Barriers and facilitators to using an objective risk communication tool during primary care dental consultations: A Theoretical Domains Framework (TDF) informed qualitative study.

OBJECTIVES: Objective risk communication tools can supplement clinical judgement and support the understanding of potential health risks. This study used the Theoretical Domains Framework (TDF) to identify barriers and facilitators to implementing a risk communication aid within primary care dental consultations. METHODS: Dentists (N = 13), recruited via a dental practice database and through professional contacts were interviewed using a TDF-informed semi-structured interview schedule. Data were analysed inductively and deductively coding the themes using the TDF. RESULTS: Eight theoretical domains (environmental context and resources; beliefs about consequences; goals; memory, attention, and decision processes; optimism; reinforcement; social influences and behavioural regulation) and thirteen sub-themes were identified. Insufficient resources and patient factors were commonly encountered barriers and led to increasing pressure to prioritise other tasks. Whilst dentists had a favourable view towards a risk communication aid and acknowledged its benefits, some were sceptical about its ability to facilitate behaviour change. Self-monitoring strategies and colleague support facilitated tool usage. CONCLUSIONS: This study identified six barriers and seven facilitators to implementing a risk communication tool within primary care dental settings. Dentists appreciated the value of using a risk communication tool during dental consultations, although some required further support to integrate the tool into practice. CLINICAL SIGNIFICANCE: Our findings provide a sound theoretical base for interventions aimed at facilitating patient behaviour change through the use of risk communication in dentistry. Further research should apply behavioural science to support the implementation of the tool in clinical practice.

Carious typodont teeth's effectiveness in pre-doctoral SIM lab to reinforce operative learning.

INTRODUCTION: The concept of ideal preparations in dental schools are highly emphasized during the first two years of students' learning. However, students do not have as much opportunity to practice skills that would prepare them for real-life stituations such as non-ideal preparations and caries removal. OBJECTIVE: This study aimed to determine the benefits of utilizing carious typodont teeth in the Operative curriculum for first- and second-year UCSF dental students METHODS: This study was completed by hosting a workshop in which the students performed a Class II preparation on #19 carious typodont tooth. The students filled out pre- and post-surveys with questions about their confidence with performing a preparation and their opinions on the current curriculum. RESULTS: The pre-survey responses showed that the majority of the first- and second-year students did not believe that the traditional non-carious typodont teeth were a good representation of prepping on real, carious teeth. The pre-survey responses also showed that most of the first- and second-year students thought that the addition of carious typodont teeth would improve their learning experience. The post-survey results displayed that the majority of the students thought that prepping carious typodont teeth helped to better reinforce concepts such as preparation design, taught them the difference between ideal and non-ideal preparations, and allowed them to better understand tooth anatomy with the addition of the dentin layer. CONCLUSION: The use of the carious typodont teeth in pre-clinical operative lab was found to be beneficial to first- and second-year UCSF student's learning based on the pre- and post-survey results.

Impact of oral health integration training on children's receipt of oral assessment, fluoride varnish and dental services.

OBJECTIVES: To evaluate the impact of an oral health integration training program on children's receipt of oral health and dental services in Southern Oregon. METHODS: Children under 19 years with at least 6 months of Medicaid enrolment and at least one healthcare visit from 2014 to 2018 were included. The treatment group included children with at least one visit with a trained provider (n = 5541); children with no visits with trained providers (n = 8273) were the control group. The percentage of the treatment group who received oral health assessments was calculated, and regression models were developed to estimate the difference in likelihood of receiving fluoride varnish and dental services between treatment and control groups. RESULTS: The percentage of children receiving oral health assessments increased over time. Visiting a trained provider was consistently associated, each year, with a greater likelihood of receipt of fluoride varnish and preventive and diagnostic dental services but was not associated with treatment dental services or dental sealants. CONCLUSIONS: This study reports evidence for the overall impact of an oral health integration training on children's receipt of oral and dental services. Health systems implementing these types of training strategies should consider how to reach specific underserved subgroups, increase paediatric dentists, and expand efforts to include older children.

Can mHealth promotion for parents help to improve their children's oral health? A systematic review.

