Validating a short form of the Parental-Caregivers Perceptions Questionnaire (P-CPQ) and the Family Impact Scale (FIS) in Finnish language.

AIM: This study aimed to adapt the short-form versions of the Parental-Caregivers Perceptions Questionnaire (P-CPQ), and the Family Impact Scale (FIS) in the Finnish language and to test its validity and reliability. Another aim was to compare the background factors of parents with respect to P-CPQ and FIS outcomes. METHODS: This study was conducted among a convenient sample of parents who visited the public dental clinic in Sievi, Finland, from May to October 2016. A total of 54 parents of 2-8-year-old children completed the short-form of the P-CPQ questionnaire and 50 parents of 2-8-year-olds completed the FIS questionnaire while visiting for their children's routine dental check-up. Parents completed the self-administered P-CPQ and FIS questionnaires. Reliability and validity of the short-form of the P-CPQ and FIS were assessed. Differences between gender, and family size were evaluated using the Mann-Whitney U test and the differences between age groups were evaluated using the Kruskal-Wallis one-way ANOVA test. RESULT: The Finnish versions of both the short forms of the P-CPQ and FIS had alpha values within the acceptable range. The scales also showed good construct validity. Toddlers (2-4-year olds) had the highest scores for both the P-CPQ and FIS-8 subscales. Likewise, families with 5 or more children had high FIS scores. CONCLUSION: The short form of the P-CPQ and FIS in Finnish language are valid and reliable. The oral health of the child seems to have the greatest family impact among parents with five or more children and in families with 2-4-year olds.

Validating and assessing the oral health-related quality of life among Hungarian children with cleft lip and palate using Child-OIDP scale.

AIMS: To validate the Child-Oral Impact on Daily Performance (Child-OIDP) in the Hungarian language and to explore the oral health-related quality of life (OHRQoL) and associated factors among Hungarian children with cleft lip or/and palate (CLP). METHODS: This cross-sectional study consists of a survey and clinical examination among conveniently selected children with CLP visiting the Pécs cleft lip and palate clinic, Pécs, Hungary. OHRQoL was assessed using the Hungarian version of Child-OIDP. Additionally, a validated structural questionnaire was used for gathering information related to oral hygiene practice. Clinical examination was done to register the dental status using ICDAS criteria, consequences of untreated dental caries (pufa), and bleeding on probing. Results were presented as proportions, means, and standard deviations (SD). Construct validity and internal reliability of the Hungarian Child-OIDP was assessed using the Pearson and Spearman's correlation coefficients, respectively. The logistic regression model examined the association between OHRQoL and explanatory variables. RESULTS: A total of 45 children with CLP participated in this study. The Hungarian Child-OIDP had the Cronbach's alpha value 0.73, and the Spearman's correlation coefficient was 0.31. The mean (SD) Child-OIDP score among the study participants was 4.4 (7.0) and three-fifths (65.9%, n = 27) of the participants reported impact in one or more items of the OHRQoL scale. Tooth brushing was more frequent among 6-10-year-olds compared to 11-16-year-olds. The proportion of those requiring restorative treatment need (DS ≥ 1) was 90.2% (n = 37), those with PUFA/pufa (score ≥ 1) was 24.4% (n = 10), and those with bleeding on probing (> 15%) was 63.4% (n = 26). Children aged 11-16 years had a higher impact on OHRQoL compared to the younger ones. Girls had a higher impact on OHRQoL compared to boys. Children with clefts involving both lip and palate had poorer OHRQoL than the rest. The same was true for those having a high dental caries rate. CONCLUSION: The Hungarian Child-OIDP was a reliable and valid measure. There was a substantial impact on OHRQoL among Hungarian children and adolescents with CLP. Age, gender, cleft type and dental caries were associated with poor OHRQoL.

The effect of a brief computer-assisted intervention on oral health-related behaviours among adolescents.

AIM: The aim of this study was to see if a brief, computer-assisted intervention tool could be pleasant to use for adolescents. Another aim was to evaluate if the computer programme could affect adolescents' oral health-related behaviours. MATERIALS AND METHODS: Study design: For oral health promotion on schoolchildren, a computer-assisted intervention with personal feedback was performed. The effectiveness of the programme on participants' oral health behaviours as well as the feasibility of the programme were evaluated by responses of the participants. The study was conducted on 13-15 year-old schoolchildren (n=112). The computer programme included 19 questions about oral health-related behaviours and it provided personal feedback and tips towards better oral health. Additionally, the participants gave feedback about the programme. After four weeks, the intervention was repeated, the same questions were asked again, and the effect of the intervention on oral health behaviours was evaluated. RESULTS: More than half of the children considered the computer programme useful, girls (56.9%) more often than boys (44.9%) (p = 0.057). Almost everyone reported having learnt new information through the programme. Most of the new information concerned oral hygiene and the effects of different beverages on dental health (over 40% on both issues). Both genders reported having changed their oral health behaviours towards better habits. Girls generally improved their meal quality, while boys cut down on snacking and used more xylitol products. The computer-assisted intervention gave positive results and the programme seemed to be easy and pleasant to use for both adolescents and oral health professionals. STATISTICS: The results concerning the computer programme were described as frequencies, distributions and graphically. Chi-square test or Fisher's exact test was used when compared distributions between different questions and gender as well as questions and groups. The participants were categorised into three groups according to their sum scores (calculated from responses to the questions on oral health-related behaviours). The differences between the sum scores at baseline and after the intervention were analysed with the paired samples t-test. CONCLUSIONS: Information technology seems to have a remarkable potential in motivating patients towards better oral health behaviours.

