Assessment of Oral Health Promotion Programs in Schools and their Long-Term Effects.

Background: School-based oral health promotion initiatives are essential for enhancing children's and teenagers' oral health outcomes. However, the long-term efficacy of these initiatives is yet unknown. Methods: Over the course of a year, 500 children between the ages of 6 and 12 years participated in prospective observational research. Two groups of 250 participants each-the intervention group and the control group-were created. While the control group only got basic oral health information, the intervention group participated in a full program aimed at promoting oral health. Over the course of 2 years, baseline data on the participants' oral health condition were gathered, and follow-up evaluations were carried out every 6 months. Results: At the 12-month follow-up, the intervention group showed a substantial decrease in dental caries prevalence (15.2% vs. 23.6%, P < 0.001) as compared to the control group. In addition, the intervention group showed better oral hygiene habits than the control group (P < 0.001), such as decreased plaque index and more frequent brushing. In conclusion, school-based initiatives to promote oral health are successful in enhancing children's and adolescents' long-term dental health outcomes. These initiatives are essential in lowering the prevalence of dental caries and encouraging good oral hygiene habits. Ensuring the long-term dental health and well-being of future generations requires sustained investment in school-based oral health promotion efforts.

Barriers and Facilitators to Dental Care Services Utilization Among Children With Disabilities: A Systematic Review and Thematic Synthesis.

BACKGROUND: This systematic review investigates barriers and enablers to dental care utilization by disabled children. Given the high global prevalence of disabilities in children, coupled with poor oral hygiene and a 45% rate of dental caries in this group, developing inclusive oral health strategies is critical. The review aims to synthesize literature on factors affecting oral healthcare improvement for disabled children, identifying barriers, facilitators and knowledge gaps. METHODS: The review was conducted following the Joanna Briggs Institute's methods and reported according to PRISMA guidelines. A comprehensive search spanned multiple databases, considering perspectives from carers, parents, dentists and health professionals. The focus was on studies involving children up to age 17 with disabilities, as defined by WHO, using dental care services. Exclusions included non-qualitative studies, populations over 18 and nondisabled children. There were no restrictions on publication date or language. Thematic synthesis of the studies extracted themes related to barriers and enablers in oral healthcare for disabled children. RESULTS: Thematic synthesis identified five overarching themes: stigma, communication issues, professional development, oral health education and medical-dental collaboration. Facilitators included enhancing accessibility and availability of dental care through a holistic approach, improving dental care facility environments and ensuring skilled dental care providers. DISCUSSION: The review underscores the importance of interprofessional collaboration, improved parent/caregiver education and specialized dental facilities to support children with disabilities. It identifies key barriers and facilitators in dental care, including challenging stereotypes, improving communication between providers and parents, enhancing holistic training and addressing gaps in oral health education and integrated healthcare systems. CONCLUSION: Addressing the complex dynamics of dental care for disabled children is essential for developing inclusive and effective preventive and therapeutic strategies. This review highlights the need for tailored approaches and enhanced support systems to improve oral health outcomes in this vulnerable population. PATIENT AND PUBLIC CONTRIBUTION: The members of the family support department, Middle East and North Africa (MENA) Organization for Rare Disease and Disability who provided the disability voice and contributed to providing input to the review protocol.

Parental perceptions of an oral health promotion program in early childhood education and care settings: A qualitative study.

OBJECTIVES: Early Childhood Caries is a global health problem. The Bright Smiles Bright Futures (BSBF) program seeks to equip educators, children, and parents with skills and knowledge about oral health promotion habits early in life. The aim of this study was to examine parental perceptions of the BSBF program and identify key facilitators and barriers for its implementation. METHODS: Twelve mothers of children who participated in the BSBF program in five Early Childhood Education and Care (ECEC) settings in NSW, Australia were recruited in this qualitative study. Data were collected via focus groups and interviews, transcribed verbatim and coded to categorize for inductive thematic analysis. RESULTS: Five major themes emerged: Promoters of the BSBF oral health program, barriers to the BSBF oral health program implementation and participation, online resources, impact of the BSBF oral health program, and strategies for enhancing the BSBF oral health program. While participants reported that the program encouraged their children's toothbrushing, they found issues with the program's materials, ECEC center attendance, and communication about the oral health program with their children. The program improved message retention, attitudes, routines, and family perceptions toward oral health. Participants recommended oral health literacy, changed delivery formats, increased dental access, and inclusion of interactive elements to enhance the program. CONCLUSIONS: The findings from this study provide insight to improve parents' experiences and engagement in oral health promotion. This can help to raise awareness of the importance of child oral health among policymakers, healthcare professionals, and the public to inform public health policy discussions.

