Geriatric oral health care content and barriers to its incorporation in undergraduate nursing curricula: New Zealand survey.

INTRODUCTION: An increasingly older population demands major remodeling of our health care system. Older adults are most likely to be affected by the oral-systemic connection due to their impairment in functional capacity and reduced ability to undertake routine oral care. An economic way to improve oral health outcomes in older populations is by involving nurses and caregivers in ensuring the maintenance of oral health for older adults. This study aimed to investigate the present educational content relevant to the oral health of older adults, the oral-systemic connection, and assessment methods in New Zealand nursing education. METHODS: A cross-sectional survey was conducted among nursing educators to understand the extent of oral health care education. Quantitative descriptive data were analyzed using SPSS software and qualitative data were analyzed descriptively and presented as themes. RESULTS: The results indicated that the majority of oral health topics were already incorporated into nursing education, however most important topics such as risk factors associated with dental caries, periodontal health, and risk factors are not taught in almost 40% of the schools. The four themes identified in qualitative analyses are "no barrier", "lack of expertise", "no space for more content" and oral health content "already included". CONCLUSION: Educators reported that oral health topics are already incorporated into New Zealand undergraduate nursing curricula. However, the quantity and quality of oral health content relevant to older adults need to be improved and updated to suit the current oral health care needs of the growing older population.

Clinical and Microbiological Evaluation of a Chlorhexidine-Modified Glass Ionomer Cement (GIC-CHX) Restoration Placed Using the Atraumatic Restorative Treatment (ART) Technique.

The aims of this study were to investigate the clinical effectiveness and patient acceptability of a modified glass ionomer cement placed using the atraumatic restorative treatment (ART) technique to treat root caries, and to carry out microbiological analysis of the restored sites. Two clinically visible root surface carious lesions per participant were restored using ART. One was restored with commercial glass ionomer cement (GIC) (ChemFil® Superior, DENTSPLY, Konstonz, Germany) which acted as the control. The other carious root lesion was restored with the same GIC modified with 5% chlorhexidine digluconate (GIC-CHX; test). Patient acceptability and restoration survival rate were evaluated at baseline and after 6 months. Plaque and saliva samples around the test and control restorations were collected, and microbiological analysis for selected bacterial and fungal viability were completed at baseline, and after 1, 3, and 6 months. In total, 52 restorations were placed using GIC and GIC-CHX in 26 participants; 1 patient was lost to follow-up. After reviewing the restorations during their baseline appointments, participants indicated that they were satisfied with the appearance of the restorations (n = 25, 96%) and did not feel anxious during the procedure (n = 24, 92%). Forty-eight percent (n = 12) of the GIC-CHX restorations were continuous with the existing anatomic form as opposed to six for the GIC restorations (24%), a difference which was statistically significant (p = 0.036). There was no statistically significant reduction in the mean count of the tested microorganisms in plaque samples for either type of restorations after 1, 3, or 6 months. Restoration of carious root surfaces with GIC-CHX resulted in higher survival rates than the control GIC. ART using GIC-CHX may therefore be a viable approach for use in outreach dental services to restore root surface carious lesions where dental services are not readily available, and for older people and special needs groups.

Knowledge of nursing graduates on oral health care for older people in the long-term care.

OBJECTIVES: Oral health self-care deteriorates in older adults due to a decreasing level of cognition increasing disability and/or a reduction in manual dexterity. Older adults in hospital care or residential care therefore increasingly need assistance for oral health care. There is an increase in dentate patients entering residential care due to advances in dentistry. It is suggested therefore that nurses in aged care increasingly need advanced knowledge to care for their older dentate patients to prevent and minimize progression of oral diseases, given the impact of poor oral health on general health. The current study was conducted to investigate the oral health care knowledge of nursing graduates across Aotearoa New Zealand. METHODS: A cross-sectional study was conducted among third year nursing graduates in 18 nursing institutes in New Zealand. Oral health care knowledge and oral-systemic connection knowledge, and predictors of oral health care knowledge were investigated. RESULTS: Total 148 students participated in the student's survey, making it 15% of 2020 graduates. The students' survey results suggested that nursing graduates have good basic oral health knowledge, however, their knowledge of the oral-systemic disease connection and the value of an examination of the oral cavity were poor. CONCLUSION: The oral health care knowledge of nursing students and their ability to care for older adults relies on oral health care education in their nursing programs. A revision of curricula to improve oral health education in nursing programs is strongly recommended.

