries and children's centres) reported opportunities to have behaviour change conversations with parents, and welcomed further tailoring of the online training to help them capitalise on these interactions within these settings. Dental and non-dental practitioners are similarly motivated to have conversations with parents about improving their oral health. Brief online training can improve their capability to initiate these conversations in ways that do not damage the therapeutic relationship. To recover oral health services beyond COVID-19, there is potential for professionals working with parents in non-dental settings to develop skills in oral health promotion. [ FROM AUTHOR] Copyright of Patient Education & Counseling is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Comparison of the number of carious lesions in children before and after confinement linked to the COVID-19 crisis: a retrospective study.

Introduction: dental caries is an infectious pathology that is very often found during childhood. It has a multifactorial origin. This study aims to determine the incidence of carious lesions following the first confinement linked to the Covid-19 crisis. Material(s) and Method(s): retrospective study based on dental records of children from 0 to 18 years old from Cesar de Paepe site of the CHU Saint-Pierre, Belgium. First, data from patients who came for a consultation in pediatric dentistry between June and July 2019 and 2020 were collected. Then, these patients were classified into 3 distinct categories: patients who came for a check-up, during treatment or for a first visit to the pediatric dental consultation. Result(s): 1,631 patients were selected for the 2019 period compared to only 914 for 2020, i.e. a 44% drop in attendance. The very highly significant differences concerned the distribution in the categories and the presence of new caries between the two years. Discussion(s): The change in daily life caused by confinement might explain the appearance of new carious lesions. Conclusion(s): Our results confirm a highly significant increase in carious lesions following confinement.Copyright © 2022 Association des Medecins anciens etudiats de l'Universite libre de Bruxelles (A.M.U.B.). All rights reserved.

Science-Informed Health Policies for Oral and Systemic Health.

Oral, dental and craniofacial (ODC) health has a profound impact on general health and welfare throughout life, yet US dentists and physicians operate across misaligned silos. This protracted division limits access to optimal health, supports fee for services, and exacerbates health disparities. Early in the 20th century, the most frequent dental therapy was tooth extraction: removed infected teeth were substituted by prosthetic appliances - commonly, dentures or nothing. Most adults assumed becoming edentulous was a normal corollary of aging. With the discovery of penicillin and other antibiotics, healthcare professionals and policy makers predicted infectious diseases would become irrelevant. However, given numerous health threats, including SARS-CoV-2, HIV, multidrug-resistant bacteria, Zika virus, Ebola virus, and now monkeypox, public and professional awareness of transmissible infectious diseases has never been more evident. Ironically, little attention has been paid to unmet transmissible, infectious, common oral diseases - dental caries and periodontal diseases. Therefore, these persist within "the silent and invisible epidemic". The preventable death of a young boy in 2007 from an infected untreated tooth that produced bacterial meningitis is a profound reminder that our nation has vast inequities in education, health, and welfare. The impact of oral infections on hospital-acquired pneumonia, post-operative infection in cardiac valve surgery, and even academic performances of disadvantaged children displayed through sociodemographic characteristics and access to care determinants also are profound! This paper asserts that current and emerging ODC health knowledge and science will inform health policies and advance equity in access to care, affordable costs, and optimal healthcare outcomes. We recommend that legal and regulatory systems and public health programs be required to ensure health equity. A fair healthcare system that addresses holistic healthcare must be transparent, accessible, integrated and provide a standard of oral healthcare based upon scientific evidence for all people across the lifespan.

Safety Assessment of the Modified Lactoperoxidase System-In Vitro Studies on Human Gingival Fibroblasts.