Assessing the impact of oral health disease on quality of life in Ecuador: a mixed-methods study.

Introduction: Globally, oral health diseases surpass all other non-communicable diseases in prevalence; however, they are not well studied in underserved regions, where accessibility to dental services and oral health education is disparately worse. In Ecuador, further research is needed to understand such disparities better. We aimed to assess the effect of oral health disease on individuals' quality of life and how social disparities and cultural beliefs shape this. Methods: Individuals 18 or older receiving care at mobile or worksite clinics from May to October 2023 were included. A mixed-methods approach was employed, involving semi-structured interviews, Oral Health-Related Quality of Life (OHRQoL) measures, and extra-oral photographs (EOP). Results: The sample (n = 528) included mostly females (56.25%) with a mean age of 34.4 ± 9.44. Most participants (88.26%) reported brushing at least twice daily, and less than 5% reported flossing at least once per day. The median OHRQoL score was 4 (min-max), significantly higher among individuals ≥40 years old, holding high school degrees, or not brushing or flossing regularly (p < 0.05). Identified barriers to good oral health included affordability, time, and forgetfulness. Participants not receiving care with a consistent provider reported fear as an additional barrier. Participants receiving worksite dental services reported these barriers to be alleviated. Dental providers were the primary source of oral hygiene education. Most participants reported oral health concerns, most commonly pain, decay, dysphagia, and halitosis - consistent with EOP analysis. Discussion: Findings underscore a need for multi-level interventions to advance oral health equity.

Special education teachers' involvement and perceived barriers to delivering oral health education for students with disabilities-A cross-sectional study.

BACKGROUND: Dental caries is prevalent among children, including those with disabilities. Although the World Health Organization recommends school-based oral health promotion (OHP) programmes involving teachers, limited research has explored teachers' roles and perspectives. AIM: To assess special education teachers' involvement and difficulties regarding oral health education (OHE), attitudes towards OHP and barriers to oral healthcare access for students with disabilities (SWDs). DESIGN: This descriptive cross-sectional study, conducted in Al-Ahsa, Saudi Arabia, involved 264 special education teachers using a validated, self-administered questionnaire, and descriptive and analytical statistics were used for data analysis. RESULTS: Only 39% of teachers incorporated OHE into their teaching, and just 20.8% received training for OHE delivery. Teachers showed strong support for integrating OHE into the curriculum (84.1%) and a no-sugar policy (78%). There was, however, less support for school-based toothbrushing (39%). OHE barriers included insufficient resources (56.1%), limited knowledge (29.2%) and misconceptions about primary teeth removal (47.4%). The three most common barriers to oral healthcare access were extended waiting lists (75.0%), long waiting times (73.1%) and fear of dental equipment (67.4%). CONCLUSION: This study highlights the need for collaboration between healthcare professionals, educators and parents to enhance OHE and reinforce OHP for SWDs within special education and beyond.

Effectiveness of immersive technologies in oral health promotion and education: A systematic review.

OBJECTIVE: To evaluate the effectiveness of immersive technologies in oral health promotion and education. METHODS: An extensive literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. This study was systematically performed in six electronic databases (PubMed, Google Scholar, Web of Science, Cochrane, Scopus, and EBSCO). The risk of bias was assessed with the Cochrane tools using RoB 2.0 and ROBINS-I. RESULTS: PICOS criteria were formulated for study inclusion. The bibliographical search identified 10,074 articles, which were filtered subsequently. Finally, the most pertinent nine articles were included and scrutinized for data synthesis and analysis. This includes five randomized controlled trials and four non-randomized controlled trials in different countries that focused on children (33.3%), adolescents (11.1%), and adults (55.6%). The interventions used virtual reality (VR) and augmented reality (AR) to promote knowledge and attitudes towards oral care, improve toothbrushing performance, and smoking cessation, and reduce anxiety levels in oral health education. CONCLUSION: This systematic review demonstrates that immersive technologies, including VR and AR, significantly enhance oral health knowledge, attitudes, and self-efficacy, leading to improved health outcomes. CLINICAL SIGNIFICANCE: Immersive technologies such as VR and AR have the potential to provide innovative and effective methods for enhancing oral health promotion and education, while promoting positive health behaviours, which are crucial for improving overall oral health outcomes.