OBJECTIVE: This systematic review evaluated the effectiveness of oral health education using mHealth approach to parents for improving their children's oral health. DATA: Twelve studies were included after the screening and five studies in the data synthesis. The sample size varied from 34 to 1055. There was a very low level of evidence showing that mHealth approach could increase parents' knowledge and improve their brushing behaviors for children when compared to a negative control group. There was a low level of evidence showing mHealth approach could be more effective than printed material in increasing the parents' oral health knowledge. SOURCES: This systematic review was registered on PROSPERO (#CRD42021289324) with no funding support. STUDY SELECTION: Studies targeting parents/caregivers of children age 12 or under were included. Interventions should be oral health promotion delivered via mobile devices. Study outcomes were parents' oral health knowledge, attitude and behaviors, and children's oral health status. Eight electronic databases/registration platforms: PubMed, Cochrane Library, Embase, WoS, Global Health, Engineering Village 2, WHO ICTRP and ClinicalTrials.gov were lastly searched on 6th Oct 2021. The risk of bias tools used were RoB 2.0, ROBINS-I and NIH quality assessment tool for pre-post study. Meta-analysis using a fixed-effect model or vote counting based on the direction of effect was performed. CONCLUSION: All included studies had a high risk of bias. Low/very low certainty of evidence existed that the mHealth approach could improve parents' oral health knowledge. However, there lacks evidence to show the effects of mHealth intervention exerted on other outcomes. CLINICAL SIGNIFICANCE: The mHealth intervention could be a good approach to improve the parent's oral health knowledge. However, the theoretical model must be considered when designing the educational content. More research should be conducted to test the effectiveness of mHealth approaches on children's oral health status.

Efficacy of oscillating rotating versus side-to-side powered toothbrushes on plaque and gingival index reduction: A systematic review.

BACKGROUND: The authors conducted a systematic review to assess the efficacy of oscillating rotating (OR) versus side-to-side (SS) powered toothbrushes on plaque and gingival index reduction. METHODS: The authors searched 3 electronic databases and the gray literature for randomized clinical trials in which investigators compared OR with SS powered toothbrushes. Two authors independently screened the studies, performed data abstraction, and assessed the risk of bias. The authors used random-effects model meta-analyses to pool results across trials and the Grading of Recommendations Assessment, Development and Evaluation approach to rate the certainty of evidence. RESULTS: This systematic review included 24 trials in which researchers enrolled a total of 2,998 patients. There was moderate-certainty evidence that SS toothbrushes may result in little to no difference in plaque index reduction from baseline to 4 weeks compared with OR toothbrushes (standardized mean difference, 0.02; 95% confidence interval, -0.46 to 0.42). There was moderate-certainty evidence that SS toothbrushes may result in little to no difference in gingival index reduction from baseline to 4 weeks compared with OR toothbrushes (standardized mean difference, 0.13; 95% confidence interval, -0.47 to 0.22). There was moderate-quality evidence suggesting little to no difference in adverse events. CONCLUSIONS: The evidence does not suggest the superiority of either OR or SS toothbrushes for plaque or gingival index reduction. PRACTICAL IMPLICATIONS: Clinicians and patients considering the use of either of these toothbrushes are unlikely to observe more benefits with one type versus the other.

Relationship between oral symptoms during diving work and preventative dental visits in Japanese male occupational divers.

This cross-sectional study examined the relationship between dental symptoms experienced by occupational divers during diving and their participation in preventative dental visits. The questionnaire for this study was sent by post to 160 establishments and 215 members of the Japan Diving Association and participants were asked to complete a self-reported questionnaire. Data from 242 occupational divers (male, aged 20-79 yr) were analyzed. Multiple logistic regression analysis and correspondence analysis were performed to determine the relationship between dental symptoms experienced during diving and participation in preventative dental visits. We found that divers who experienced tooth pain while diving had not undergone preventative dental visits within the previous year (odds ratio: 2.76, 95% confidence interval: 1.12-6.80). This was also confirmed by correspondence analysis These findings suggested that not undergoing preventative dental visits was related to tooth pain during diving.

Both non-surgical dental treatment and extractions increase the risk of medication-related osteonecrosis of the jaw: case-control study.

OBJECTIVES: Medication-related osteonecrosis of the jaws (MRONJ) is a serious condition whose risk factors remain unclear. The aim of this study is to investigate the role of oral health and of dental treatment in the development of MRONJ. MATERIALS AND METHODS: A case-control study was conducted in Brisbane, Australia. Hospital records were used to identify incident cases of MRONJ between January 2010 and March 2017. Cases were individually matched to up to 3 controls according to age, sex, primary disease, and type of antiresorptive therapy. Demographic data, medical histories and public dental records were collected. Associations between oral health, dental treatment, and MRONJ were investigated using conditional logistic regression. RESULTS: Overall, 44 cases were identified and matched to 115 controls (total sample = 159). Only one-third of patients received a dental examination in the year prior to commencing antiresorptive therapy (27% of cases and 34% of controls). After adjusting for potentially confounding variables, non-surgical dental treatment (OR = 6.3; 95% CI = 2.1, 19.1; p < 0.001) and dental extractions (OR = 8.0; 95% CI = 3.0, 21.0, p < 0.001) were significantly associated with development of MRONJ. CONCLUSIONS: Current levels of preventative dental care are insufficient to eliminate the need for dental treatment and extractions during antiresorptive therapy, and the consequent increase in risk of MRONJ. CLINICAL RELEVANCE: Optimizing the health of the oral cavity and ongoing preventative dental care must be a priority for patients prior to the initiation of antiresorptive medications.

