Bridging the Gap: Dental Students' Attitudes toward Persons with Disabilities (PWDs).

BACKGROUND: Persons with disabilities (PWDs) face significant barriers in accessing dental care, resulting in poorer oral health outcomes compared to the general population. To reduce dental healthcare disparities, dental professionals must develop positive attitudes and acquire the necessary skills to treat PWDs effectively. This study aimed to assess the experiences, education, training levels, and attitudes of dental students and interns toward PWDs, and to explore the relationships between their exposure to PWDs, their education/training regarding managing PWDs, and their attitudes toward PWDs. METHODS: Participants were recruited using convenience sampling. From May to June 2023, a pretested, validated online questionnaire (developed based on existing survey instruments and modified to fit the study context) was distributed to 98 eligible dental students and interns at King Faisal University. Descriptive and analytical statistics were used for analysis. RESULTS: The response rate was 88.78%. There was a statistically positive correlation between students' exposure to PWDs and their attitudes (p < 0.05). Statistically significant relationships were found between students' education/training and their attitudes towards educational experiences and instructors (p < 0.01) and interpersonal interactions with PWDs (p < 0.05). No statistically significant relationship existed between the year of study and future encounters with PWDs (p = 0.176). Additionally, 42.5% of students felt inadequately prepared to treat PWDs, and 88.5% expressed a desire for further education. Notably, 20.7% reported no training on PWDs, while 70.1% preferred clinical education. CONCLUSIONS: The study underscores the importance of exposure and training in shaping dental students' attitudes toward PWDs. Dental schools should prioritize structured teaching, greater contact with the disabled community, and hands-on experiences to ensure dental professionals are both well prepared and positively inclined to treat PWDs. These findings have significant implications for improving dental education curricula.

The new system for classification of periodontal and peri-implant disease: A questionnaire study of implementation by Swedish dental hygienists.

OBJECTIVE: To what extent do dental hygienists (DH) employed by the Public Dental Health Service (PDHS) in Sweden use the new classification system, their knowledge of it and their attitudes towards it. METHODS: A web-based questionnaire was distributed to DHs in the PDHS in different regions of Sweden. A total of 197 registered DHs responded. The questions covered their knowledge, attitudes and possible barriers to implementation of the new classification system of periodontal and peri-implant diseases, and a question about their perceived need for a complementary digital tool to facilitate its implementation. RESULTS: Seventy per cent of the DHs stated that they used the new classification system. Twenty-nine per cent of the participants were confident in classifying periodontitis under the new system. Furthermore, 36% of the participants considered their knowledge of the new system to be good and 33% to be poor or non-existent. Several DHs stated that the new system was too time-consuming, that it caused stress, that their knowledge was inadequate and that they, therefore, considered it too difficult to use. Eighty per cent of the participants were positive to a digital tool as a complement and support to classify periodontitis and peri-implantitis. CONCLUSION: The present study showed that most of the DHs used the new classification system and one-third considered their knowledge to be good, although it was difficult and time-consuming. Furthermore, in general, the DHs were positive to a digital tool to facilitate application of the new classification system.

Prisoners' perceived oral and general health and their experience with accessing, understanding and assessing health information: A qualitative study.

Prisoners' oral health and general health are closely connected and generally poorer than that of the wider population. Moreover, knowledge of prisoners' health literacy is scarce. This study aimed to explore prisoners' perceived oral and general health and how they accessed, understood and assessed health information to gain insight into their health literacy. Twelve prisoners in a high-security prison and a halfway house participated in individual semi-structured interviews. Data was analysed through thematic analysis, which identified five themes: inconsistent self-reporting of general and oral health; autonomous health behaviour through utilizing personal resources; preference for personalized adapted health information; psychological and physical proximity; and barriers. The prisoners perceived their oral and general health as good despite several health problems. They expressed scepticism towards health information from public authorities and made their own health-related choices based on previous experiences, their own 'common sense' and the experiences of people they trusted. Health information was considered useful when adjusted to their needs. Obtaining health-related information through physical encounters was considered more accessible than through online platforms. Adapting the communication to prisoners' expressed needs and their health literacy can enhance the accessibility to improve their oral and general health. In-person encounters would be preferable.

Geo-Mapping of the Spatial Accessibility to Public Oral Health Facilities among Schoolchildren in Selangor, Malaysia.