One strategy in caries prevention is to inhibit the formation of cariogenic biofilms. Attempts are being made to develop oral hygiene products enriched with various antimicrobial agents. One of them is lactoperoxidase-an enzyme that can oxidise (pseudo)halide ions to reactive products with antimicrobial activity. Currently, commercially available products utilise thiocyanate as a substrate; however, several alternatives that are oxidised to products with greater antimicrobial potential have been found. In this study, toxicity against human gingival fibroblasts of the lactoperoxidase system was evaluated using four different (pseudo)halide substrate systems-thiocyanate, iodide, selenocyanate, and a mixture of thiocyanate and iodide. For this purpose, cells were treated with the systems and then apoptosis, cell cycle, intracellular glutathione concentration, and mitochondrial superoxide production were assessed. The results showed that each system, after generating 250 µM of the product, inhibited cell divisions, increased apoptosis, and increased the percentage of dead cells. It was concluded that the mechanism of the observed phenomena was not related to increased superoxide production or the depletion of glutathione concentration. These findings emphasised the need for the further in vitro and in vivo toxicity investigation of the modified lactoperoxidase system to assess its safety and the possibility of use in oral hygiene products.

Impact of the COVID-19 lockdown on the oral health status of paediatric dental patients in Greece.

BACKGROUND: Limited evidence regarding the post-COVID-19 dental status of paediatric patients is available, with most studies assessing only children's oral health habits. AIM: To evaluate the effect of the COVID-19 lockdown on the oral health of paediatric dental patients in Greece. DESIGN: This was a retrospective cohort study that included a questionnaire on children's oral health behavior and a clinical examination assessing dental caries and dental treatment needs using the International Caries Detection and Assessment System criteria, dmft/DMFT, and Treatment Need Index. The Wilcoxon signed-rank test was used for a statistical comparison between questionnaire and clinical data before, during, and after the lockdown. RESULTS: A total of 102 children with a median age of 9 years were recruited from the current cohort of patients that had their last dental examination 6 months prior to the lockdown. Results from the questionnaire showed decreased brushing frequency with increased eating frequency and sugar consumption during the lockdown period (p < .001). Moreover, 16.5% had to visit the dentist for urgent care during the lockdown, 13.6% experienced dental pain, and 51.5% did not experience any dental emergencies. Clinical examination, after the lockdown, recorded significantly increased mean dmft/DMFT scores by 0.63 units in the primary dentition (p = .01) and 0.52 units in the permanent teeth (p = .002). Significantly higher treatment needs, with more carious lesions requiring extensive treatment after the lockdown, were recorded (p < .001). CONCLUSION: The COVID-19 lockdown negatively affected children's oral health behavior: caries prevalence increased and more complex dental treatments were required.

Cariogenic diet consumption during lockdown.

BACKGROUND: During stressful situations such as pandemic-associated lockdowns, individuals' diets may change towards (cariogenic) 'comfort food'. This study assessed the dietary patterns during the lockdown in the Colombian population. METHODS: A cross-sectional online survey was designed. A convenience sample of 489 adults was drawn, with 50% of them being in COVID-19 lockdown and the other being not or only partially in lockdown. The questionnaire collected data about the type and frequency of food consumed, with a special focus on cariogenic (i.e., rich in free sugars and starches) food. Descriptive analyses were performed, and a generalised linear model was estimated to predict the frequency of cariogenic diet consumption in this period of time. RESULTS: Sweet whole wheat bread (38.2%, p = 0.005), flavoured milk (26.4%, p = 0.002), sugar-sweetened bubble gums (39.8%, p = 0.001), toffees (35.4%, p = 0.004), soft candies (e.g., gums) (35.4%, p = 0.018), chocolates (55.3%, p = 0.017), filled doughnuts (28.5%, p = 0.013) or grapes (51.2%, p = 0.002) were significantly consumed more during the lockdown. Multivariable generalised linear modelling showed being single, having children and being in lockdown were significantly associated with higher frequency of cariogenic food consumption. CONCLUSIONS: Lockdown was found to be associated with detrimentally altered food consumption patterns and, specifically, a more cariogenic diet. Healthcare professionals should consider this when reopening services, and political decision-makers may want to reflect on the unwarranted side effect of lockdown.

