The COVISTRESS oral-health study: Dental-care access in France during the COVID-19 pandemic / Accès aux soins dentaires pendant la pandémie de Covid-19 en France : l'enquête COVISTRESS-santé orale

The COVID-19 pandemic led to an interruption in dental-care services during the initial lockdown period. This study assesses the impact of this period on the perception of oral health and accessibility to dental care in France. A questionnaire survey was carried out (COVISTRESS.ORG) to study the stress and health behaviors of adults before, during, and after the first lockdown, i.e., at the time of the response. An "oral health" questionnaire assessed changes in the perceived difficulties for accessing dental care. Between November 2020 and April 2021, 339 adults completed the "oral health" section. The perceived-difficulty-in-accessing-dental-care score (on a scale of 0 to 100) was 21.6 ± 26.7 before the pandemic, 52.9± 39.5 during lockdown, and 38.1± 35.3 after it. Before the pandemic, this score was linked to an unfavorable perception of oral health and to difficulties in accessing health care. During lockdown, the score was associated with high dental care needs (RR=4.1; CI95%=1.2­13.8), and perceived difficulties in accessing the health care system (5.06; 1.8­14.1), particularly transport difficulties (3.0; 1.1­9.1). The factors explaining the change in difficulties from before to after the lockdown differ according to when the assessment was done. This study demonstrates the negative impact of the pandemic on perceived difficulties for accessing dental care, within a population with few socially disadvantaged people.

La pandémie de Covid-19 a entraîné une interruption des soins dentaires lors du premier confinement. Cette étude évalue les répercussions de cette période sur la perception de la santé orale et de l'accès aux soins dentaires en France. Une enquête par questionnaire a été menée (COVISTRESS) pour étudier le stress et les comportements de santé des adultes avant, pendant et après le premier confinement, soit au moment de la réponse. Un questionnaire « santé orale ¼ a évalué l'évolution de la perception des difficultés d'accès aux soins dentaires. Entre novembre 2020 et avril 2021, 339 personnes ont répondu au volet « santé orale ¼. Le score de difficulté perçue d'accès aux soins dentaires (0 à 100) passe de 21,6 ± 26.7 avant la pandémie à 52,9 ± 39,5 pendant le confinement et à 38,1 ± 35,3 après celui-ci. Avant la pandémie, ce score est lié à une perception défavorable de la santé orale et aux difficultés d'accès aux soins de santé. Pendant le confinement, le score est lié à un besoin élevé en soins dentaires (RR=4,1 ; IC95 %=1,2-13,8), à la perception de difficultés d'accès au système de santé (5,06 ; 1,8-14,1), notamment des difficultés de déplacement (3,0 ; 1,1-9,1). Les facteurs expliquant l'évolution des difficultés avant et après le confinement diffèrent selon le temps d'évaluation. Cette étude montre les répercussions négatives de la pandémie sur la perception de l'accès aux soins, dans une population intégrant peu de personnes socialement défavorisées.

Translation and preliminary validation of a French version of an ageism scale for dental students.

BACKGROUND AND AIM: The World Health Organization considers ageism an important barrier to age-appropriate care for older adults. A new ageism scale for dental students (ASDS) has been validated in the United States, Brazil, Greece and Romania. The aim of this study was to validate a French version (ASDS-Fr). METHOD AND MATERIALS: The 27-item ageism scale was translated from English into French, and its content validity was investigated using the content validity index. The translated version was completed by 180 dental students in the Dental School of Clermont-Ferrand in France. Principal component analysis (PCA) was performed and internal consistency reliability was calculated. RESULTS: The final PCA model resulted in 10 items and three components that together accounted for 57.2% of the overall variance. The first component contained four items that point to a negative view of older adults; the second contained three items that appeared to reflect an absolving of responsibility for providing care to older adults; and the third contained three items that deal with gerodontology education. CONCLUSIONS: This preliminary validation of the ASDS-Fr produced a new 10-item scale with three components with acceptable validity and reliability.

Could the use of saliva substitutes improve food oral processing in individuals with xerostomia? A systematic review.

Xersotomia is associated with food avoidance and low nutritional assessment. This review seeks to document whether products called "saliva substitutes" or "artificial saliva" can really replace saliva in food oral processing. Pubmed and Science Direct were searched for articles using the keywords "saliva substitutes" and "artificial saliva." An advanced search was applied using the terms "xerostomia" and/or "food oral processing" and/or "eating" and/or "mastication" and/or "chewing" and/or "swallowing." The analysis methods and the inclusion criteria were documented in a protocol published in the International prospective register of systematic reviews (PROSPERO with the registration number CRD42019124585). The search included 43 articles, published between 1979 and 2017. Among the included studies, 17 were observational studies, 5 were pilot studies, 21 were crossover studies, and 14 of these studies were blinded. The Strobe score for the included articles varied from 7.5 to 20. The possible effects of the use of saliva substitutes on the ingestion function were poorly investigated. No evidence was based on physiological studies. It is unknown whether using a saliva substitute has an effect on the composition and rheological properties of the food bolus, on the lubrication of the oral and laryngeal mucosa or on both phenomena. Moreover, saliva substitutes were not formulated to improve food oral processing and most of them are flavored. New saliva substitutes and artificial saliva should be designed and formulated to improve food oral processing.

Assessment of the oral health knowledge of healthcare providers in geriatric nursing homes: additional training needs required.

OBJECTIVES: This study was aimed at assessing the knowledge of oral health and training needs of health workers in geriatric nursing homes. BACKGROUND: Providing daily oral care to dependent elderly people is the best way to prevent oral disorders. Because there are no dental hygienists in France, health workers play an important role in providing oral care in nursing homes and should have correct and adequate knowledge. MATERIALS AND METHODS: Health workers from 8 geriatric nursing homes in Puy de Dôme (France) completed a 58-item questionnaire. Oral health knowledge regarding dental decay, periodontal diseases, oral hygiene and denture care was assessed. Univariate and bivariate analyses were performed. RESULTS: A total of 99 health workers took part in the study. The total mean score was significantly different if health workers had received training in oral disorders (49.3 ± 11.7 vs. 43.9 ± 10; p < 0.05) or in the maintenance of oral health (50.5 ± 10.5 vs. 42.9 ± 10; p < 0.01). The mean scores obtained in the 'dental decay' subsection and in the 'oral and denture hygiene' subsection were the lowest. CONCLUSION: Geriatric nursing home staff need training in understanding the impact of oral health on general health. Theoretical knowledge of oral diseases has to be improved in order for health workers to understand oral hygiene procedures and to help them identify early oral disorders.