[Barriers for visiting a dental clinic among (frail) older individuals; the momentum of the influenza vaccination as finding place]. / Barrières bij (kwetsbare) ouderen voor bezoek tandartspraktijk; griepprikmomentum als vindplaats.

As age increases, the proportion of older people visiting a dental practice decreases. The aim of this survey was to gain insight into the extent to which frailty and/or dental status are related to visiting a dental practice and what barriers older (frail) people experience in this respect. A questionnaire was distributed among people eligible for the annual flu vaccination in Winschoten, The Netherlands. In total, 1027 people aged 60 and over completed the questionnaire. 60-80% of them had recently visited a dental practice depending on their frailty. Dental status was the decisive factor for not visiting a dental practice. Edentulous individuals were more likely not to visit than (partially) dentate individuals. Barriers to visiting a dental practice were related to making an appointment, costs, and/or the services provided. The flu vaccination seems to be an interesting momentum to identify people who do not, or no longer, visit a dental practice.

[The oral health of frail home-dwelling elderly in the general practice]. / De mondgezondheid van kwetsbare thuiswonende ouderen die de huisarts bezoeken.

The number of frail home-dwelling elderly is increasing, and they are likely to retain their own dentition longer when ageing. With increasing age, the number of dental visits declines, while the number of visits to the general practitioners' (GP) clinics increases. The aim of this study was to assess the oral health status and dental visits of frail home-dwelling elderly that visit their GP. The study consisted of questionnaires and an oral examination. Subjective and objective oral health was determined by the Geriatric Oral Health Assessment Index-NL and the Oral Health Assessment Tool. Almost half of the frail elderly had not visited the dentist for over 2 years and a quarter had objective oral health problems. The educational level and the dental status were of influence on the dental visits and on their oral health. In about a third of the subjects, a subjective oral health problem was observed, which was influenced by the extent of the subject's frailty. A multidisciplinary approach can improve the oral health status of frail home-dwelling elderly.

[Collaboration of oral care and well-child care: for better preventive dentistry]. / Samenwerking mondzorg en jeugdgezondheidszorg; voor betere tandheelkundige preventie.

The new Dutch clinical practice guideline Oral Care for Children and Young People advises parents to visit the oral care professional before or from the eruption of the first tooth, because oral care starts with the first deciduous tooth. However, this is not yet standard for everyone. Still, almost all parents of newborns (> 95%) visit well-baby clinics with their newborn. This article describes how well-baby clinics and oral care can collaborate and how in the Netherlands, young children and their parents can be contacted earlier for (preventive) dental care. There are a few examples of projects in which well-child clinics and oral care collaborate, such as the Gezonde Peutermonden project (toddlers' healthy mouths project), the GigaGaaf project (giga whole project) and the case of a practice in Haarlem, in the Schalkwijk district. Because these projects are still in progress, it is not yet clear whether a collaboration between well-child clinics and oral care will also have an effect on the caries prevalence in children.

[18 years old: choose wisely! Provision of information about changing health insurance status]. / 18 Jaar: verstandig kiezen! Informatievoorziening rond veranderende verzekeringsstatus.

From the age of 18, dental care is no longer covered by basic healthcare insurance [in the Netherlands]. Individuals can voluntarily take out additional insurance however. The aim of this study was to map out what information those nearly 18 years old receive about the changes in coverage of dental care (Part A) and what their preferences were concerning information on this topic (Part B). Part A consisted of desk research on the websites of 4 health insurers and government agencies, complemented with interviews with portfolio holders. Part B consisted of a questionnaire survey among 18-year-old secondary school pupils training for university and vocational students (n = 106).The websites of health insurers and government agencies contained some information, 2 health insurers sent information by post about dental insurance and 1 also got in touch by phone. The level of knowledge about the insurance system among 18-year-olds was low, information often did not seem to have been received and they did not look for information themselves. Secondary school pupils training for university preferred to receive written information, vocational students preferred to receive it orally. Conclusion: Information about the changing health insurance status is available but does not reach those nearly 18 years old effectively. Cooperation and clarity on the responsibilities regarding the provision of information is recommended.