Spatial accessibility to health services influences service utilisation and eventually impacts the disease burden. This cross-sectional study analysed the spatial accessibility of schoolchildren to public oral health facilities and school dental services (SDS) and vice versa in Selangor. Overlay and proximity analysis from geo-mapping software was employed to map the primary dental clinics with SDS, the public schools, and the proximity between primary dental clinics with SDS and public schools by travelling distance (5 km, 10 km, 20 km) and travelling time (15 min, 30 min). Over half of the schoolchildren in Selangor are within 5 km of accessibility to primary dental clinics and SDS teams. Meanwhile, nearly half of the primary and secondary schools, particularly in rural areas, are located within a more than 5 km service area of public oral health facilities. The SDS teams have a travel burden of more than 20 km to the public schools in Selangor's northern and north-western districts of large geographical areas. Simultaneously, most public primary and secondary schools are within 15 min of driving time from primary dental clinics. Geo-mapping highlights the inequalities in spatial accessibility to public oral health facilities with SDS among schoolchildren in Selangor. It is time to prioritise the resources, SDS, and preventive programmes to reduce inequalities in oral health accessibility among schoolchildren in Selangor.

Perceived Patient Barriers to Tooth-Retaining Treatment in Tanzania.

BACKGROUND: Dental caries is the most common chronic health condition of humankind and goes untreated in many resource-limited settings. When clinical dental care is accessible, tooth extraction is often chosen over potentially more quality-of-life favorable restorative services. OBJECTIVES: To identify patient-perceived barriers to utilization of dental restorative services among Tanzanian dental patients. METHODS: A cross-sectional study was conducted among adult patients in 5 public dental facilities in Tanzania. Participants (N = 736) were interviewed before and after their dental visit on the same day using structured questionnaires. Sociodemographic characteristics, oral care-seeking behavior, previous experiences with dental restorations, and perceived barriers toward utilization of dental restorative services were assessed. Among patients treated for dental caries, logistic regression models estimated associations between patient factors and receipt of either dental extractions or restorative treatment. RESULTS: About one-third (36.3%) of patients who reported being diagnosed with dental caries received a dental restoration. Stated barriers to utilization of restorative care included uncertainty about treatment outcomes (43.1%), cost (31.5%), and fear of treatment (31.0%). Among all patients who had received restorative treatment in the past, almost two-thirds (61.7%) reported ≥1 negative experience associated with the treatment. In multivariable adjusted modeling, higher education and income levels, having health insurance, and less perceived uncertainty about treatment outcomes were positively associated with receiving restorative treatment. CONCLUSIONS: In this setting, most public dental patients with caries received extractions over restorative care. Addressing cost, quality of care, and other patient concerns may all be needed to increase utilization of tooth-retaining procedures. KNOWLEDGE TRANSFER STATEMENT: For many public dental patients in Tanzania, dental caries is addressed with extractions over restorative care. To advance greater utilization of tooth-sparing treatment, patient factors, including uncertainty about the quality of restorative care and delayed dental care-seeking behavior, should be addressed. Targeted interventions to increase patient awareness on positive outcomes of restorative care and strengthen preventive dental visits are required.

Caregiver perception of children's dental caries and experience of accessing dental health services for their children / Percepção do cuidador sobre a cárie dentária infantil e experiência no acesso a serviços de saúde bucal para seus filhos

Objective: this study aims to know the caregiver's perception of children's dental caries and their experience of accessing dental health services in children. Material and Methods: this research was an analytic observational study with a cross-sectional method and used a purposive sampling technique with a sample of 56 respondents. Data were obtained through a questionnaire and the sampling technique used purposive sampling with samples were all caregivers at Cahaya Tazkia Kindergarten, Yapita Kindergarten, and Aisyiah 52 Kindergarten Surabaya. Data were analyzed using a correlation Spearman test. Results: perceived benefit and self-efficacy had a significant correlation with the experience of accessing dental health services (p-value ≤ 0.05) with coefficient correlations were 0.168 and 0.936 respectively. Meanwhile, perceived susceptibility, perceived severity, and the perceived barrier had no correlation with the experience of accessing dental health. Most male respondents in this research had a proper job to manage their children to go to dental health. Perceived susceptibility, perceived severity, perceived benefit, and self-efficacy of women caregivers in productive age were good but the perceived barrier showed a high mean. Respondents with that characteristics did not have steady jobs. Conclusion: women caregiver between the age of 21-40 years old believes that maintaining oral health is beneficial and will result in an increased number of accessing dental health services for their children. But caregivers who were women and also did not have a steady job had barriers to accessing dental health for their children (AU).