Examining Caregiver- and Family-Level Psychosocial Influences on Child Oral Health Behavioral Outcomes in Racially and Economically Minoritized Urban Families.

OBJECTIVES: Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high risk for poor oral health outcomes. METHODS: Data were drawn from the baseline wave of the CO-OP Chicago Cohort Study (U01DE030067), a longitudinal study on child/caregiver dyads exploring oral health behaviors and caries development in young children (N = 296 dyads; child mean age = 5.36, SD = 1.03; caregiver mean age = 33.8 years, SD = 6.70; caregiver race = 43% Black; caregiver ethnicity = 55% Latinx). The oral health behavioral outcomes included child toothbrushing frequency, child plaque levels, and caregiver assistance with child toothbrushing. The data included demographics; caregiver depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, social functioning, social support, and resilience; and family-level household chaos. RESULTS: Multiple regression models indicated that greater household chaos was significantly related to lower caregiver assistance with child toothbrushing (p = 0.0075). Additionally, caregiver anxiety and PTSD symptoms as well as number of children in the home significantly predicted higher levels of household chaos (p < 0.01). Notably, 18% of caregivers reported clinically significant PTSD. The relationships between caregiver-level psychosocial factors and child oral health behaviors were not significant. CONCLUSIONS: The results suggest household chaos may play an important role in child oral health behaviors and highlight the importance of investigating family-level factors for understanding and addressing child oral health risk.

Social Story Intervention for Training Expected Behaviors among Preschool Children: A Systematic Review and Meta-Analysis.

Promoting appropriate behaviors in early childhood is crucial for children's future development. This systematic review aimed to explore the efficacy of social story (SS) intervention in teaching expected behaviors among preschool children. A structured search strategy was applied to five online electronic databases. The references were systematically screened in accordance with the PRISMA statements. Randomized or non-randomized controlled studies, as well as single-subject studies, in which SSs served as a behavioral training approach for children aged 2 to 6 years were included. Information related to study design, characteristics of the participants, target behaviors, and implementation of SS intervention was extracted. A meta-analysis was performed using the random-effects model, where similar outcomes were evaluated by similar intervention across multiple studies. Twenty-one studies were identified for qualitative analysis, while two studies formed the basis of the meta-analysis. SS interventions were employed to teach a variety of behaviors among typically developing children as well as those with various disabilities, such as autism, developmental delay, hearing impairments, attention deficit hyperactivity disorder, or other disabilities. The target behaviors included oral health practices, peer interaction, staying on-task, self-regulation, sleep habits, and controlling aggressive behavior during group activities. The SSs were used either alone or combined with other strategies, such as positive reinforcement, music therapy, role play, group discussion, video self-modeling, immediate practices, or additional audio commentary. Most studies reported improvements in appropriate behaviors and/or reductions in unfavorable behaviors. The meta-analysis indicated that children practiced more toothbrushing steps when using SS interventions compared to conventional oral health instruction (Z = 3.60, MD = 0.66, 95%CI 0.30 to 1.02, p < 0.001). SS interventions have the potential to teach target behaviors, particularly toothbrushing behaviors, among preschool children. More well-designed randomized controlled trials are warranted to determine the efficacy of SS interventions among children with various developmental profiles.

Assessment of patterns and related factors in using social media platforms to access health and oral health information among Sri Lankan adults, with special emphasis on promoting oral health awareness.

