Clinical Outcomes and Oral Health-Related Quality of Life after Periodontal Treatment with Community Health Worker Strategy in Patients with Type 2 Diabetes: A Randomized Controlled Study.

Interventions engaging community health workers (CHW) for diabetes management aim to improve diabetes care and self-management behaviors among patients. We evaluated the effects of nonsurgical periodontal treatment (NSPT) with the CHW strategy on oral self-care behaviors, periodontal status and oral health-related quality of life (OHQoL) in patients with type 2 diabetes mellitus (T2DM). The participants were randomly assigned to experimental (EG; n = 35) and control (CG; n = 33) groups. All participants received NSPT, whereas the patients in the EG also received one-on-one 30 min lessons from a CHW over 4 weeks. The EG exhibited greater improvement in the probing pocket depth (ß = -0.2, effect size [ES] = 0.61) and clinical attachment level (ß = -0.2, ES = 0.59) at 1-month follow-up than the CG did. The ES increased over the 1-, 3- and 6-month follow-ups, indicating an increase in OHQoL (ES = 0.19, 0.60, and 0.62, respectively) in the EG. The patients in the EG were more likely to change their oral self-care behaviors than patients in the CG were. The NSPT with CHW strategy had a positive effect on 1-month periodontal treatment outcomes, long-term OHQoL and oral self-care behaviors in patients with T2DM.

Effectiveness of a theory of planned behavior-based intervention for promoting periodontal preventive behaviors among medical students in Taiwan.

OBJECTIVE: To evaluate the effectiveness of an oral self-care education intervention based on the Theory of Planned Behavior in Taiwanese undergraduates. PARTICIPANTS: We recruited 63 and 90 students in the experimental group (EG) and comparison group (CG), respectively, from a medical university. METHODS: A quasi-experimental design was employed. The EG received health education and a brief action and coping planning intervention. RESULTS: The EG was significantly more likely to brush for more than 3 minutes (adjusted odds ratio [aOR] = 2.52), use the modified Bass brushing technique (aOR = 7.81), and floss (aOR = 21.21) at the 2-week follow-up than was the CG. At the 6-week follow-up, the combined effect of high action and coping planning with high perceived power for predicting floss use was observed in the EG (p < 0.05). CONCLUSIONS: Intervention may promote periodontal-disease-preventing behaviors in undergraduates, particularly for achieving adherence to daily flossing.

Randomized Controlled Trial on Effects of a Brief Clinical-Based Intervention Involving Planning Strategy on Self-Care Behaviors in Periodontal Patients in Dental Practice.

BACKGROUND: Strengthening adherence to self-care behaviors in patients with periodontal disease (PD) and reducing the plaque index is crucial for improving PD treatment. We evaluated the effectiveness of a theory of planned behavior (TPB)-based health education intervention involving a planning strategy on self-care behaviors in patients with PD. METHODS: A randomized controlled trial was conducted; 158 and 139 patients comprised the experimental group (EG) and control group (CG), respectively. Both groups received a leaflet, and the EG also received a planning intervention, which was a brief one-on-one counseling session with a planning sheet. Data were collected using a self-administered questionnaire. RESULTS: Between-group comparisons of TPB measures revealed significant differences in all domains when controlling for baseline covariates. The EG exhibited significantly higher levels of action and coping planning than the CG at two-week follow-up (effect size (ES) = 5.54 and 5.57, respectively) and six-week follow-up (ES = 5.66 and 5.66, respectively). Between-group differences in changes of brushing behaviors increased significantly. More frequent use of dental floss was observed in the EG than in the CG at two-week and six-week follow-ups (24.7% and 22.8%, respectively). CONCLUSIONS: The intervention involving planning strategy effectively promoted adherence to self-care behaviors in patients with PD.

Periodontal Treatment Experience Associated with Oral Health-Related Quality of Life in Patients with Poor Glycemic Control in Type 2 Diabetes: A Case-Control Study.

Severe periodontitis is a risk factor for poor glycemic control. The appropriate medicaltreatment and plaque control of periodontitis positively affects blood-sugar control in diabetespatients. We aimed to identify the factors associated with glycemic control and examine theperiodontal treatment (PT) experience and oral health-related quality of life (OHQoL) for patientswith poor glycemic control in type 2 diabetes mellitus (T2DM). This multicenter case-control studyrecruited 242 patients with poor glycemic control and 198 patients with good glycemic control. Wecollected patients' information through face-to-face interviews using a structured questionnaire.The Oral Health Impact Profile-14 (OHIP-14) was used to measure OHQoL. Based on PT status, thepatients were classified into three groups: a non-periodontal disease group, a PT group, and a non-PT (NPT) group. Regression models were used to analyze the data. No interdental cleaning(adjusted odds ratio (aOR) = 1.78) and positive attitudes toward periodontal health (aOR = 1.11)were significantly more likely to be associated with poor glycemic control in patients with T2DM.The PT group had a significantly lower OHIP-14 score than the NPT group (6.05 vs. 9.02, p < 0.001),indicating a better OHQoL among patients with poorly controlled T2DM. However, the OHQoLdid not differ significantly in patients with well-controlled T2DM between the PT and NPT groups.This suggested that diabetic patients with poor glycemic control must improve periodontal carepractices and receive proper PT, if necessary, to improve their OHQoL.

Evaluating the effect of a community-based lay health advisor training curriculum to address immigrant children's caries disparities.

Previous programs had not designed the culturally adequate Lay Health Advisor (LHA) oral health training curriculum for medically underserved population. We evaluated the effects of LHA training curriculum for addressing immigrant children's caries disparities in their access to dental care. We used a pre/post-test study design. Immigrant women were recruited from churches, schools, and immigrant centers in an urban area. Four training classes were held. Each training cycle lasted 15 consecutive weeks, consisting of 1 weekly 2-h training session for 12 weeks followed by a 3-week practicum. The curriculum included training in caries-related knowledge, oral hygiene demonstrations, teaching techniques, communication skills, and hands-on practice sessions. Thirty-seven LHA trainees completed the course and passed the post-training exam. The data were collected using self-report questionnaires. The level of oral health knowledge, self-efficacy and attitudes toward oral hygiene were significantly increased after LHA training. There was a significant and over twofold increase in trainees' oral hygiene behaviors. An increase of >20% in LHA and their children's dental checkup was observed following training. After training, LHAs were more likely to have 3+ times of brushing teeth [Odds Ratio (OR) = 13.14], brushing teeth 3+ minutes (OR = 3.47), modified bass method use (OR = 30.60), dental flossing (OR = 4.56), fluoride toothpaste use (OR = 5.63) and child's dental visit (OR = 3.57). The cross-cultural training curriculum designed for immigrant women serving as LHAs was effective in improvement of oral hygiene behaviors and access to dental care.