Objetivo: este estudo tem como objetivo conhecer a percepção do cuidador sobre a cárie na primeira infância e sua experiência de acesso aos serviços de saúde bucal em crianças. Material e Métodos: esta pesquisa foi um estudo observacional analítico transversal e utilizou uma técnica de amostragem intencional com uma amostra de 56 entrevistados. Os dados foram obtidos por meio de um questionário e a técnica de amostragem utilizou amostragem intencional com todas as amostras sendo cuidadores do Jardim de infância Cahaya Tazkia, Jardim de infância Yapita e Jardim de infância Aisyiah 52 Surabaya. Os dados foram analisados por meio de um teste de correlação de Spearman. Resultados: o benefício percebido e a autoeficácia tiveram correlação significativa com a experiência de acesso aos serviços de saúde bucal (p-valor ≤ 0,05), com coeficientes de correlação de 0,168 e 0,936, respectivamente. Enquanto isso, a suscetibilidade percebida, a severidade percebida e a barreira percebida não tiveram correlação com a experiência de acesso à saúde bucal. A maioria dos entrevistados do sexo masculino nesta pesquisa tinha um trabalho adequado para gerenciar a saúde bucal de seus filhos. A suscetibilidade percebida, a severidade percebida, o benefício percebido e a autoeficácia de cuidadores mulheres em idade produtiva foram bons, mas a barreira percebida apresentou uma média alta. Os entrevistados com essas características não tinham empregos fixos. Conclusão: mulheres cuidadoras na faixa etária de 21 a 40 anos acreditam que a manutenção da saúde bucal é benéfica e resultará em maior número de acessos aos serviços de saúde bucal de seus filhos. No entanto, cuidadoras que eram mulheres, mas que não tinham emprego fixo, apresentavam barreiras para o acesso à saúde bucal de seus filhos (AU)

Utilização de serviços odontológicos no Brasil / Use of dental services in Brazil

O objetivo do presente estudo foi analisar a utilização de serviços odontológicos no Brasil. Trata-se de um estudo quantitativo, observacional, transversal, analítico. Os dados individuais foram obtidos das Pesquisas Nacionais de Saúde desenvolvidas nos anos de 2013 e 2019. Os dados foram analisados considerando os pesos amostrais decorrentes de amostras complexas. Para cada estudo, foram desenvolvidas técnicas de análise múltipla que contemplaram os objetivos do estudo. Os resultados foram discutidos em três artigos científicos aceitos para publicação em periódicos e um artigo em fase de finalização. Os resultados encontrados indicam que a população negra, residente na região Norte e Nordeste, de menor classe social e escolaridade apresentam maior chance de ter ido ao dentista há mais de dois anos e de nunca ter ido ao dentista, bem como maior chance de realizar procedimentos odontológicos cirúrgicos ou de urgência na última consulta odontológica. Observou-se em relação às características do domicílio, que morar em área rural, maior aglomeração e menor renda familiar reduziram as chances de ter utilizado serviços odontológicos no último ano. Por outro lado, pessoas que residiam em domicílios cadastrados na Estratégia de Saúde da Família tiveram menor chance de não ter realizado uma consulta odontológica ao longo da vida, ou de terem ido ao dentista há mais de um ano. Ao analisar especificamente a utilização de serviços públicos odontológicos, após ajuste para idade e sexo, a escolaridade, a cor da pele ou raça e a renda familiar demonstraram efeito predisponente na utilização de serviços públicos odontológicos. Os fatores facilitadores foram residir em domicílios cadastrados em equipes de atenção primária ou localizados em áreas rurais. Os fatores de necessidade associados à utilização de serviço odontológico público foram autopercepção de saúde bucal ruim ou péssima e não ter realizado tratamento restaurador no último atendimento odontológico. Em relação aos fatores contextuais, a utilização de serviço público odontológico esteve associada à maior cobertura populacional por equipes de saúde bucal na atenção primária. De forma geral, observamos um acesso desigual aos serviços odontológicos no Brasil. Esse cenário ocorre quando fatores sociais e facilitadores determinam quem utiliza os serviços, em detrimento da necessidade de utilização. Apesar disso, observamos um efeito importante, decorrente da oferta de serviços odontológicos na atenção primária como um fator mitigador de tais desigualdades, o que demonstra um efeito positivo das estratégias adotadas na Política Nacional de Saúde Bucal (AU).