BACKGROUND: Social media has evolved beyond its conventional purpose of communication and information sharing to become a potent tool for disseminating health and oral health awareness. This study seeks to assess the patterns and related factors of using social media platforms to access health and oral health information among Sri Lankan adults, with special emphasis to promotion of oral health awareness. METHODS: In March 2023, individuals aged ≥ 18 years residing in Sri Lanka, who are users of social media participated in this electronic questionnaire-based survey. Statistical analyses of the collected data were done using the SPSS version 21 software, with a p-value of < 0.05 set to determine the level of statistical significance. RESULTS: A total of 421 persons participated in this survey. Majority (68.4%) belonged to the age category of 18 to 30 years, and 55.5% were females. WhatsApp (96.8%) was the most frequently used social media platform across all age groups and both genders. Statistically significant differences were identified between genders in the usage of Telegram, Twitter, and Viber within the 18-30 years age category, with a higher percentage of males using these platforms (p ≤ 0.05). Similar significant differences were observed in the 31-40 years age group for WhatsApp and Telegram (p ≤ 0.05). Among 95.4% of online health information seekers, YouTube (74.9%) was the most popular platform. One-quarter of the respondents preferred social media platforms, and 22.3% preferred websites for obtaining oral health information. Furthermore, 74.9% had positive opinions on obtaining oral health information via social media, while only 17% reported pleasant experiences with social media platforms for oral health promotion. In assessing the reliability of oral health information on social media, 48% relied on the quality of the information. The most preferred source of oral health information was short videos from professionals (43.1%). Additionally, 69.5% reported changes in their oral health behaviours after accessing information through social media. CONCLUSION: Social media is a viable platform for promoting public oral health awareness in Sri Lankan; hence, workable strategies need to be employed, to further ensure its effective and wider use in a culturally and socioeconomically diverse country like Sri Lanka.

Can oral health care be a gateway to improve cardiovascular disease? A scoping review.

Background: Cardiovascular diseases (CVDs) are a significant cause of morbidity and mortality worldwide, resulting in a high socioeconomic burden. Growing evidence has shown a link between oral diseases and several chronic conditions including CVDs. The focus of this review is to investigate and summaries the evidence surrounding oral health interventions and their potential impact on reducing both the risk and/or severity of CVDs. Methods: A scoping review was conducted to examine oral health interventions for managing CVD outcomes and risks. The review adhered to the Joanna Briggs Institute (JBI) framework for evidence synthesis and followed the reporting standards outlined by the Preferred Reporting Items for Systematic Reviews and Meta-analysis- extension to Scoping Review (PRISMA-ScR). A systematic search across EBSCOhost, PubMed, and Scopus databases from 2012 to 2024 was utilized to identify relevant studies. Inclusion criteria focused on English language articles with a sample size of at least 50, evaluating the impact of oral health interventions on CVD outcomes. Results: Out of the initial 2,154 studies identified in the search, 12 studies met the inclusion and exclusion criteria and were included in the final analysis. Overall, the studies revealed that along with surgical and non-surgical periodontal therapy, regular oral hygiene care practices, including toothbrushing, tongue brushing, and flossing, significantly reduced the risk of cardiovascular events and mortality. These interventions in patients with or without CVD baseline have shown a decrease in CVD risk markers as well as a reduction in bacterial colonization. Similarly, consistent oral hygiene routines, combined with regular dental visits, were associated with a lower risk of heart failure and CVD risk mortality. Conclusion: The evidence extracted from this review suggests that periodontal therapy, regular dental cleaning, and re-enforcing of oral health regimes can stabilize oral health conditions and subsequently improve CVD progression/risks. However, limited to no evidence exists regarding the therapeutic effects of oral health promotion in managing CVD markers and its direct impact on disease outcomes, warranting further investigation.

The value-for money of preventing and managing periodontitis: Opportunities and challenges.

