Knowledge, Attitudes, and Practices Towards ECC Prevention in Thai Medical Personnel.

OBJECTIVE: This study aimed to identify the knowledge, attitudes, and practices related to the prevention of early childhood caries (ECC) amongst medical personnel in well-baby clinics (WBC). METHODS: Participants were 152 health care professionals, including public health officers, nurses, and physicians, working in WBC in Chonburi Province, Thailand. Participants completed a 6-part online questionnaire asking about demographic data, knowledge and attitudes related to ECC, ECC prevention practices, collaboration, referral systems, and suggestions for improving collaboration between dental and medical personnel in WBC. RESULTS: Whilst most participants had high levels of knowledge about oral care instructions, tooth brushing frequency, and cariogenic foods and beverages, they knew less about recommendations for timing of the first dental visit, fluoride concentration in toothpaste, and the time for exfoliation of primary teeth. There were significant differences in the proportions of correct answers to questions related to the first dental visit and bottle feeding and in total knowledge scores between physicians and other health care professionals. Most participants demonstrated a positive attitude towards ECC prevention. More than 70% of participants always advise parents on oral hygiene and nutrition related to ECC prevention, but only 29% always refer patients to see dental personnel. Attitudes, collaboration, and referral systems were significantly associated with ECC prevention practices, but not knowledge. CONCLUSIONS: This study demonstrates that attitudes, collaboration, and referral systems are key contributors to ECC prevention amongst Thai medical personnel. In addition to training programmes, consistent interprofessional policy and referral systems should be formulated, especially in primary care settings.

DIET, BODY MASS INDEX AND DENTAL CARIES AMONG THAI CHILDREN AGED 3 TO 5 YEARS.

Early childhood caries (ECC) can cause pain and interfere with healthy nutrition affecting a child growth. The aim of this study was to determine if there is an association between dental caries and body mass index (BMI) among Thai children aged 3 to 5 years. We randomly selected 100 students attending Suan Missakawan School, Bangkok, Thailand. We examined each child to determine the number of decayed, missing and filled teeth (DMFT) giving a DMFT score. We also measured the height and weight for each subject and calculated their body mass index (BMI) as weight in kilograms divided by height in meter squared. Parents or guardians were asked to complete a questionnaire asking general information and the diet of the child. Data from the questionnaire were analyzed using the Kruskal-Wallis test. Associations between caries and variables were examined using the Spearman's correlation with significance set at p<0.05. The mean (±SD) age of the subject, the mean (±SD) DMFT score of the subject and the mean (±SD) BMI for the subjects were 4.21(±0.71) years old, 5.27(±4.78) and 16.46(±2.56) kg/ m2, respectively. Seventy-one percent of subjects had a normal BMI, 25% were overweight and 4% were underweight. Eighteen percent had no caries (DMFT score=0), 32% had a few caries (DMFT score=0.1-3.0), 14% had many caries (DMFT scores=3.1-6.9), and 36% had very many caries (DMFT≥7). The DMFT score was not significantly associated with a history of sugar consumption or BMI. The DMFT score was significantly negatively associated with estimated fat consumption and estimated iron consumption based on the diet reported by the parents or guardians. Further studies are needed to determine if these reported diets reflect actual consumption and if the associations are still significant.

ASSESSING ASSOCIATIONS BETWEEN CARIES PREVALENCE AND BODY MASS INDEX AND NUTRITIONAL DATA AMONG CHILDREN AGED 6-12 YEARS.

The purpose of this cross sectional study was to examine associations between dental caries and body mass index (BMI) and diet in 6 to 12 year old children. One hundred subjects were included in the study. The number of decayed, missing and filled teeth (DMFT), height and weight were examined in each subject. The primary caregiver for each subject completed a diet questionnaire. The data were analyzed using a chi-square test, a Fisher's exact test, a Kruskal-Wallis test and an independent sample t-test. Associations between variables and caries were examined using a Spearman's correlation with significance set at a p-value < 0.05. The mean age, BMI and number of DMFT were 9.21 ± 2.1 years old, 18.52 ± 4.8 kg/m2, and 4.03 ± 4.36, respectively. Sixty-seven percent of subjects had a normal BMI, 24% were overweight, and 9% were underweight. Twenty-three percent of subjects had no dental caries (DMFT score = 0), 23% had moderate to many caries (DMFT scores = 3.1-6.9), 22% had very many caries (DMFT scores ≥ 7), 17% had few caries (DMFT scores < 3). Overweight and underweight children did not have a significantly different number of DMFT than normal weight children. The number of DMFT did not correlate with reported sugar (R = -0.128) or carbohydrate (R = -0.174) consumption. There was no significant association between BMI and dental caries and amount of sugar and carbohydrate consumption and dental caries.