The present study aimed to analyze dental services utilization in Brazil. This is a quantitative, observational, cross-sectional, analytical study. Individual data from the National Health Surveys developed in 2013 and 2019. Data were analyzed by adjusting the sample weights resulting from complex samples. For each study, multivariate analysis techniques addressed the study's objectives. The results will be discussed in three scientific papers accepted for publication in journals and one article in the process of being finalized. It was noticed that the population subgroups comprising Blacks and those residing in the North or Northeast, with lower social class and education, had a greater chance of having a last dental appointment more than two years and never having been to the dentist. In addition, this population stratum also had a greater chance of undergoing surgical or emergency dental procedures in the last dental appointment. The outcome never had a dental appointment was significantly associated with illiterate, males, without private dental insurance, self-rated oral health as bad or very bad, household not enrolled in primary care teams, household in a rural area, high household crowding, and low household income per capita. The highest prevalence of public dental service utilization on an individual level was observed among unable to read or write people, indigenous, black or brown, with lower per capita household income, living in the rural area, and who self-rated oral health as regular or very bad/bad. On the contextual level, highest public dental service utilization was observed among those living in federal units with increased oral health coverage in primary health care. In general, we observe inequalities in dental services utilization in Brazil. This scenario occurs when social characteristics and facilitating aspects determine who uses the services, to the detriment of the need to use them. Despite this, we observed an important effect resulting from the provision of dental services in primary care as a mitigating factor for such inequalities, demonstrating a positive effect of the strategies adopted in the National Oral Health Policy (AU).

An Investigation of the Association between Health Screening and Dental Scaling in Korea.

Dental disease is one of the most prevalent chronic diseases worldwide, and its expenditure is continuously increasing. Periodontal disease is increasing as a chronic non-communicable disease in adults and older people. Health screening has been shown to be cost-effective and improves the quality of life through the early detection of diseases. This study aimed to analyze the relationship between national health screening and dental scaling as a preventive service for periodontal disease. The study used sample cohort data from 2002 to 2015 provided by the National Health Insurance Sharing Service in South Korea. A logistic regression analysis of the utilization of dental scaling was performed to identify the independent effects of national health screening. People who underwent health screening showed a higher tendency to undergo dental scaling. Additionally, disparities in utilization according to socioeconomic status were reduced among those who underwent screening. The intervention to extend dental coverage could be more beneficial when combined with health screening, encouraging more people to participate and reducing inequalities in utilization.

Associação entre equipe de saúde bucal da Estratégia de Saúde da Família e qualidade de vida relacionada à saúde bucal em adultos / Association between the dental health team of the Family Health Strategy and oral health related quality of life in adults

Objetivo: avaliar a influência da equipe de saúde bucal (eSB) na qualidade de vida relacionada à saúde bu-cal (QVRSB) de adultos. Métodos: a amostra deste estudo transversal foi composta por adultos adscritos às Estratégias de Saúde da Família (ESFs) de Santa Maria, RS. Variáveis sociodemográficas, como idade, sexo, cor da pele, renda familiar e escolaridade, foram avaliadas através de questionário semiestruturado. Variáveis de serviço odontológico foram mensuradas através do motivo de procura ao serviço e da presença de eSB, avaliada a partir dos dados oficiais do município. Biofilme dental, sangramento gengival e cárie dental foram coletados através de exame clínico odontológico. O desfecho foi a QVRSB mensurada pelo questionário OHIP-14. Modelos foram construídos por meio de regressão de Poisson, para avaliar a associação entre presença de eSB e QVRSB. Resultados: ao total, 80 adultos adscritos a quatro ESF (duas com eSB) foram in-cluídos. A ausência da eSB influenciou negativamente a QVRSB de adultos (razão de média: 1,21; intervalo de confiança de 95%: 1,07-1,36). Além disso, idade, cor da pele não branca, menor renda familiar, menor escolaridade, procura ao serviço odontológico por dor dental e pior saúde bucal foram associados a uma pior QVRSB (P<0,05). Conclusão: indivíduos sem acesso à eSB apresentaram uma pior QVRSB. Estratégias de promoção de saúde devem incluir a ampliação do acesso à ESF, aumentando a equidade no acesso aos cuidados odontológicos.(AU)