Updates and Original Case Studies Focused on the NMR-Linked Metabolomics Analysis of Human Oral Fluids Part III: Implementations for the Diagnosis of Non-Cancerous Disorders, Both Oral and Systemic.

This communication represents Part III of our series of reports based on the applications of human saliva as a useful and conveniently collectable medium for the discovery, identification and monitoring of biomarkers, which are of some merit for the diagnosis of human diseases. Such biomarkers, or others reflecting the dysfunction of specific disease-associated metabolic pathways, may also be employed for the prognostic pathological tracking of these diseases. Part I of this series set the experimental and logistical groundwork for this report, and the preceding paper, Part II, featured the applications of newly developed metabolomics technologies to the diagnosis and severity grading of human cancer conditions, both oral and systemic. Clearly, there are many benefits, both scientific and economic, associated with the donation of human saliva samples (usually as whole mouth saliva) from humans consenting to and participating in investigations focused on the discovery of biomolecular markers of diseases. These include usually non-invasive collection protocols, relatively low cost when compared against blood sample collection, and no requirement for clinical supervision during collection episodes. This paper is centred on the employment and value of 'state-of-the-art' metabolomics technologies to the diagnosis and prognosis of a wide range of non-cancerous human diseases. Firstly, these include common oral diseases such as periodontal diseases (from type 1 (gingivitis) to type 4 (advanced periodontitis)), and dental caries. Secondly, a wide range of extra-oral (systemic) conditions are covered, most notably diabetes types 1 and 2, cardiovascular and neurological diseases, and Sjögren's syndrome, along with a series of viral infections, e.g., pharyngitis, influenza, HIV and COVID-19. Since the authors' major research interests lie in the area of the principles and applications of NMR-linked metabolomics techniques, many, but not all, of the studies reviewed were conducted using these technologies, with special attention being given to recommended protocols for their operation and management, for example, satisfactory experimental model designs; sample collection and laboratory processing techniques; the selection of sample-specific NMR pulse sequences for saliva analysis; and strategies available for the confirmation of resonance assignments for both endogenous and exogenous molecules in this biofluid. This article also features an original case study, which is focussed on the use of NMR-based salivary metabolomics techniques to provide some key biomarkers for the diagnosis of pharyngitis, and an example of how to 'police' such studies and to recognise participants who perceive that they actually have this disorder but do not from their metabolic profiles and multivariate analysis pattern-based clusterings. The biochemical and clinical significance of these multidimensional metabolomics investigations are discussed in detail.

Study protocol for First Dental Steps Intervention: feasibility study of a health visitor led infant oral health improvement programme.

BACKGROUND: Dental caries in childhood is a burden on the daily lives of children and their families, and associated with poor oral health in adulthood. In England, dental caries is the most common reason for young children to be admitted to hospital. It is believed that most tooth extractions (due to decay) for children aged 10 years and under, could be avoided with improved prevention and early management. National public health policy recommendations in England include specific oral health initiatives to tackle tooth decay. One of these initiatives is delivered as part of the Healthy Child Programme and includes providing workforce training in oral health, integrating oral health advice into home visits, and the timely provision of fluoride toothpaste. This protocol seeks to assess the delivery of the First Dental Steps intervention and uncertainties related to the acceptability, recruitment, and retention of participants. METHODS: This study seeks to explore the feasibility and acceptability of the First Dental Steps intervention and research methods. First Dental Steps intervention will be delivered in local authority areas in South West England and includes oral health training for health visitors (or community nursery nurses) working with 0-5-year-olds and their families. Further, for vulnerable families, integrating oral health advice and the provision of an oral health pack (including a free flow cup, an age appropriate toothbrush, and 1450 ppm fluoride toothpaste) during a mandated check by a health visitor. In this study five local authority areas will receive the intervention. Interviews with parents receiving the intervention and health visitors delivering the intervention will be undertaken, along with a range of additional interviews with stakeholders from both intervention and comparison sites (four additional local authority areas). DISCUSSION: This protocol was written after the start of the COVID-19 pandemic, as a result, some of the original methods were adjusted specifically to account for disruptions caused by the pandemic. Results of this study will primarily provide evidence on the acceptability and feasibility of both the First Dental Steps intervention and the research methods from the perspective of both families and stakeholders.

