Oral Health Literacy Inventories for Caregivers of Preschool-aged Children: A systematic review.

Purpose: The purpose of this systematic review was to describe the oral health literacy (OHL) inventories that have been used among caregivers of preschool-aged children.Methods: Four databases were searched (CINAHL, Cochrane Database of Systematic Reviews, Dentistry & Oral Sciences Source, PubMed), to identify peer-reviewed, full-text studies published in English on the oral health literacy among caregivers of preschool-aged children from 2010-2021. All studies were assessed for eligibility using PRISMA guidelines. Inclusion criteria were experimental, non-experimental, or mixed methods peer-reviewed studies, conducted in the United States. Eligible studies were independently evaluated using the Effective Public Health Practice Project's Quality Assessment Tool.Results: The initial search yielded 182 articles; 11 studies met the inclusion criteria after screening: observational (n=8), experimental (n=2), and quasi-experimental (n=1). Main outcome measures included: oral health literacy, oral health knowledge, oral health attitudes and behaviors, child oral health status (COHS), child oral health-related quality of life (C-OHRQoL), and child oral health-related expenditures. However, this review focused only on caregivers' OHL and the associated measurements for this variable. Most studies utilized the Rapid Estimate of Adult Literacy in Dentistry (REALD-30); the remainder used the Basic Research Factors Questionnaire (BRFQ), the Oral Health Literacy Inventory for Parents (OH-LIP), or self-designed survey questions.Conclusions: Few studies met the inclusion criteria. There was an uneven distribution of studies using different inventories for the measurement of oral health literacy limiting the generalizability of the findings to low-income and minority groups. Most caregiver OHL studies focused on dental word recognition, only a few measured knowledge and comprehension. More comprehensive inventories could be designed to evaluate caregivers' knowledge and understanding of dental terms.

Caregivers' Comprehension of the Terms Decay and Cavities: A qualitative analysis.

Purpose: Tooth decay and cavities are the most common oral health consequences for young children that may result from inadequate oral health literacy (OHL) or understanding of their caregivers. The purpose of this study was to describe the understanding of terms related to decay and cavities among caregivers of preschool-aged children.Methods: English-speaking caregivers with children aged <6 years were recruited from two private dental practices located in Washington State. A qualitative analysis was performed using responses regarding the terms decay and cavities as part of the 36 item Oral Health Literacy Inventory for Parents (OH-LIP). Responses were recorded, transcribed, coded, and assigned to domains and categories.Results: Responses from 111 participants were included in the analysis. About one fifth of the participants (19.8%, n=22) indicated that they did not know what decay was or provided an incorrect response. The majority (71.2%, n=79) made the association that decay was something bad that happens to the teeth. However only a minority of the participants (9%, n=10) correctly identified decay as destruction of the tooth surface because of bacterial action. When asked to define the word cavities, more than half (68.5%) indicated that cavities were something harmful to teeth, while only about one quarter (27%, n=30) correctly identified cavities as resulting from the decay process.Conclusion: Knowledge disparities related to the terms decay and cavities among caregivers suggest that more education is needed regarding the tooth decay process and factors causing dental caries to ensure timely preventive services are received. Gaps in oral health literacy should be addressed by health care professionals. Dental hygienists are in an ideal position to educate caregivers as well as non-dental health care professionals who provide services to caregivers and children.

Oral Health Education and Promotion Activities by Early Head Start Programs in the United States: A systematic review.

Purpose: Dental caries is a non-communicable, preventable disease that disproportionately affects low-income children in the United States (US). The purpose of this systematic review was to describe oral health education and promotion activities designed to prevent early childhood caries (ECC) provided by Early Head Start (EHS) programs in the United States.Methods: Five databases were searched including CINAHL, Dentistry & Oral Sciences Source through EBSCO, PubMed, Google Scholar, and the Wiley Online Library, to identify peer-reviewed quantitative studies published in English on oral health education and promotion activities within EHS programs from 2000 to 2019. Studies were assessed for eligibility using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram (PRISMA). Two researchers independently evaluated the included studies.Results: The initial search yielded a total of 363 articles. Following the screening process, five studies met the inclusion criteria (observational, n=2; quasi-experimental, n=3). The main outcome measures included oral health knowledge, attitudes and behaviors, oral health education, oral health promotion, and oral health activities. Three studies investigated the effectiveness of oral health education and promotion interventions among EHS staff and parents. Two studies examined oral health activities such as education, toothbrushing instructions, toothpaste use, dietary education, and dental assessment.Conclusion: Studies that focused on increasing pediatric oral health knowledge and practice behaviors among both EHS staff members and parents reflected positive outcomes. Ongoing research is needed to examine the effectiveness of oral health education and promotion activities as they relate to the oral health outcomes of children enrolled in EHS programs.