[Impact of the corona lockdown on daily oral health care behaviour of young children]. / Impact van corona-lockdown op het dagelijks mondgezondheidsgedrag van jonge kinderen.

This study explores the possible effects of the current corona pandemic and the ensuing measures on parental oral care behaviour, particularly during the lockdown period. Moreover, this study examines to what extent these effects differ according to the educational level of the parents. In total, 120 parents of children aged 4-5 years completed a digital questionnaire about parental oral care behaviour. The results show that during the coronavirus lockdown, 26% of parents skipped toothbrushing more often in the morning, 44% let their child snack more often, and 22% let their child drink sweetened drinks more often. In addition, parents with a high educational level skipped tooth brushing in the morning more often than parents with a low educational level. In contrast, parents with a low educational level skipped toothbrushing more often in the evening than parents with a high educational level. The results of this small study suggest that the coronavirus lockdown affected parental oral care behaviour.

[Kies-voor-Tanden Study: caries among 17-year-olds in the Netherlands]. / Kies-voor-Tandenonderzoek 2017: cariëservaring bij 17-jarigen in Nederland.

This fourth in a series of 5 articles in the context of the 2017 Kies-voor-Tanden study presents the results for 17-year-olds. 34% of the 17-year-olds had flawless permanent teeth. In 2017, there were still differences in oral health among the socio-economic groups, to the advantage of the high socio-economic group. The oral health of 17-year-olds had stagnated during the previous 6 years and even appeared to be deteriorating according to some indicators. In addition, knowledge about the dental insurance system after the 18th birthday was poor. Conclusion: The oral health of 17-year-olds had not improved in the previous years. This trend must be followed by monitoring research. In addition, interventions to improve the oral health, knowledge and behaviour of adolescents should be set up and evaluated.

[Kies-voor-Tanden Study: caries among 23-year-olds in the Netherlands]. / Kies-voor-Tandenonderzoek 2017: cariëservaring bij 23-jarigen in Nederland.

This fifth and final in a series of 5 articles in the context of the 2017 Kies-voor-Tanden study presents the results for 23-year-olds. 21% of the 23-year-olds had flawless permanent teeth. In 2017, there were still differences in oral health among the socio-economic (SES) groups, to the advantage of the high SES group. The oral health of the low SES group had shown some improvement in the previous 6 years, while this was not the case within the high SES group. The preventive dental behaviour of 23-year-olds was not optimal and the knowledge about the dental insurance system was poor. Conclusion: the oral health of 23-year-olds had partly improved, partly stagnated. Since not everyone will be able to access information through oral care professionals, other ways of providing information to them must be considered. In the context of public health, to be able to follow trends in oral health and dental preventive behaviour of (young) adults, research monitoring oral health is of great importance.

[Oral care for patients in the palliative stage of life - do you care?] / Mondzorg bij patiënten in de palliatieve levensfase ­ ook uw zorg?

In this questionnaire study, the attitude of dentists and students regarding the provision of oral care to palliative patients was investigated. The extent to which they would like to be involved in the care for this patient group was also investigated. The results showed that both research groups had relatively little affinity with palliative patients. In general, however, they do consider oral care to be important for this group and believe a dentist can play a role in the quality of life. About one third of both research groups, nevertheless, preferred not to be involved in the provision of oral care often. Besides, when it comes to providing oral care in nursing homes or at patients' homes, approximately one third of the respondents were not very willing or not willing at all to make house calls. Dentists and students are aware of the importance of oral care in the palliative stage of life, but they do not (yet) want to be responsible for the oral care themselves.

[Kies-voor-Tanden Study: the incidence of caries among 11-year-olds in the Netherlands]. / Kies-voor-Tandenonderzoek 2017: cariëservaring bij 11-jarigen in Nederland.