Objective: to assess the influence of dental health team (DHT) on the oral health-related quality of life (OHRQoL) of adults. Methods: the sample of this cross-sectional study consisted of adults enrolled in the Family Health Strategy (FHS) in Santa Maria, RS. Sociodemographic variables such as age, sex, skin color, family income and education level were assessed using a semi-structured questionnaire. Dental service variables were measured through the reason for attending for the service and the presence of DHT, evaluated from the official data of the municipality. Dental biofilm, gingival bleeding and dental caries were collected through clinical dental examination. The outcome was OHRQoL, measured by the OHIP- 14 questionnaire. Models were built using Poisson regression to assess the association between the presence of DHT and OHRQoL. On total, 80 adults enrolled in four FHS (two with DHT) were included. The absence of DHT negatively influenced the OHRQoL of adults [mean ratio: 1.21; 95% confidence interval: 1.07-1.36]. In addition, age, non-white skin color, lower family income, less education, attending dental care due to dental pain and poorer oral health were associated with worse OHRQoL (P<0.05). Conclusion: individuals without access to DHT had a worse OHRQOL. Health promotion strategies should include expanding access to FHS, increasing equity in access to dental care.(AU)

Concurrent heavy use of general and oral health services among Finnish adults.

OBJECTIVE: The aim was to identify heavy users of public health (PHS) and public oral health (POHS) services and combined and concurrent users of these services. MATERIAL AND METHODS: Numbers of 18+ year-old patients and their visits to POHS (12,124 patients) and PHS (28,479 patients) were collected from two patient registers in a Finnish town in 2013. The combined dataset consists of 32,481 patients. Using a highest decile criterion for both for POHS and PHS, those patients who had made 8 or more visits were categorised as heavy users. Patients who had made total of 10 or more visits to the POHS and/or PHS were categorised as combined heavy users. Patients who had made 8 or more visits to both the POHS and PHS were categorised as concurrent heavy users (195 patients). RESULTS: Heavy users of POHS were more often men and those of PHS more often women. Combined heavy users were likely to be women and to be older. The combined heavy users accounted for 40% of all visits of POHS and/or PHS. Among them 30% did not have any POHS visits and 4% did not have any PHS visits. Concurrent heavy use was rare, involving 0.06% of all patients, but made 3.4% of all visits. CONCLUSIONS: Of the patients making 10 or more POHS and/or PHS visits, only five percent were concurrent heavy users of both services. As many non-communicable diseases share common risk factors the combined heavy users of PHS should be directed to use POHS and vice versa.

Oral health in children investigated by Social services on suspicion of child abuse and neglect.

Child abuse and neglect (CAN) are likely to have negative consequences on health; however, for oral health, studies on associated outcomes are sparse. The purpose of this study was to assess oral health and oral health behaviors in relation to suspected CAN among children being investigated by the Swedish Social Services. The material comprised data from the Social Services and dental records; the sample, 86 children and 172 matched controls. The children in the study group had a higher prevalence of dental caries than the control group; in addition, levels of non-attendance and dental avoidance were high, as was parental failure to promote good oral health. We found four factors that, taken together, indicated a high probability of being investigated because of suspected CAN: prevalence of dental caries in primary teeth, fillings in permanent teeth, dental health service avoidance, and referral to specialist pediatric dentistry clinics. If all four factors were present, the cumulative probability of being investigated was 0.918. In conclusion, there is a high prevalence of dental caries, irregular attendance, and a need for referral a pediatric dental clinic among Swedish children under investigation due to suspected CAN. Social context is an important factor in assessing the risk of developing dental caries, the inclination to follow treatment plans, and the prerequisites for cooperation during treatment. Routinely requesting dental records during an investigation would provide important information for social workers on parental skills and abilities to fulfill the basic needs of children.