Minimal Intervention Dentistry (MID) mainstream or unconventional option? Study exploring the impact of COVID-19 on paediatric dentists' views and practices of MID for managing carious primary teeth in children across the United Kingdom and European Union.

PURPOSE: To explore the techniques used to manage carious primary teeth during the COVID-19 pandemic by paediatric dentists and dentists with a special interest in paediatric dentistry (DwSI) who are members of the British Society of Paediatric Dentistry (BSPD) and the European Academy of Paediatric Dentistry (EAPD), and their views on the use of minimal intervention dentistry (MID) in children prior to, during and post the COVID era. METHODS: A total of 212 paediatric dentists and DwSI completed an online questionnaire. Six MID techniques were explored: fissure sealants, resin infiltration, Hall Technique (HT), 38% silver diamine fluoride (SDF), atraumatic restorative treatment (ART), stepwise removal and selective caries removal. RESULTS: The majority were specialists (26%) followed by clinical academics (23.1%) working mainly in university teaching hospitals (46.2%). Routine dental treatment for children with carious primary teeth was provided by the majority (92.5%) during the pandemic. HT (96%) and 38% SDF (65.7%) were the most commonly used techniques among the BSPD members whereas conventional restoration of non-selective caries removal and pulp therapy remained the most widely used technique among the EAPD members (66.2%). Most of the MID techniques were used as a treatment option (48.1%) rather than a choice (43.4%), with most of these choices having been affected by the patient's behaviour (82.5%). More than one thirds (39.2%) of the participants were reluctant to adopt MID after the pandemic. Several barriers such as lack of teaching and confidence as well as perceived lack of evidence were identified. CONCLUSION: A range of MID techniques is practiced broadly by a sample of paediatric dentists and DwSI across the United Kingdom (U.K) and European Union (E.U). The majority of clinicians are willing to continue using these techniques going forward after COVID restrictions are lifted. The pandemic served as an opportunity for many dentists to become familiar with various MID practices, such as SDF, which has been already established some time ago.

Project Tooth Fairy - Addressing Paediatric Dental General Anaesthesia Waiting Lists in London

Aims Oral disease poses significant health, social and economic burden globally, often causing pain, infection, hospital admission and mortality. Dental caries (tooth decay) is amongst the most common health conditions despite being non-communicable and entirely preventable. The Global Burden of Disease Study estimated that greater than 530 million children suffer from caries in their primary dentition (WHO, 2020). Within the NHS, is it estimated that 25-30% of the overall paediatric waiting list consists of cases that require removal of grossly decayed teeth under general anaesthesia (GA) (figure 1). Between 2015 and 2016, the financial cost to the NHS of extractions amounted to 50.5M. Before the COVID-19 pandemic, there was an existing burden within London NHS trusts of children on waiting lists for exodontia under GA. This issue has been further compounded by the cessation of elective dental activity in primary and secondary care settings due to the pandemic. Project Tooth Fairy was thus conceived to manage the growing paediatric GA waiting list. Methods Project Tooth Fairy is a collaborative, pan-London initiative designed to address London's growing paediatric GA waiting list. The new facility will employ clinical and non-clinical staff in a passport-type scheme allowing clinicians from different units to deliver care centrally in a purpose-built unit. The initiative started in November 2021. The project will deliver paediatric extractions, comprehensive care and complex oral surgery under GA. It will also serve as a source of training for dental trainees and anaesthetic trainees. Results Early results demonstrate that Project Tooth Fairy has treated over 250 children over two months, working with staff from over six NHS trusts, most cases comprising paediatric dental extractions. In March 2021, the total number of children waiting for paediatric GA across 19 London hospitals was around 14,400. To tackle the existing (and future) paediatric GA waiting lists in London, Project Tooth Fairy aims to increase capacity to treat 290 children over six days each week across three procedure rooms. Demand and capacity analysis suggests that approximately 212 procedures would be required each week (not including the backlog resulting from the pandemic). The backlog has seen a 61% increase from approximately 2,500 children waiting in March 2020 to an estimated 4,000 today, with projections of 7,000 by the time capacity is restored for P4 category work across London. It is estimated that 72% of these children have waited longer than 30 weeks, with greater than 1000 children waiting more than 52 weeks - a 96% increase in 52 week-waits compared to pre-COVID figures. The initiative also provides a more cost-effective solution due to the collaborative approach between trusts and staffing with an estimated saving of approximately 850,000 over 17 months compared to a more traditional system using two modular theatres. Conclusion Project Tooth Fairy is a more cost-effective and collaborative approach to tackling spiralling waiting lists within individual trusts. Nonetheless, a conceptual shift is needed away from 'downstream' strategies and those addressing the 'upstream' underlying inequalities in oral health across the population to achieve a more sustainable healthcare system.