Working characteristics for practising dental hygienists in two countries in different hemispheres.

OBJECTIVES: The study aimed to collect and compare practising characteristics for dental hygienists (DHs) in New Zealand (NZ) and Sweden. METHODS: Dental hygienists from NZ and Sweden were invited to participate in an anonymous online survey focussing on their working practices. An email, with a link to the online survey and a participant information sheet, was sent to DHs registered with their professional association in their respective country. Frequency analyses and cross-tabulations were conducted using chi-square and Fisher's exact tests to investigate possible statistical associations to allow for comparisons between the countries. RESULTS: DH is a female-dominated workforce with equal distribution of gender in both countries. The majority of DHs in NZ worked in private practice while Swedish DHs mostly worked in the public sector. NZ participants were younger and with a more recent qualification than their Swedish counterparts. The highest degree of education was a PhD for DHs working in Sweden, compared with a master's degree for NZ participants. The majority of participants from both countries treated patients 65 years of age or older, with the most common medical conditions being cardiovascular disease and diabetes mellitus. The most common dental condition observed/treated was periodontal disease. Over 60% agreed to have an understanding of information technology (IT). The most used technical equipment was digital radiology, followed by other diagnostic tools. CONCLUSION: Findings confirm previous international data on demographical uptake for the DH workforce in NZ and Sweden. A coherence was seen in patient characteristics, DHs' attitudes towards information technology and use of technical equipment.

An intraoral device for weight loss: initial clinical findings.

Introduction Obesity is a global epidemic, increasing the risk of many associated health issues.Aim The aim of this clinical study was to investigate the acceptability and tolerability of an intraoral device, designed to facilitate weight loss.Method Seven healthy obese participants were recruited. The device, which incorporated closed-field magnets with keepers to restrict mouth opening, was cemented to the participants' first molars. The participants were given a commercially available liquid diet for two weeks. The comfort and tolerability of the device were assessed using a quality of life questionnaire during review appointments at 1, 7 and 14 days and two weeks after device removal.Results The participants reached a mean weight loss of 6.36 (SD = 3.79) kilograms, which represents approximately 5.1% of their body weight. The participants had trouble pronouncing some words and felt tense and embarrassed 'only occasionally'. The participants 'hardly ever' reported a change in taste sensation or felt uncomfortable drinking. However, participants indicated that they occasionally had discomfort and felt that life in general was less satisfying. Qualitative analysis showed that the participants were happy with the outcome and were motivated to lose more weight.Conclusion The participants tolerated the device for a two-week period with satisfactory weight loss and were further motivated to continue their weight loss journey.

Graduate mobility: Where do dentistry graduates choose to practise?

BACKGROUND AND OBJECTIVE: The international higher education market has grown and developed rapidly. International students generate attractive income for host universities, and gaining an international education benefits students in an increasingly globalised world. However, there is little research regarding where international students intend to work and settle beyond graduation. This study investigated where dentistry students intended to practise after graduation, and whether international students who graduated between 2001 and 2016 are currently practising in their host country (New Zealand) or have migrated overseas. METHODS: A cross-sectional survey was used to investigate current students' intended destination of practice after graduation. Additionally, names of international graduates since 2001 were matched against the 2017 register of practitioners to determine if they were currently registered to practise in their host country. A frequency and bivariate analysis was conducted. RESULTS: Almost 64% of current international students indicated their intention to stay in their host country after graduation. However, only 22% of graduates since 2001 were currently practising in New Zealand. The number of international graduates who registered to practise in New Zealand increased between 2001 and 2016. CONCLUSION: Less than one-quarter of international graduates were currently practising in their host country; however, longitudinal data showed that this is an increasing trend. These findings can be used to inform how we might prepare current and future graduates for both local and globalised labour markets.

Direct Restorations, Endodontics, and Bleaching: Materials and Techniques Used by General Dentists of New Zealand.