This article gives an overview of the societal and economic aspects of periodontitis and periodontal care. Despite its largely preventable nature, periodontitis is highly prevalent worldwide and imposes a substantial health and economic burden on individuals and society as a whole. The worldwide estimated direct treatment costs and productivity losses due to periodontitis (including for periodontitis-related tooth loss) amounted to US$ 186 billion and US$ 142 billion in 2019, respectively. The burden of periodontitis is particularly evident in low and disadvantaged populations. Smoking, dietary habits, and presence of systemic diseases along with social and commercial determinants are considered as risk factors for the periodontal diseases. The cost-effectiveness of preventing and managing periodontitis has been explored in several studies but it has been highlighted that there is scope for improvement in defining the methodology and quality of reporting of such studies. A recent report by The Economist Intelligence Unit examined the cost-effectiveness of interventions to prevent and manage periodontal diseases, suggesting that prevention of periodontitis through prevention of gingivitis by means of individual home care would be more cost-efficient than four other examined approaches. Future research in this field is recommended to further decipher the economic burden of periodontitis to society and to assess the value for money of alternative approaches to address periodontitis with particular emphasis on public health preventive strategies and intersectoral care approaches that address the common risk factors of periodontitis and other non-communicable diseases simultaneously.

Adolescents' views on oral health care and promotion in Norway: everyday practices, recommendations, and future visions.

Introduction: In this study, we aimed to understand adolescents' perspectives on oral health care and promotion. Our research was conducted in the context of Norway's oral health care system, where societal factors like income and education influence health disparities. Despite free public dental care for all residents younger than 19 years, challenges persist in promoting oral health among adolescents, a group whose oral health behavior and literacy remain largely unexplored. Materials and methods: A thematic analysis of an anonymized dataset from 80 adolescents aged 12-20 years was conducted. Results: Five central themes were recognized: (1) Feeling fresh vs. feeling indifferent: A broad spectrum of attitudes; (2) Bridging gaps, building habits: Collaborative efforts in oral care; (3) "Create good experiences at the dentist so people come back again"; (4) Requested qualities in oral health promoting solutions; (5) Reminder tools for everyday use. Taken together, these themes highlight adolescents' oral health practices and resources, recommendations for dental clinics, and visions for future oral health promotion. Discussion: Based on the results, the discussion highlights a need for tailored oral health promotion and ideas to reach adolescents in meaningful and effective ways. Reflections on the theme of social inequalities are provided.

A Qualitative Study of Preschool Children's Perspectives on an Oral Health Promotion Program in New South Wales, Australia.

In Australia, dental caries are observed in almost half of children starting school. Oral health promotion programs are being implemented in early childhood education and care (ECEC) settings to promote oral health. This study examined children's perceptions of one such program, the Bright Smiles Bright Futures (BSBF) program in ECEC settings in New South Wales, Australia. Data were collected using focus group discussions from 15 children aged 3-5 years, transcribed verbatim, and analysed through inductive thematic analysis. Three themes were identified as follows: (i) oral health knowledge of children, (ii) oral hygiene practices routine and skills development, and (iii) evaluation of the oral health promotion kit and opportunities for improvement. Children's perspectives highlight the BSBF program's success in communicating key messages to promote oral health. The integration of family-centric approaches, acknowledgement of children's preferences, and the use of interactive tools collectively enhance the overall effectiveness of the oral health promotion program.

Finding the person behind caries disease: The dental caregivers' experiences of empowering patients to implement beneficial behavioral changes.

OBJECTIVES: This study aimed to elucidate dental professionals' experiences of how to empower patients at risk of developing new or additional caries to promote caries-related preventive behavioral changes. METHODS: Semi-structured in-depth interviews were conducted, audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. To provide credibility and high-quality data, participant recruitment followed strategic sampling. The 10 participants included nine women and one man; six participants were dentists, and four were dental hygienists. In the data analysis, five descriptive and five strategic themes emerged that formed an overarching theme: Finding the person behind caries disease. RESULTS: The results indicated that by initially getting to know the person behind the patient, trusting relationships and knowledge can be generated to successfully influence patients' behaviors related to caries. The five descriptive themes included: Building a treatment alliance, Understanding habitual patterns, Motivating for changes, Implementing new behaviors, and Preserving behavioral improvements. The descriptive themes each revealed a strategy theme containing several strategy proposals for initiating and supporting caries-preventing behavioral changes. CONCLUSIONS: This study highlights the importance of establishing a treatment alliance to improve the patient's skills, knowledge, and motivation. It underscores the significance of recognizing the individual behind the patient, to facilitate optimal behavior change at the lowest possible level of treatment. CLINICAL SIGNIFICANCE: Our findings could assist in strengthening caries-related health promotion, caries prevention, and understanding of oral health literacy techniques.