How Much Do Paediatricians Know About Poverty within the Paediatric Population?

Aims Poverty is an ever increasing problem with 4.2 million children living in poverty in the UK in 2019, an increase of 600,000 from 2011(1). This has been particularly exacerbated by the COVID pandemic with an estimated 200,000 more children living in poverty in the UK since the pandemic(1). Poverty can affect multiple aspects of children's health and wellbeing, putting additional strain on already stretched NHS recourses. We wanted to assess paediatricians' knowledge about poverty, particularly around prevalence, risk factors, the effect on children's health and wellbeing and how to help families if there are concerns of poverty. From this we hoped to highlight areas where more education and support is required. Methods We designed an online survey with 11 questions including a mixture of multiple choice and free text answers. The questionnaire was distributed to all doctors working in paediatrics at a tertiary paediatric hospital, over a 4 week period. Results There were 29 respondents in total, with grades ranging from FY1 to consultant. Nearly two-thirds of respondents underestimated the prevalence of poverty in the UK and 38% underestimated the prevalence by half or more. Over 80% of respondents underestimated the percentage of children living in poverty locally. All respondents recognised parental disability and unemployment as risk factors for poverty and 90% recognised child disability or serious illness as a risk factor. Only one person suggested parental drug and alcohol use as a risk factor. The respondents were able to list a wide range of health implications of poverty, the most common answers being failure to thrive/poor nutrition, obesity, tooth decay and poor mental health. Two-thirds of respondents admitted not feeling at all comfortable about asking parents about poverty and 40% felt that they never screen for poverty when assessing patients. To assess for poverty 34% would ask about employment, 24% about housing and 41% about benefits and additional supports. All respondents would like further education and support around poverty. Conclusion Overall there was good understanding of the health implications associated with poverty and the risk factors for poverty, but an under-appreciation of the scale of the problem. The majority of doctors do not feel comfortable asking patients and families about poverty, and do not regularly ask about poverty when assessing patients. In order to identify children living in poverty and be able to signpost families to resources that could be beneficial to them, we need to equip paediatricians with the knowledge and skills to assess for poverty and what resources are available for families in the local area. To aid this we have produced a poster to be used to in the local Emergency Department and outpatients to remind doctors about poverty, advice on how to approach the topic and resources available in the hospital and in the local area that be used to sign post families.