EFFECTIVENESS OF AN ORAL HYGIENE EDUCATION PROGRAM COMBINED WITH FLUORIDE MOUTHRINSE AMONG VISUALLY IMPAIRED STUDENTS IN BANGKOK, THAILAND.

The objective of this study was to assess the effectiveness of oral hygiene education kits (OHE kits) and 0.05% sodium fluoride mouth rinse among visually impaired students (VIS) in Bangkok, Thailand. Seventy-five VIS aged 10-12 years were included in the study and examined for plaque index (PI), gingival index (GI) and mutans streptococci (MS) salivary levels at baseline and after intervention. The subjects were then randomly divided into three groups. Group 1 received OHE kits and 0.05% NaF mouth rinse and brushing instructions. Group 2 received only the OHE kits and brushing instructions. Group 3 (control) received only brushing instructions. PI, GI and MS levels, were reassessed 3 months after intervention. Pre- and post-intervention evaluation data were compared with the Wilcoxon match-pairs test (p < 0.05). The post-intervention results were significantly better in all 3 groups compared to the pre-intervention result (p < 0.01). Group 1 had the lowest PI and the PI was significantly lower than the other groups (p < 0.05). The GI was significantly lower in Group 1 than Group 3, Group 2 than Group 3 (p < 0.05). MS level was reduced significantly in group 1 and 2 compared to control (p < 0.001, p = 0.038, respectively). All groups showed the reduction of PI, GI, and MS levels. However, students who either received OHE kits with or without sodium fluoride mouthrinse showed significantly lower gingival index and lower number of MS than control group.

Effect of audiovisual eyeglasses during local anesthesia injections in 5- to 8-year-old children.

OBJECTIVE: To evaluate the effectiveness of audiovisual (AV) eyeglasses on pain reduction during local anesthetic injection in children who are 5 to 8 years old. METHOD AND MATERIALS: Forty-nine healthy, cooperative children with bilateral carious molars requiring treatment under local anesthesia were recruited in this crossover study. Treatments were done in two visits, 1 to 4 weeks apart. Subjects were randomly divided into two groups according to the sequence of AV eyeglasses used. Group I received the injection without wearing AV eyeglasses in the first visit and then wearing AV eyeglasses in a second visit. Group II was vice versa. Self-reporting pain using the Faces Pain Scale-Revised (FPS-R), face, legs, activity, crying, and consolability scale (FLACC), and heart rate (HR), were measured to assess the injection pain. RESULTS: No significant differences in sex (P = .132) and treatment arch (P = .779) were observed between the two groups using a chi-square test at P < .05. There were no significant differences in age (P = .341, t test at P ≤ .05) and previous dental experience (P = .19, Fisher's exact test at P ≤ .05) between the two groups. Pain scores were lower when the patients had their injection while wearing AV eyeglasses in both groups. No subject reported a maximum score on the pain rating scale when wearing AV eyeglasses, while 14% of the subjects reported so when not wearing the eyeglasses. AV eyeglasses significantly reduced FLACC scores (P = .03) and HR (P = .005) when compared with not wearing the eyeglasses (Mann-Whitney U test at P ≤ .05). CONCLUSION: AV eyeglasses successfully reduced pain, physical distress, and HR during local anesthesia injection.

Efficacy of xylitol and fluoride mouthrinses on salivary Mutans streptococci.

OBJECTIVE: To evaluate the level of salivary Mutans streptococci (MS) after rinsing with xylitol, fluoride, and a combination of xylitol and fluoride solutions, compared with distilled water. METHODS: Eighty healthy 8-9 years old subjects with high level of MS (> 10(5) CFU/mL) were equally divided into 4 groups. Subjects rinsed their mouths for 1 min with 10 mL of 0.05% (w/v) sodium fluoride (NaF), 12.5% (w/v) xylitol or 0.05% (w/v) NaF + 12.5% (w/v) xylitol 3 times daily over 10 weeks. Distilled water rinsed group served as a control. Paraffin-stimulated whole saliva samples were collected at baseline, 5 weeks, and 10 weeks after rinsing to determine the level of salivary MS by culturing on Mitis Salivarius Bacitracin agar. The statistical significance was calculated by Kruskal Wallis, Mann Whitney U, and Wilcoxon signed-rank tests at a significant level of P< 0.05. RESULTS: Significant reductions in MS count were observed in subjects using 0.05% NaF + 12.5% xylitol over other groups within 5 weeks and after 10 weeks and 12.5% xylitol alone after 10 weeks compared with baseline. CONCLUSIONS: The present study provides evidence for the inhibitory effect of xylitol, used in combination with fluoride, delivered in the form of mouthrinse, on salivary MS in the group of schoolchildren.