Dental attendance after treatment under dental general analgesia (DGA): a data-based follow-up study.

AIMS: To investigate dental attendance of patients in different age groups after dental general analgesia (DGA) and procedures performed on these patients during the DGA and in dental care after the DGA during the follow-up period of almost 3 years. METHODS: The study population consisted of 66 patients who were treated under DGA at a municipal health centre in Oulu, Finland between September 2010 and June 2011. The electronic patient files of the DGA patients were accessible for data collection for the follow-up period of nearly 3 years. The statistical analyses included Chi square tests and logistic regression modelling. RESULTS: Approximately every sixth (14.9%) dental visit was missed or cancelled and nearly half (43.9%) of the studied subjects had at least one missed or cancelled appointment. The factors increasing the risk of missed or cancelled appointments and dental avoidance were endodontic treatment (OR 3.62), need of more than five dental restorations (OR 3.47), tooth extractions due to caries (OR 2.22), and male gender (OR 1.80). A total of 45.5% of the patients received non-invasive procedures. CONCLUSIONS: Patients who need DGA are evidently risk patients considering dental attendance. Nearly half of the patients in this study had non-attended or cancelled appointments. DGA patients' need of treatment after DGA is extensive, even comparable to the amount of procedures generally performed under DGA. The quality or amount of preventive procedures do not appear to be at the required level to reduce the number of non-attended appointments.

Survey of family-related factors of children treated under dental general anaesthesia.

AIM: Treatment under general anaesthesia (DGA) is a rising trend in Finland. There is a great need to investigate the causes leading to it. Our purpose was to examine family-related factors reported by parents, such as the family size and favoring DGA in the family, and their influence on children being treated under DGA. This survey was based on a questionnaire targeted to parents of children whose dental treatment could not be performed in a conventional setting. MATERIALS AND METHODS: Guardians of 87 healthy children treated under DGA at a municipal health center in the city of Oulu, Finland, between November 2014 and December 2015 answered the questionnaire on family-related background factors and on the respondent's own as well as their child's presumed dental fear. RESULTS: According to most guardians (83.9% of the cases), the reason for DGA was caries. Male gender, vague family structure, large number of siblings (?4), and DGA history in the family were all important family-related background factors leading to DGA. Self-reported parental dental fear was quite common (25.3%). Children's dental fear reported by parents was associated with DGA in almost half of the cases (46.0%). CONCLUSIONS: The survey highlights the role of the entire family in association with children ending up being treated under DGA. It is essential for the success of dental health care to also consider family-related factors when planning the treatment, particularly with children demanding DGA.

The influence of general health on the need for dental general anaesthesia in children.

AIM: To analyse the occurrence and causes of dental general anaesthesia (DGA) in healthy and medically compromised children, and to investigate if there are differences between those groups considering factors associated with DGA and DGA procedures. METHODS: The data was collected from medical records of children under 7 years of age treated under DGA in the years 2009 and 2010 at the Oulu University Hospital, Finland. The children were divided into two groups: 0-35-month-olds and ≥36-month olds. Background information (year, age, gender, dental diagnosis, health) and the procedures performed were registered. The procedures were analysed considering the child's age and tooth types. RESULTS: The number of children treated under DGA increased between 2009 (58) and 2010 (82), particularly in the group of healthy children. The two main diagnoses leading to DGA were dental caries and dental fear. Dental caries as the first dental diagnosis leading to DGA was more common among the medically compromised children (61.5%) compared to the healthy children (38.6%). The procedures performed were similar among the two groups. However, they varied between the age groups and tooth types and even between upper and lower teeth. The medically compromised children had been treated more frequently under DGA in the past. CONCLUSIONS: The threshold for treating medically compromised children under DGA seems to be lower than for healthy children. However, the occurrence of DGA among healthy children has increased recently. To avoid unnecessary DGA, the control of caries should be carried out according to individual needs and independent of whether the child is healthy or has a chronic disease.

Laser fluorescence in monitoring the influence of targeted tooth brushing on remineralization of initial caries lesions on newly erupted molar teeth - RCT.