Perception towards Preventive Strategies for Dental Caries and Oral Health Promotion among School Teachers: A Focus Group Discussion

Background and Aim: There are numerous preventive strategies available globally for dental caries. However, the incidence of dental caries is high among school going children in most of the developing countries. School teachers play a major role in inculcating good habits and behaviour to the children. Thus, we aimed to assess the perception of dental caries among school teachers qualitatively by focus group discussion. Methods: One focus group discussion was conducted among the primary level government and private school teachers in Tamil Nadu. A group of 12 teachers, 6 from Government schools and 6 from Private schools were recruited. The discussion was held in a virtual platform due to COVID-19 Lockdown. The session lasted for 45-60 min. The areas of discussion included attitude towards aetiology, prevention and treatment for dental caries. Results: Analysis of interview transcripts recognized many influences on children's oral health attitudes. Majority of teachers expressed a high efficacy using toothbrushes, tongue cleaners, mouthwashes, oil pulling and massaging gums as plaque control mechanisms. Most of the participants were aware of all treatment modalities for dental caries. However, they were not totally aware of the preventive strategies of dental caries. Conclusion: This qualitative study emphasizes that the overall knowledge, perception of aetiology and treatment for dental caries were superior and noteworthy among private school teachers as compared to government school teachers. Moreover, the teachers have expressed their interest for professional oral health assistance in dietary guidelines at schools, performing preventive strategies such as topical fluoride and pit and fissure sealant application. © 2022 by the Author(s).

The invisible issue, children, and families in substandard accommodation: how can paediatric interdisciplinary teams help?

AimsIn the UK the number of children living in temporary accommodation has risen by 80% since COVID-19 [1]. One fifth of Australian children aged 0 to 5 years lived in homelessness/housing instability prior to COVID-19 [2,3]. Little is known regarding the impact of homelessness on the health of children living with homeless families. Moreover, the types of services and interprofessional collaborations needed to address children’s needs remains unknown [3,4]. This presentation outlines an innovative model of interdisciplinary collaborative health delivery that addresses these gaps [5]. The model used an embedded Nurse Practitioner ‘health hub’ to assess children and help parents meet their child’s needs.Objectives: This project captured the:1. Health of homeless children presenting to homelessness and community services in South Australia.2. Referral rates and uptake of the children3. Interdisciplinary health needs of the children living with homeless familiesMethodsA mixed methods study design was conducted. Health severity scales, extended health assessments, case note reviews, and interviews with parents and staff, to determine the health impacts of homelessness on children and the children’s interdisciplinary health needs. The conditions identified were coded using a severity scale of 1 to 3;3= severe, the child needing immediate care/intervention, 2= moderate, the child needs a referral but can wait for public hospital/clinic, 1= minor, the child does not need immediate referral). Referrals were made to: Paediatricians, dentists, physiotherapists, immunisation nurses, General Practitioners and other allied health professionals.ResultsOverall interim results show 62% of children presenting had health conditions (e.g. chronic dental caries, craniosynostosis with developmental delay) requiring interventions, while 38% were assessed as having good health requiring no intervention.Table 1 above illustrates the presenting conditions of the children attending the Nurse Practitioner led clinic. A consultation with the NP for an in-depth health assessment and often were the first comprehensive health assessment the children had received since birth.We found 18% children had a developmental delay (6 times the national average), 17% had behavioural and/or mental health issues, 17% required an ENT intervention, 24% had dental issues and 24% had a variety of presenting conditions. The correlational analysis and odds ratio results along with the interdisciplinary model of care and the case note analysis will be presented at the RCPCH conference. The intervention/evaluation reflects the complexity and depth of the unmet need in these children.ConclusionOverall the children are disconnected from health. This research identified that:• A significant number of children required medical interventions.• Children living in housing insecurity are at risk of missing out on care that is essential to their development and health• These children lack access to mainstream services• Health care costs act as a barrier to services• There is a poor referral uptake by children living in housing insecurity• There is a lack of information on the number of homeless children, particularly Aboriginal childrenIt is imperative that the health needs of children living with housing instability are measured and the responses of health professional interventions are tracked.