BACKGROUND: To investigate the selection and use of direct restorative materials, endodontic techniques adopted, and approaches to bleaching by general dentists in New Zealand. METHODS: A questionnaire comprising 19 sections and 125 questions was distributed via mail to 351 general dentists in New Zealand who were selected, at random, from the Dental Council of New Zealand's 2016 register. RESULTS: A total of 204 questionnaires were returned, of which 188 were usable. Direct resin composite was the most commonly used material for occlusoproximal cavity restorations in premolars (93.7%) and permanent molars (85.2%). Resin-modified glass ionomer cements (34%) and resin composite materials (31.4%) were more commonly used in the restoration of deciduous molars. Home-based vital bleaching was provided by a significant number of dentists (86%), while only 18% provided practice-based bleaching. Cold lateral condensation was the most commonly used obturation technique (55.8%), and 83% of respondents reported using rubber dam for treatments. CONCLUSIONS: The findings from this study indicate that dentists in New Zealand are adapting to new materials and technologies to provide high quality care to their patients. Aesthetic treatments such as bleaching have become an integral part of general dental practice.

Indirect Restorations and Fixed Prosthodontics: Materials and Techniques Used by General Dentists of New Zealand.

BACKGROUND: To investigate the selection and use of materials and techniques for core buildup, indirect restorations, and fixed prosthodontics by general dentists in New Zealand. METHODS: A questionnaire comprising 19 sections and 125 questions was distributed via mail to 351 general dentists in New Zealand who were selected from the Dental Council of New Zealand's 2016 register. RESULTS: The majority of the respondents (68.8%) reported using resin composite light-cured materials for the core buildup of vital posterior teeth. A large number of respondents (52%) did not use dentine pins, with the majority of them (25%) being recent graduates (<10 years). Fibre posts were used by 61.6% of the dentists surveyed. The majority of dentists (54.6%) reported using addition-cured silicone impression material for crown and bridge impressions. Glass-ionomer cements (37.5% of participants) and resin-modified glass-ionomer cements (35.8%) were the most common luting cements used. Direct resin composite veneers were the preferred material of choice rather than indirect restoration of anterior teeth (40.4%). CONCLUSIONS: The study showed that New Zealand dentists surveyed are using current state-of-the-art materials and techniques, with their choice of material being greatly influenced by clinical indications and patients aesthetic demands.

Demographics, Practising Arrangements, and Standards: Survey among New Zealand Dentists.

BACKGROUND: To determine the demographic profile and practising arrangements of general dentists in New Zealand. METHODS: A questionnaire comprising 19 sections with 125 questions was distributed via mail to 351 general dentists in New Zealand who were selected, at random, from the Dental Council of New Zealand's 2016 register. RESULTS: Two hundred and four questionnaires were returned, of which 188 were usable giving a response rate of 53.5%. The majority of the respondents (63.5%) were male and practice principals (56.8%). Fifty-nine percent of the practices were located in city or town centres with a wide geographic distribution. Sole practitioners accounted for 24.1% of respondents, with the mean number of dentists per practice being 3.2. The majority of respondents (71.6%) attended five or more continuing professional development courses in the past year. Ninety-one percent of respondents used a computerized management system, and 95.3% used the Internet. The use of nickel-titanium endodontic files (83.9%) and digital imaging (82.2%) was the most frequently cited clinical innovations. Articaine was the most popular local anaesthetic of choice. CONCLUSIONS: Dentistry is an ever-changing profession, with evidence that NZ dentists continue to develop, learn, and embrace advancements in technologies to supply high-quality evidence-based treatment.

Epidemiology of dental caries among adolescents in Tamil Nadu, India.

OBJECTIVE: Economic and dietary changes in the Indian state of Tamil Nadu have led to compromised oral health status of the adolescent population. Adequate epidemiological data are not available to address the prevention or treatment needs in this region of India. The aim of this study was to measure the prevalence and severity of dental caries among adolescents of Tamil Nadu, a southern state of India. METHODS: The study sample included 974 adolescent school students (12-15 years of age) from both rural and urban areas of Tamil Nadu, India. The decayed, missing and filled teeth (DMFT) index of these students was measured using the World Health Organization oral health survey method, in a quantitative cross-sectional study. RESULTS: The oral health survey indicated that the prevalence of dental caries among adolescents in rural and urban areas of Tamil Nadu was 61.4%, with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, mother's education, type of school and caste as significant predictors of dental caries. CONCLUSION: Female gender, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to be affected by dental caries. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region.