The effect of an oral health education program after three years.

Three years after providing an oral health education program (OHEP) to nursing personnel, the authors analyzed the effect of the program on knowledge of the importance of oral health and on perception among the nurses of the possibility to implement oral care in patient care. The study was based on a cross-sectional survey of all nursing personnel (N = 2,901) in five municipalities in the Southwestern Sweden, of whom 950 had attended four one-hour lessons during an OHEP in 1996. The response rate to the survey questionnaire was 67% (1,930 subjects). Statistical analysis was performed by means of descriptive and analytical statistics. The program was shown to have an independent effect on the dependent variables "knowledge of oral health" and "assessment of implementation possibilities," This study has given further evidence of the feasibility of an educational program to improve both knowledge and implementation of oral health care.

Dental surgery in pediatric patients with spina bifida and latex allergy.

Dental rehabilitation is a common outpatient pediatric surgical procedure. It requires the dentist to restore or extract the teeth of children with severe tooth decay or poor dental hygiene. Medical, physical, or emotional problems can make safe treatment in an outpatient setting impossible. These children require sedation or anesthesia for the dentist to gain access to their oral cavities. This article discusses caring for pediatric patients with spina bifida and latex allergy undergoing dental rehabilitation. Perioperative nurses must act as patient advocates in providing a latex-safe environment and also ensure quality care.

Staff attitudes to oral health care. A comparative study of registered nurses, nursing assistants and home care aides.

This study compares differences in attitude, of oral health care of nursing personnel working with dependent elderly and severely disabled patients. A questionnaire was administered to 398 personnel covering (1) personal oral health care habits, (2) experiences and attitudes in assisting oral care and (3) willingness to assist patients/residents with their daily oral hygiene. Three hundred and sixty-four persons answered the questionnaire, including 70 registered nurses, 148 nursing assistants and 146 home care aides. The study revealed that oral care assistance is viewed as more disagreeable than other nursing activities. Although registered nurses were found to have more positive attitudes toward oral care assistance than the other nursing groups, they were seldom involved in the daily practice of oral hygiene care. The results indicate a gap between knowledge and practice in nursing personnel's attitudes toward oral health care of dependent elderly and severely disabled patients.

Experiences with sedation and restraint during dental treatment in Romania.

In August, 1995 dental treatment was provided in an orphanage in Romania. This treatment took place over three weeks using three different dentists. Two dental nurses served for full the duration. For the last two weeks the team was joined by a dental health educator. All have given accounts of their time in Romania. The patients had various degrees of handicap but generally co-operation for treatment was poor. Most patients needed pre-operative sedation of oral valium. A papoose board was used for restraint. All the contributors agree that this was extremely helpful in controlling the patients. Dental treatment was mostly-restricted to extractions. A parallel preventive programme was run by the dental health educator. The team encountered bureaucratic problems which were overcome. All 220 children in the orphanage were screened and treated. Local children and adults were also given dental treatment when time allowed. The team wish to express gratitude to all who helped and supported them. They plan a future mission in 1997. In 1994, a dental team had previously travelled to Romania and carried out treatment of handicapped children using sedation & restraint. The principal difference between 1994 and 1995 was the introduction of the papoose board as the method of restraint. The papoose board is a temporary restraint device for use during medical or dental procedures. It is a set of canvas flaps with velcro fasteners on a board. A head strap and wrist straps are important accessories. Pre-operative sedation was given to the children 2-3 hours in advance of dental treatment. This usually was 10-20 mg oral valium. The child was then led into the dental surgery by hand and placed on the papoose board, which was already situated on the reclined dental chair. Before the child realised what was happening the wrist straps and leg straps were in place. Within seconds the other straps were closed and the child was totally restrained and ready for dental treatment. Dental treatment was then carried out using local anaesthesia. Care has to be taken that the restraint does not impair the patient's breathing, circulation, cause over-heating or positional injuries. A dental health education programme was run in parallel with the treatment service. The individual accounts of experiences follow. Firstly, the joint account of Dental Nurses Catherine Treacey and Karen Vaughan from the Dublin Dental Hospital, who were working for the full three weeks. Then follow the accounts of the dentists. On week 1 by Anne O'Neill, who works with the Eastern Health Board in the Dun Laoghaire area, week 2 by Robert Gorby, a dentist in private practice in Carlow, and week 3 by Brendan Fanning who works part-time for the Eastern Health Board, in Wicklow and part-time in practice in Ashford, Co. Wicklow. The final account is of the dental health education programme by Miriam Henshaw, Health Educator who works for the Eastern Health Board in the Wicklow area.

Oral hygiene care levels in Iowa intermediate care facilities.

This study was undertaken to improve understanding of current oral hygiene care practices in intermediate care facilities. Questionnaires were sent to directors of nursing of all licensed intermediate care facilities in Iowa. Results show that an estimated 57% of residents needed direct oral hygiene assistance. In all intermediate care facilities, the majority of direct oral hygiene care was provided by aides. Oral hygiene care was often not provided at an optimal level, and the main reasons reported for this lack of care were uncooperative residents (82%), lack of perceived need by aides (68%), and inadequate time/personnel (49%). Development and promotion of oral hygiene care programs in intermediate care facilities must take into consideration the realities and problems involved. Otherwise, efforts to introduce or implement new or improved care programs will fail.