Toothbrushing competency among high-risk grade one students: an evaluation of two methods of dental health education.

OBJECTIVE: To evaluate the effectiveness of two methods of dental health education (DHE) for improving toothbrushing competency among grade one students at high risk for dental diseases. METHODS: Fifty elementary schools in the former city of North York, Ontario, Canada, were assigned to one of two groups. In one group, students received a classroom-based DHE lesson that was reinforced by two small group sessions (n = 243). In the other group, students received only a single classroom-based DHE lesson (n = 206). Trained examiners assessed 11 toothbrushing skills at pre- and postintervention. RESULTS: At the preintervention test, few significant differences were found between the groups and many students did not display competency in fundamental oral health skills, such as placing a toothbrush at the gum line. Following DHE interventions, students in both groups demonstrated improvements in most skills. A significantly higher proportion of students who received both classroom and small group sessions displayed gains in competency in three skills, compared to students receiving only a classroom lesson. These skills were brushing anterior lingual surfaces, brushing posterior lingual surfaces, and brushing all areas in a routine fashion. Students receiving only a classroom session did not display greater improvements in any skill areas compared to "classroom plus small group" students. Some students in both groups still lacked fundamental skills at the end of the DHE program. CONCLUSIONS: While one must exercise caution in interpreting the results due to several methodologic limitations, findings suggest that for high-risk grade one students, a classroom-based lesson combined with small group sessions is a more effective method of improving toothbrushing skills compared to a single classroom-based lesson.

Oral hygiene knowledge of high-risk Grade One children: an evaluation of two methods of dental health education.

The effectiveness of two methods of dental health education (DHE) for improving oral hygiene knowledge among high-risk Grade One students was evaluated. Fifty elementary schools in the former City of North York, Canada were assigned to one of two groups. In one group, students received a classroom-based DHE lesson which was reinforced by two small-group sessions (n=243). In the other group, students received only a single classroom-based DHE lesson (n=206). After DHE interventions, students in both groups displayed improved knowledge for most oral hygiene questions (e.g., when should you throw your toothbrush away?). However, for several questions, a significantly higher proportion of "classroom plus small-group sessions" students displayed improved knowledge compared to students receiving only a classroom lesson. These items included: awareness that cavity prevention and removal of germs are two purposes of oral hygiene; and knowledge that teeth help people to eat and talk. Results suggest a classroom-based lesson combined with small-group sessions is a more effective method of improving oral hygiene knowledge among high-risk Grade One students compared to a single classroom-based lesson.

The dental health of 12-year-old children in Dominica: a report of a survey using WHO methods.

As part of the process of assisting in the planning of a primary dental health care system in the Commonwealth of Dominica, we conducted a survey of mostly 12-year-old children. The purpose of the survey was to assess the oral health status and identify the needs for treatment and prevention. Secondary purposes included training Dominican dental auxiliaries and assistants to collect epidemiologic data and to use the findings to compare oral health status by region and previous coverage by the auxiliaries. The sample was obtained from schools throughout the country. Examinations were conducted according to standard WHO methods, using mirrors and explorers. The findings were recorded on prepared forms and the data were processed in Toronto using microcomputers. We found 31% of children to be caries-free and the mean DMFT score to be 2.5 (95% CI 2.2-2.7). Only 8% of lesions had been treated. No differences were observed by region but in areas covered by dental auxiliaries, children had fewer decayed teeth, fewer DMFT and higher F/DMFT ratios. Only 17% scored 0 on the CPITN index and 63% scored 2, meaning they had calculus. Debris was 3.6 times more likely to be found among those with gingival bleeding or calculus compared to those with periodontal health. Single surface restorations made up 82% of the estimated 2.0 caries treatment services required. The survey findings will allow planners to design specific preventive and treatment programs to meet Dominica's needs.

Ontario dental assistants' job satisfaction: relationship to work stress and intention to change jobs.

Low job satisfaction has been linked to rapid turnover of dental assistants with resultant loss of productivity and reduced quality of patient care. Work dissatisfaction has also been linked to stress related diseases. The aim of this mailed survey of 1,000 Ontario certified dental assistants was to test a survey instrument developed in the United States and to relate satisfaction to work stress and to the intent to change jobs. Eighty-one per cent of eligible subjects responded. The satisfaction sub-scales of the survey instrument were found generally to have acceptable construct validity and to be reliable when applied to an Ontario population. However, some minor modifications were necessary. Although over 36 per cent said they were generally very satisfied with their work, the intent to change jobs was significantly related to areas of dissatisfaction concerning recognition for work done and opportunities for personal and professional growth. Stress was related to dissatisfaction with work-related fatigue, time pressure and nonpatient tasks. These findings have implications for dental practice management.

Work-related stress and its predictors among Canadian dental assistants.

This paper reports the results of a survey of 1000 certified dental assistants in Ontario, Canada. The aim was to obtain data on work-related stress, its sources and predictors. Of those responding to the survey, 38.8% said that their work was moderately stressful and 14.5% said it was very or extremely stressful. Approximately one-third had been bothered by stress at work on three or more days in the previous week. The main sources of stress were working under constant time pressures, running behind schedule and feeling undervalued by the dentist. Stepwise regression analysis revealed that the main predictors of work stress were not having a clear job description, working long hours, life stress while not at work and age. However, these variables explained less than 10% of the variance in job stress scores. Overall, 22.8% said it was very likely that they would seek work in another practice or seek work outside dentistry in the coming year. There was a significant association between work stress and job intentions; 43.0% of those reporting high levels of stress intended to change jobs compared to 8.9% of those who said that their job was not at all stressful (P less than 0.0001). These findings have implications for the way in which dental practice is organised and managed.