"I Just Wanted a Dentist in My Phone"-Designing Evidence-Based mHealth Prototype to Improve Preschool Children's Oral and Dental Health: Multimethod Study of the Codevelopment of an App for Children's Teeth.

BACKGROUND: Dental caries in preschool children is a global health concern. With increased access to technology and the disruption of health care during the pandemic, mobile health apps have been of interest as potential vehicles for individuals' health maintenance. However, little is known about caring for their child's teeth and what their preferences would be regarding the content or design of an oral health app. OBJECTIVE: This study aims to co-design the prototype of an app named App for Children's Teeth with parents, providing a source of information for them about caring for their children's teeth and promoting positive dental habits. METHODS: This multimethod study conducted user involvement research with a purposive sample of parents or carers of children aged ≤6 years to (1) understand their use of the internet through the eHealth Literacy Scale and interviews, (2) determine their opinions about content related to children's oral health, and (3) collect feedback about the app's acceptability using the Theoretical Framework of Acceptability. There were three stages: (1) interviews with parents to understand their needs, preferences, and abilities; (2) prototype design with app developers; and (3) parent feedback interviews using the think aloud method for data collection. Data were deductively analyzed using a codebook strategy, whereas data from the think aloud sessions were analyzed inductively using reflexive thematic analysis. RESULTS: The prototype design stage involved 10 parents who reported using the internet for health information but found it to be scattered and contradictory. Parents generally welcomed the App for Children's Teeth but expressed concerns about screen time and practicality. They suggested guidance regarding oral hygiene practices, teething symptoms, and pain relief. Parents appreciated features such as clear fonts, categorization according to their child's age, and "In a Nutshell" bullet points. Topics that resonated with parents included information about teething, finding a dentist, and breastfeeding. They believed that the app aligned with their goals and offered suggestions for future developments, such as outlining the process of finding a dentist and incorporating a forum for parents to communicate and exchange ideas. CONCLUSIONS: The coproduction design approach highlighted parents' need for solutions such as mobile health apps to access reliable information about oral health. Parents identified key design concepts for the app, including a simple and uncluttered interface, content categorization according to their child's age, and practical guidance supported by visual aids. Despite potential challenges related to screen time restrictions, parents provided insights into how such an app could fit seamlessly into their lives. TRIAL REGISTRATION: Open Science Framework; https://osf.io/uj9az.

Effectiveness of theory-based educational interventions of promoting oral health among elementary school students.

BACKGROUND: The aim of the present study was to determine the effect of oral health education programs on the oral health of primary school students. METHODS: In this randomized controlled trial study, 190 elementary fifth-grade female students were chosen using the multistage cluster sampling method. In this study, the Plaque Index (PI), Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index (CPI), tooth brushing using fluoride toothpaste, dental flossing frequency and factors affecting them were determined according to social cognitive theory (SCT). Interventions were implemented using the play method and with the help of three pamphlets, five posters, a celebration of oral health, and the creation of a Telegram group. Data were analyzed using descriptive statistics indexes, t tests, paired sample t tests, chi-square tests, and Pearson correlation tests. RESULTS: The results showed that 3 months after the intervention, compared to before the intervention, the percentage of participants in the intervention group who brushed their teeth twice or more per day increased by 48.5%, and the percentage of participants who used dental floss at least once per day increased by 64.2%. The rate of gum bleeding decreased by 6.3%. The good OHI-S rate increased by 44.4%. Dental plaque decreased by 38.1%. CONCLUSION: The results demonstrated that a gamification design can be effective and useful in promoting the oral health of students. TRIAL REGISTRATION: registration timing: retrospective, registration date: 18/10/2022, registration number: IRCT20141128020129N2.

Polish pregnant women's knowledge on early childhood caries prevention and oral hygiene in children.

