[Priorities and recommendations in oral health care for older people]. / Prioritering en aanbevelingen in de mondzorg voor ouderen.

The oral health of older people in the Netherlands, especially those who are vulnerable and dependent on care, is insufficient. Older people and other stakeholders participated in a so-called Priority Setting Partnership study to identify hindrances that have been experienced in oral health care and to distil from their experience items for the agenda for further research. For this reason, discussions were held in 5 focus groups with respectively 1 group of older people, caregivers, external parties and health care professionals. In a fifth focus group, a so-called 'consensus group', the definitive list of prioritised items on the agenda was formulated. The most important priorities concern policy and organisation of oral health care, awareness, cooperation among various health care professionals, the financing and organisation of oral health care for older people living at home and education concerning oral health care for all health care professionals. Awareness about the importance of good oral health for older people among health care professionals is the first step towards better oral health care for older people in the Netherlands.

Changes in the professional domain of Dutch dental hygienists.

OBJECTIVE: This study's purpose was to compare the scope of practice of Dutch dental hygienists educated through a two- or three-year curriculum ('old curriculum dental hygienists' [OCDHs]) with that of hygienists educated through a new extended four-year curriculum leading to a bachelor's degree ('new curriculum dental hygienists' [NCDHs]). METHODS: In 2005 and 2007, we obtained surveys from 320 OCDHs and the first 67 NCDHs, respectively, in which respondents were asked to complete a questionnaire and score how often they performed certain dental tasks. By means of factor analysis, these tasks were grouped into nine activity groups and 5 remaining single activities. T-tests and Mann-Whitney U-tests were used to compare the scope of practice between OCDHs and NCDHs. RESULTS: NCDHs worked more often in dental offices (instead of being self-employed) and generally worked more hours per week than OCDHs. They performed more often tasks dealing with caries diagnosis and treatment and less often tasks dealing with prevention and periodontology. These differences were statistically significant. However, in dental offices the differences between OCDHs en NCDHs were far less pronounced. In those practices OCDHs performed dental sealants, small corrections of dentures and/or restoration and caries diagnosis during dental check-up no less frequently than NCDHs. CONCLUSIONS: Although prevention remains the core domain (or role) of all Dutch dental hygienists surveyed, the scope of practice substantially differed. This, however, depended not only on education, but also on type of practice. The new curriculum answers to and legitimates an already developed practice of task delegation.

[Task redistribution in Dutch dental care in relation to dental hygienists' job satisfaction]. / Taakherschikking in de Nederlandse mondzorg en de werktevredenheid van mondhygiënisten.

In research into a professional cross-section of dental hygienists, we studied the extent to which task redistribution has an influence on job satisfaction. The research among randomly chosen dental hygienists consisted of questions about organizational and personal characteristics, the set of assigned tasks, task characteristics and job satisfaction. The respondents were divided into 3 clusters which differed in the breadth of their sets of tasks. Although prevention and periodontology services remain the core tasks in dental hygienists' jobs, the degree of task redistribution differed strongly from cluster to cluster. Respondents with a considerable degree of task redistribution experienced the most task variation, but scored significantly lower on the task characteristics autonomy, feedback, task identity and task importance. This explains why redistribution does not directly correspond with a greater degree of job satisfaction. Moreover, it is precisely the dental hygienists with a broad set of tasks who are significantly less satisfied with their salary than those with a traditional set of tasks.

Differences in oral health behaviour between children from high and children from low SES schools in The Netherlands.

OBJECTIVE: To identify the determinants of dental caries in relation to socio-economic status (SES) within oral health, children's eating habits and parental attitudes towards oral health. BASIC RESEARCH DESIGN: Dental screening data were collected from 6- and 10-year-old schoolchildren from low and high SES schools in The Netherlands in this cross-sectional study. METHODS: The clinical examination was performed by trained dental hygiene students who collected the data on dental caries, dental plaque and duration of brushing. The paper questionnaire completed by the parents included 18 questions about oral health behaviour, eating habits and parental attitudes towards oral health. RESULTS: Two of the six parameters of oral health behaviour were statistically associated with the high caries prevalence in the low SES group (brushing frequency (p = 0.028) and age at the first visit to the dentist (p = 0.044)). High intake of fruit juices and/or soft drinks (p = 0.043) and low calcium intake (p = 0.028) were identified as risk determinants for caries with low SES. All parameters of parental attitudes towards oral health were associated with caries, but not with SES. CONCLUSIONS: This study confirmed that the high caries prevalence in children from low SES schools was associated with oral health behaviour and eating habits. The role of parents was indirectly associated with the occurrence of dental caries. Therefore, it is important to include parents in all intervention programmes in order to reduce the prevalence of caries.