In this third article in a series of 5 in the context of the 2017 Kies-voor-Tanden Study, the results for the 11-year-olds are presented. The study was conducted among 11-year-olds who lived in Alphen aan den Rijn, Gouda, Breda or Den Bosch and consisted of a clinical oral examination and a questionnaire completed by both them and their parents. Of the 11-year-olds, 61% had caries-free permanent teeth. In 2011, this percentage was 73%. In 2017, there were still differences in oral health among socio-economic groups, to the advantage of the higher socio-economic group. The conclusion is that the oral health of 11-year-olds has not improved in the last 6 years. Despite the low prevalence of DMFS, there appears to be a trend towards deterioration. For risk groups, interventions to keep the teeth intact should be aimed primarily at improving preventive behaviour and good oral health self-care.

[Kies-voor-Tanden Study of children and adolescents: motivation and study design]. / Kies-voor-Tandenonderzoek 2017 onder jeugdigen: aanleiding en onderzoeksopzet.

In 2017, Dutch research institute TNO carried out research commissioned by the National Health Care Institute intended to gain an up-to-date and representative picture of the oral health and the preventive dental behaviour of 5, 11, 17 and 23-year-olds in the Netherlands and to identify possible changes therein since previous measurements. Since the motivation, background, study design, material and method were identical for the 4 ages, and the same issues, to a certain extent, are to be considered in the discussion in each of a series of 5 articles, these identical and generic matters will be described in this article.Since there is no system in the Netherlands to structurally monitor oral health, these Kies-voor-Tanden studies are eminently important for following trends in oral health and preventive dental behaviour in children and adolescents over longer periods of time. Data of this kind are indispensable in formulating meaningful policy on oral health. The continuation of research monitoring oral health is therefore strongly recommended.

[Kies-voor-Tanden Study: the incidence of caries among 5-year-olds in the Netherlands]. / Kies-voor-Tandenonderzoek 2017: cariëservaring bij 5-jarigen in Nederland.

This second in a series of 5 articles in the context of the 2017 Kies-voor-Tanden study presents the results for 5-year-olds. The study was conducted among 5-year-olds living in Alphen aan den Rijn, Gouda, Breda or Den Bosch and consisted of completing a questionnaire and undergoing a clinical oral examination. 76% of the 5-year-olds had a caries-free deciduous dentition. This percentage represented an increase compared to previous research. No change was seen in children with caries experience. In 2017, there were still differences in oral health among the socio-economic groups, in favour of the highest socio-economic group. Conclusion: the oral health of the 5-year-olds seems to be moving in the right direction, but there is still a social gradient and there is still room for improvement. For risk groups, interventions to keep the teeth intact should be aimed primarily at improving behaviour and oral health self-care to prevent caries.

[Socioeconomic differences in oral health outcomes among adults in the Netherlands]. / Sociaal-economische verschillen in mondgezondheidsuitkomsten van volwassenen in Nederland.

The aim of the present study was to describe the oral health situation of the adult Dutch population in terms of caries experience and the need for periodontal treatment. The research consisted of a clinical dental examination and a questionnaire on oral health and was carried out among 25- to 74-year-olds living in Den Bosch, distinguished according to age and educational level. The group with a low socioeconomic status (SES) had more teeth affected by caries, had undergone less extensive dental treatments and were more in need of periodontal treatment than the high SES group. On this basis, it can be concluded that socioeconomic statuswas also negatively correlated to several oral health indicators in 2013. One has to consider whether the picture sketched by this study matches Dutch society's expectations.

[The prevalence of tooth wear in the Dutch adult population]. / De prevalentie van gebitsslijtage onder de volwassen Nederlandse bevolking.