Risk factors for medication-related osteonecrosis of the jaws: A systematic review.

The purpose of this study was to identify the patient populations at risk of medication-related osteonecrosis of the jaw (MRONJ) and determine which medical and dental comorbidities are significant risk factors for this disease. An electronic search of Embase, MEDLINE, Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform and ProQuest Dissertations and Theses Global was conducted to identify all human studies that reported risk factors for MRONJ. Only a qualitative analysis was performed due to significant heterogeneity in the collected data. The search strategy identified 2872 records, of which 219 studies were eligible for inclusion. A total of 4106 patients with MRONJ were identified, 39 different systemic diseases were implicated, and 14 medical and 11 dental risk factors were reported, although no statistical analysis of the significance of each of these factors was possible. The clinical reach of MRONJ may be wider than anticipated, and more data on the significance of each potential risk factor are needed to guide the identification and management of at-risk patients.

Community-specific, preventive oral health policies: preventive measures on dental caries.

In all health fields, limited infrastructure and resources hinder the provision of basic services to low-income populations. Subsequently, oral health is often neglected, as over 90% of caries remains untreated in developing communities. In order to deliver the most cost-effective prevention methods, public health officials must assess each available strategy on an individual community basis. In this paper, examples from oral health will demonstrate the importance of community-specific determinants in the formation of preventive public health policies. These determinants include economical, cultural, social, and political elements that can assist policy makers in generating effective functional public health policies.

La salud bucal en la percepción del adolescente / Adolescents' perception of oral health

Objetivo En la fase de la adolescencia, el individuo no siempre experimenta los mejores índices de salud y vitalidad. El objetivo de éste es evaluar la percepción del adolescente sobre las condiciones de su salud bucal, así como sobre los factores para su manutención y promoción. Material y Método Fue aplicado un cuestionario semi estructurado a los adolescentes (n=493) de la Fundación Mirim del Municipio de Araçatuba-SP, Brasil. Resultados Entre los entrevistados, el 68,4 por ciento conceptuó salud bucal como higiene y el 16,2 por ciento como apariencia. Ya la percepción de los mismos cuanto a su Salud bucal fue un 53,6 por ciento buena y un 24 por ciento óptima. Con referencia a los medios para tener salud bucal, el 90,1 por ciento relató la higiene bucal, pero apenas el 4,8 por ciento de los adolescentes mencionó el cepillado de la lengua. La estética (62,9 por ciento) fue uno de los principales motivos citados, cuanto a la importancia de los dientes. Fue observada una relación estadística significante entre la percepción de la Salud bucal regular y la visita al dentista hace menos de 6 meses (X 2 =30,75, p < 0,05). Conclusión Pese a que los adolescentes presentan una idea sobre Salud bucal, y sobre su manutención y promoción, estos temas deben ser más trabajados, principalmente por medio de Educación en Salud, para que esos adolescentes obtengan una buena Salud bucal y que ésta se mantenga por el resto de sus vidas. Además, ellos se vuelven multiplicadores de conocimientos para aquéllos que no tienen acceso a las mismas informaciones.

Objective An individual does not always experience the best health and vitality indexes during her/his adolescence. This study evaluated young people's awareness of their oral health and the factors involved in dental maintenance and promotion Material and Method Adolescents (n=493) from the Mirim Foundation in the town of Araçatuba in the state of São Paulo, Brazil, were asked to fill in a semi-structured questionnaire. Results 68.4 percent of the youngsters interviewed regarded oral health as referring to hygiene and 16.2 percent to physical appearance; 53.6 percent of the group perceived their oral health to be good and 24 percent optimum. 90.1 percent indicated oral hygiene when asked how oral health could be ensured; however, only 4.8 percent mentioned brushing their tongues. Physical appearance (62.9 percent) was one of the main reasons stated as being important for teeth. A statistically significant relationship was observed between perception of regular dental and mouth health and having visited the dentist at least six months beforehand (x 2 =30.75; p<0.05). Conclusion Even though the youngsters had a general idea regarding their oral health, its maintenance and promotion, better information should be made available regarding such topics and be approached through health education so that these adolescents can have good oral health for the rest of their lives, as well as becoming knowledge multiplying agents for those who do not have access to the same information.