BACKGROUND: Early childhood caries (ECC) is one of the most common chronic diseases among children. In Poland 86.9% of six-year-olds have ECC. One of the factors determining adherence to ECC prophylaxis and oral hygiene is mothers' knowledge. The aim of this study was to assess the level of knowledge demonstrated by pregnant women about ECC prevention and oral hygiene, and to analyse the determinants of this knowledge. METHODS: A quantitative survey was conducted using Computer Assisted Telephone Interview technique on a randomly selected representative sample of 1,000 women over the age of 18 in their second and third trimesters of pregnancy. The significance level was established at 0.05 and p-values were presented as: p < 0.05, p < 0.01 and p < 0.001. RESULTS: The highest percentage of wrong or "I don't know" answers were related to questions about: the number of free dental check-ups for children (76.8%), the date of the child's first visit to the dentist (66.5%), the age when the child has mixed dentition (72.2%). Women with higher education had better knowledge than women with lower or secondary education. Women with good and very good financial situation showed a higher level of knowledge compared to women with average, bad and very bad financial situation. CONCLUSIONS: When developing prevention strategies and educational programs as part of prenatal care for women to reduce the incidence of ECC, it is important to take into account the identified areas that need support and specific target groups (mothers with lower socioeconomic status).

Referral from well-child care clinics to dental clinics leads to earlier initiation of preventive dental visits: A quasi-experimental study.

BACKGROUND: An ealy first preventive dental visit for children is recommended no later than twelve months. However, still many children have their first dental visit relatively late. AIM: To evaluate whether active or passive referral by a well-child care (WCC) physician of babies for a first preventive dental visit leads to earlier initiation of dental care. DESIGN: From WCC clinics in two Dutch regions, 629 parents of babies participated. Parents received an active referral from a WCC physician for a dental visit for their babies (n = 204) or received care as usual (CAU) (n = 136) in one region and a passive referral (n = 143) or CAU (n = 146) in the other region. Active referral involved parents receiving a scheduled appointment at the dental practice, and passive referral involved parents making an appointment themselves. During the WCC visit, parents completed a baseline questionnaire. At age 2.5 years, parents received a follow-up questionnaire about dental attendance. RESULTS: Of the active referral intervention group, 59.3% had their first preventive dental visit in their first year compared with 3.7% in the CAU group (p < .001); for the passive referral group, 46.9% compared with 9.6% (p < .001). CONCLUSION: Referral of babies by WCC for their first preventive dental visit leads to earlier initiation of dental care. An active referral had a larger effect than passive referral.

Development of oral health resources and a mobile app for caregivers and autistic children through consensus building.

LAY ABSTRACT: Caregivers of autistic children often lack knowledge regarding oral homecare and when and where to see the dentist. To address this need, we developed a series of information on oral health. An autistic child assisted in developing two social stories to showcase a dental visit. A mobile app was developed to deliver the above mentioned. Other features include creation of customised social stories and visual schedule and an inbox to allow dentists to send messages to parents. The developed information and social stories were reviewed by experts and parents. The app also underwent anonymous and independent testing by parents. Overall the information and app were well received by the experts and parents.

Conceptualising a theoretical framework for planning and evaluating workplace oral health promotion programs.

ISSUED ADDRESSED: Workplaces have considerable potential for enhancing personal resources and providing a supportive working environment for staff health, including oral health and well-being. To date, assessments of workplace oral health promotion (WOHP) activities have observed benefits ranging from self-reported oral health to clinical parameters. However, previous WOHP actions were not based on a theoretical framework and did not consider the working environment as part of the planning and evaluation process. METHODS: This article used evidence-based health promotion theoretical frameworks, and associated facilitators and barriers, in constructing an integrated and theoretically robust approach to planning and evaluating oral health promotion activities in the workplace. RESULTS: The PRECEDE-PROCEED Model for planning and evaluation, the reach effectiveness adoption implementation maintenance, and the Salutogenic Model of Health were chosen to complement each other in the planning and evaluation process, based on their different features and the applicability of those features to the workplace setting. Because of the limited literature in this area, the current article also used evidence from oral health promotion in other settings (including schools and the community) and general health promotion in the workplace to construct a theoretical framework for planning and evaluating WOHP activities. CONCLUSIONS: The theoretical framework developed could assist in planning or improving existing workplace health promotion programs that focus on or incorporate oral health elements. SO WHAT?: Future research on applying and adapting the proposed framework is required.