This study, performed in 2013, aimed to assess the prevalence of tooth wear in the Dutch adult population. The prevalence of tooth wear was not only determined for different age groups but also according to gender, socioeconomic status and types of teeth. Results were compared with the outcomes of a previous study in a comparable population in 2007. The data were collected as part of a comprehensive dental-epidemiological research project. The 1,125 adults from the city of 's-Hertogenbosch who participated in the project were subdivided into 5 age groups. Tooth wear was quantified using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected by tooth wear was higher in older age groups. Men showed more tooth wear than women, as did individuals with lower socioeconomic status, among whom a similar tendency was observed. Tooth wear prevalence found in 2013 was higher in all age groups than in 2007. One can conclude that tooth wear is a common condition in the Dutch adult population.

[Dental visits among people over 65; a study in a general dental clinic in Drenthe, the Netherlands]. / Tandartsbezoek van 65-plussers; onderzoek uit een algemene praktijk in Drenthe.

In this study, factors that may influence the dental visiting patterns of people over 65 living independently were investigated. The results of a questionnaire (n = 164; 53% response) revealed that 89% of them regularly visited the dentist for a check-up. Factors affecting dental visits were: whether or not one had difficulty planning a visit, whether or not one was motivated to make an appointment and actually made one, the condition of one's teeth; whether or not one had dental insurance and whether or not one reacted to a dental reminder (post)card. Mobility played no greater role among non-regular dental visitors than among regular visitors. Anticipating the possibility of an older patient living independently might fail to show by means of an active call policy seems more relevant than organising transport.

[DSQ-13-youth: measuring instrument for patient satisfaction with dental attendance among adolescents, young adults and parents of young children]. / DSQ-13-jeugd: meetinstrument voor patiënt­tevredenheid van adolescenten, jongvolwassenen en ouders over tandartsbezoek.

The Dental Satisfaction Questionnaire (DSQ) is a questionnaire consisting of 31 items assessing patient satisfaction with dental attendance. By means of factor analysis (principal component analysis), the number of items of the DSQ was reduced to 13, which together constitute the DSQ-13-youth. The first objective was to investigate the psychometric properties of the DSQ-13-youth; the second was to compare the satisfaction scores on the various dimensions between and within subgroups (23-year-olds, 17-year-olds and parents of 5-year-olds). The DSQ-13-youth has 4 domains measuring patient satisfaction with dental attendance. The internal consistency of those domains was high; the correlation between the domains low to moderate and the factor structure was highly congruent in the various subgroups. The differences in satisfaction scores between and within subgroups were small. The DSQ-13-youth is a reliable instrument to assess patient satisfaction with dental attendance among adolescents, young adults and the parents of young children in urban areas.

[Disease burden of extreme treatment anxiety; quality of life for patients with and without extreme dental treatment anxiety]. / Ziektelast en kwaliteit van leven bij patiënten met en zonder extreme angst voor tandheelkundige behandelingen.

In this study, a comparison was made between disease-specific (oral health-related) quality of life (OHQoL), measured with the OHIP-14 questionnaire, and generic (general health-related) quality of life (GHQoL), measured with the EQ5D-5L questionnaire, in patients with and without extreme dental treatment anxiety. A total of 76 patients who could not be treated due to extreme dental treatment anxiety were referred to a centre for special dentistry. These patients were matched, according to age, gender and socioeconomic status, with participants in an epidemiological study on oral health (n = 1125). Wilcoxon signed-rank tests were used on both groups to compare GHQoL and OHQoL. The total OHIP score was higher (representing a lower quality of life) in the patient group than in the control group. Anxiety patients scored higher on all 7 domains of the OHIP-14. With respect to general quality of life, patients with extreme treatment anxiety were found to report lower utility scores than the matched control group. With these results, a total disease burden of 74,000 disability-adjusted life years (DALYs) was calculated for extreme treatment anxiety in the Netherlands. The findings of this study reveal that having extreme dental treatment anxiety results in a significant disease burden in the Netherlands.

[Dental erosion and young adults: what do they know and how would they like to receive information?] / Gebitsslijtage en jongvolwassenen: wat weten ze en hoe wensen ze informatie.