Jordanian dentists' knowledge and implementation of eco-friendly dental office strategies.

OBJECTIVE: To investigate the implementation of eco-friendly dental office strategies by Jordanian dentists. METHODS: Self-designed questionnaires were provided to 150 dentists working in private dental practices in the city of Amman, the capital of Jordan. Dentists' names and addresses were obtained from the Jordanian Dental Association. RESULTS: Overall, the level of knowledge about eco-friendly dental offices strategies was high for amalgam, radiology, paper waste, infection control and energy and water conservation. In terms of implementation, the majority of Jordanian dentists apply few eco-friendly dental offices strategies. The most frequently identified barriers to implementation of eco-friendly dental offices strategies were cost and lack of incentives from the government. CONCLUSION: Most Jordanian dental practices are not eco-friendly. A continued focus on the impact of dental practices on the environment is needed through formal and continuing dental education. Results of this study can guide policy development to encourage implementation of eco-friendly strategies.

Bisphenol A blood and saliva levels prior to and after dental sealant placement in adults.

PURPOSE: This study examined the effects of a widely used (Delton Pit & Fissure Sealant - Light Cure Opaque, DENTSPLY Professional, York, PA) pit and fissure sealant material on bisphenol A (BPA) levels in blood and saliva, among both low and high-dose groups over time. METHODS: A convenience sample of 30 adults from the Old Dominion University population were randomly and evenly divided into 2 independent variable groups: a low-dose group (1 occlusal sealant application) and high-dose group (4 occlusal sealant applications). A 2 group, time series design was used to examine the presence and concentration of BPA in serum and saliva after sealant placement. Differences comparing low-dose and high-dose groups were examined 1 hour prior (baseline), 1 hour post, 3 hours post and 24 hours after sealant placement, as measured by a direct-competitive BPA Enzyme Linked ImmunoSorbent Assay (ELISA). Hypothesized outcomes were evaluated by applying a parametric, 2 way ANOVA for repeated measures technique to data on the 30 participants ranging in age from 18 to 40 years, and were of mixed gender and ethnicity. RESULTS: BPA was detected in the saliva of all participants prior to sealant placement and ranged from 0.07 to 6.00 ng/ml at baseline. Salivary BPA concentration levels peaked over a 3 hour period following sealant placement and returned to baseline levels within 24 hours. BPA was significantly elevated at all post-sealant placement time periods for both the low-dose (1 occlusal sealant application) and high-dose (4 occlusal sealant applications) groups with peak levels of 3.98 ng/ml and 9.08 ng/ml, respectively. The blood serum did not contain BPA at any point in this investigation. CONCLUSIONS: Exposure to BPA from sources other than dental resins contributes to salivary baseline concentration levels and indicates environmental exposure and use of products containing BPA. Use of specific molecular formulations of dental sealant material determines the release of BPA, therefore, dental sealant materials should be reviewed independently when questioning the release of BPA from dental sealants. In addition, dosage amounts of the dental sealant material used in this study do not influence the serum concentration levels of BPA. Further research is needed to examine the cumulative estrogenic effects of BPA from dental sealants.

Eating disorders in the oral health curriculum.

Due to the oral/systemic nature of eating disorders, this serious health issue requires comprehensive patient assessment and coordinated health treatment. The purpose of this study was to assess the breadth and depth of eating disorder and comprehensive care within the dental and dental hygiene curriculum. Survey data were collected from deans of U.S. dental programs (n=24) and dental hygiene program directors (n=94). Statistically significant differences were observed between dental programs (DP) and dental hygiene programs (DHP) as more DHP reported including anorexia nervosa (p<.001), bulimia nervosa (p<.001), and oral manifestations of eating disorders (p=.003) within their curricula. Clock hours dedicated to these topics ranged from seventeen to thirty-five minutes, with no statistically significant differences observed between DP and DHP. Only 58 percent of DP and 56 percent of DHP included patient communication skills specific to eating disorders. Moreover, DHP were observed dedicating more instruction time for this skill (p=.011). As greater emphasis is placed on oral/systemic health and the provision of comprehensive care, many oral health professionals may not be adequately trained to identify, provide education, and communicate with patients regarding the oral/systemic nature of eating disorders. The findings from this study indicate that there is a need for appropriate training to better prepare oral health professionals for comprehensive patient care.