OBJECTIVE: This study aimed to monitor mineralization changes in initial caries lesions on newly erupted second molars using laser fluorescence (LF) scanning after a 1-month targeted tooth brushing intervention. METHODS: Altogether, 124 13- to 14-year-old school children were invited to participate. Of those who fulfilled the clinical criteria (at least one initial lesion with LF value >10 in second molars), 51 gave their written consent to participate. Laser fluorescence values were registered at baseline and after 1-month follow-up period. All participants were individually taught targeted tooth brushing of their second molars and randomly provided tooth paste with 0 or 1500 ppm fluoride. Brushing frequency was investigated at baseline and after the follow-up. Change in LF values was compared considering the tooth, content of fluoride in the paste and brushing frequency. RESULTS: In lesions with LF values ≤30 at baseline, change in LF values demonstrated improvement. Improvement was detected especially in upper molars. In lesions with LF values >30 at baseline, improvement was least detected. Brushing frequency increased slightly during the intervention. CONCLUSIONS: Laser fluorescence is a simple method and useful in monitoring remineralization of incipient lesions even in weeks. Targeted tooth brushing seems to induce remineralization even in weeks. Laser fluorescence could be a valuable motivating tool in promoting patients' self-care.

Oral health care-related beliefs among Finnish geriatric home care nurses.

OBJECTIVES: The aim was to investigate beliefs about oral health care tasks among nursing staff caring for home-dwelling older people using the Nursing Dental Coping Beliefs (nursing DCBS) index. METHODS: The study population comprised nursing staff working at the homes and sheltered accommodations of older people in Ylivieska, Finland (N = 141). The data were collected using the nursing DCBS index (five-point Likert scale). RESULTS: On average, the nurses held moderate to high Oral health care beliefs, Internal locus of control beliefs and External locus of control beliefs, but low beliefs about Self-efficacy. The nurses with an earlier adjunct education scored lower for Oral health care beliefs on the factor Knowledge about preventing gum diseases (OR = 0.3, 95% CI: 0.1-0.9) than did the others. Regarding beliefs about External locus of control, the age group 31-49 years scored lower on the factor Retaining teeth as one ages (OR = 0.2, 95% CI: 0.1-0.7), but scored higher on the factor How to prevent dental diseases (OR = 5.6, 95% CI: 1.1-29.3) than did younger nurses (≤30 years). The nurses with only a nursing education showed significantly higher mean scores on the Self-efficacy factor Confidence of the need for dental knowledge than did those with an earlier adjunct education (P = 0.034). CONCLUSIONS: The nursing staff mostly believed that oral diseases are preventable and teeth can be retained in advanced age, but failed to recognize the value of dental knowledge and had little confidence in their ability to manage oral diseases. Improving the oral health-related knowledge and self-efficacy beliefs of nursing staff will require additional oral health education.

Self-reported causes for referral to dental treatment under general anaesthesia (DGA): a cross-sectional survey.

AIM: To determine causes leading to dental care under general anaesthesia (DGA) in public health care reported by the patients or the parents/caregivers. STUDY DESIGN: All the patients referred to DGA at the Municipal Health Centre, Oulu, Finland, during 10 months were invited to participate in the present cross-sectional survey. They were sent a questionnaire on indications for referral to DGA, dental fear, possible reasons for it as well as prior treatment of dental fear. For measuring overall dental fear, the modified Corah dental anxiety scale (MCDAS) and visual analogue scale (VAS) forms were also included in the questionnaire. RESULTS: The most common self-reported indication for referral to DGA was dental fear (63.9%). For children and adolescents (<18 years), need for extensive care was the second most common reported cause. The great majority of the respondents reported having dental fear (90.8%). Dental fear was more common among females than males, but the difference between the genders was not statistically significant. The most common cause for dental fear was earlier negative experiences in dental care (51.9%). The mean MCDAS score was 19.0 (SD 5.7; 5-25) indicating severe dental anxiety. An increasing trend towards older age groups could be seen in VAS scores reporting fear of pain, needles, scaling, scolding by the dentist, extractions, as well as endodontic treatment. Dental fear had been taken into consideration in dental treatment preceding DGA. CONCLUSION: Dental fear is the most common self-reported indication for referral to DGA and should be taken into consideration.

A cohort study on the association of early mutans streptococci colonisation and dental decay.

In children, a strong relationship between the timing of colonisation of mutans streptococci (MS) and future caries risk has been shown to exist. The aim of the study was to examine the association of early MS colonisation with dental decay and the need for restorative treatment. The subjects had been participants in an earlier Finnish mother-child study and assumed to be high-caries-risk subjects due to their mothers' high MS levels. The information on MS colonisation at 2 years of age was available for 164 children. Of them, comprehensive data on dental health, visits and treatments until 10 years of age were found in the registers for 147 subjects. The children who had not been colonised by MS at 2 years of age (n = 118) maintained their teeth caries-free longer than the MS-colonised (n = 29) children. The median value for the caries-free time for MS-colonised children was 4.6 years, in comparison with 8.0 years for non-MS-colonised children (p < 0.001, hazard ratio 2.70; 95% CI 1.72-4.25, Cox regression). Until 10 years of age, the MS-colonised children had made on average 4.6 visits for restorative treatment, while the non-MS-colonised had made 2.8 visits (p = 0.005, Student's t test). The results suggest that the avoided early MS colonisation may lead to favourable long-term effects on caries experience and need for restorative treatment.