Dental erosion occurs often among adolescents and young adults in the Netherlands. This problem requires attention because its consequences are irreversible. In this study (part of the 'Dental Research and Practice in the North Netherlands' project) a questionnaire was distributed to 331 young adults (age 20 to 25) from 25 dental practices. The goal of the study was to find out how much young adults know about dental erosion and how they wish to receive dental information. The results show that much is still unknown about dental erosion among young adults and that the extent of knowledge depended of the level of education and on information on dental erosion that had already been received. Participants preferred to receive information in a conversation with an oral healthcare professional, with the support of printed matter.

A scoping review of the uses of the care index in children.

OBJECTIVE: To conduct a scoping review of literature to describe how the care index (CI) and restorative index (RI) are used in child populations and to determine whether they are fit for purpose. BASIC RESEARCH DESIGN: Scoping review conducted using the Arksey and O'Malley (2005) framework. METHOD: Electronic and manual literature searches (1980-2015) were conducted. Titles and abstracts were screened, full-texts of potential studies were reviewed two reviewers extracted data independently, followed by data charting and summarising. RESULTS: Out of 104 articles meeting all criteria, most were cross-sectional (92%), and 56% were conducted in UK and Brazil. Most commonly (63%) studies used CI and RI to obtain epidemiological data on dental care levels. Of the studies that defined CI and RI, most used and specified the standard definition. The CI and RI scores varied either due to patient related factors such as age, gender or dental care related factors including, cost of treatment and method of provider remuneration. CONCLUSION: Overall, it is recommended that future studies should clearly state the definitions and thresholds used to obtain CI and RI, which would enable comparison between communities and allow temporal trends to be studied. Additionally, deriving separate CI and RI scores for groups based on caries extent would help to highlight inequalities in the provision of care. Further research is needed to explore the applicability of CI and RI to changing approaches to caries management with current care recommendations emphasising on minimal treatment and secondary prevention.

[Caries in deprived areas 2. Youngsters]. / Cariës in Krachtwijken 2. Jongeren.

In the Netherlands, no epidemiologic data on the oral health of cultural groups of children and adolescents living in deprived areas are available. The aim of the present study was to obtain an impression of the amount of caries experience among poorly educated groups of youngsters in deprived areas, in comparison with a reference group of poorly educated youngsters from the cities of Alphen aan den Rijn, Gouda, 's-Hertogenbosch and Breda. 725 Poorly educated respondents participated in a clinical and sociological study. The reference group had the lowest caries experience and the youngsters living in deprived areas with a non-Dutch cultural affiliation had the largest amount of caries experience. The latter group had more untreated caries and in 20-year-olds, a relatively large number of teeth had been extracted. Despite the low numbers, the difference in average DMFS scores among 14- and 20-year-olds were statistically significant. In the Netherlands a cultural dichotomy in oral health appears to exist, independent of level of education, in which youngsters with a non-Dutch cultural background are at a disadvantage.

[(Erosive) tooth wear in children and adolescents in the Netherlands: how big is the problem?] / (Erosieve) gebitsslijtage bij jeugdigen in Nederland: hoe groot is het probleem?

According to international research, the prevalence of (erosive) tooth wear among children and adolescents has grown steadily in recent decades. The question was whether this also applies to the Netherlands and what changes in consumption patterns may play a role in this development. From 1998 up to and including 2011, 9 studies have been carried out on the prevalence of (erosive) tooth wear among the young. A meta-analysis of these studies reveals that an increase has also taken place in the Netherlands. Furthermore, a tendency was found for greater prevalence with increasing age. It is generally assumed that changes in the supply of food and drink and therefore consumption patterns have been a major reason for this increase in children and adolescents. However, longitudinal studies, in which both the prevalence and incidence of (erosive) tooth wear are investigated, are needed to support these assumptions. Such studies are, however, scarce and, moreover, the results show no consistent picture.