Fatores associados às faltas em tratamentos ortodônticos em centro de especialidades odontológicas / Factors associated with absences from orthodontic treatment at a dental specialty center

Resumo O objetivo deste estudo foi identificar os fatores associados ao não comparecimento dos usuários ao tratamento ortodôntico, em três centros de especialidades odontológicas regionais (CEO-R) localizados no estado do Ceará. Metodologia: Os dados foram extraídos de prontuários de pacientes que concluíram o tratamento ortodôntico. Foi calculada a taxa de ausências, com o objetivo de estabelecer um coeficiente de faltas entre os municípios. A fim de descrever o padrão geográfico da ocorrência, foram construídos mapas temáticos baseados nas distribuições. Para as associações entre a variável desfecho (falta ao tratamento) e as independentes (sexo, idade, quebra de aparelho, mudança de profissional, renda e local de residência do usuário), utilizou-se a análise de regressão logística múltipla com p ≤ 0,05. Resultados: Foram examinados 237 prontuários em 20 municípios, com 8.283 consultas ortodônticas realizadas e 2.665 (32,17%) faltas. Apresentou diferença estatisticamente significativa a variável mudança de profissional. Conclusão: O maior número de faltas foi associado à mudança de profissional.

Abstract The aim of this study was to identify the factors associated with the users failing to keep orthodontic treatment appointments (absences), in three regional dental specialty centers (CEO-R) located in the State of Ceará. Methodology: This was a cross-sectional epidemiological study with secondary data source of 3 CEO-R, from which 237 medical records of complete orthodontic treatments were examined, with 8.283 appointments and 2.665 (32.17%) missing appointments. Data collection was standardized by an electronic questionnaire.. Factors associated with users missing appointments were calculated by means of absence rates and thematic maps were constructed based on distributions of the geographical pattern of occurrence. To evaluate the association between the outcome variable (absence from treatment) and the independent variables (sex, age, breakage of appliance, change of professional, income and place of user's residence) multiple logistic regression analysis was used with p ≤ 0.05. Results: There were high absence rates for both city headquarters and non-headquarter CEO-Rs. The variable change of professional showed statistical significance, in relation to the number of absences. Conclusion: The highest number of absences was associated with change of professional.

Factors supporting dentist leaders' retention in leadership.

OBJECTIVE: The aim was to study factors associated with staying in a dentist leadership position. PARTICIPANTS AND METHODS: We used an electronic questionnaire to gather data from 156 current or former Finnish dentist leaders in 2014. Principal component analysis categorized statements regarding time usage and opportunities in managerial work into five main components. Associations between these main component scores and the tendency to stay as a leader were analyzed with logistic regression. RESULTS: Out of the five main components, two were significantly associated with staying as a leader: 'career intentions', which represented intent to continue or to leave the leadership position; and 'work time control opportunities', which represented how leaders could control their own work time. Other factors that supported staying were leadership education, more work time available for leadership work, and lower age. The main component 'work pressure' decreased, although not significantly, the odds of continuing; it included lack of leadership work time, and pressure from superiors or subordinates. CONCLUSIONS: Leaders have important roles in health care, ensuring everyday operations as well as developing their organizations to meet future challenges. Knowledge of these supporting factors will enable dentist leaders and their organizations to improve working conditions in order to recruit and retain motivated and competent persons. In addition, well-designed education is important to inspire and encourage future leaders.

Oral health promotion in patients with chronic renal failure admitted in the Intensive Care Unit.

Oral hygiene deficiency is common in patients treated in ICUs and it enables biofilm colonization by microorganisms that lead to respiratory infections. A 30-year-old female patient with chronic renal failure was hospitalized. Dental procedures were performed in the ICU and contributed to the patient's health after a few days.

Prevalence, risk surfaces and inter-municipality variations in caries experience in Danish children and adolescents in 2012.

OBJECTIVE: The aim of this study was to describe the caries experience, prevalence and distribution related to tooth type and surfaces in the primary and permanent dentition in children and adolescents in Denmark in 2012. In addition, to examine if explanatory factors influence the inter-municipality variation in caries experience. MATERIALS AND METHODS: Data was collected in the public Child Dental Health Service. In total, 5636 caries registrations on 3-, 9-, 15- and 18-year-olds were collected in 35 of the 98 Danish municipalities. Caries experience was expressed by mean def-s/DMF-S and caries prevalence by def-s = 0/DMF-S = 0. Inter-municipality variations were illustrated. Multivariate regression analyses were applied to assess the influence of fluoride concentration in drinking water, proportion of immigrants and personal income on the inter-municipality variation in mean def-s/DMF-S. RESULTS: Only 4.6% of 3-year-olds had def-s (mean = 0.25), compared to 44.9% of 9-year-olds (mean = 3.07), primarily located occlusally and interproximally on the primary molars. Mean DMF-S for the 9-, 15- and 18-year-olds were 0.27, 1.97 and 4.40, respectively. Caries were primarily located occlusally and in pits on the permanent molars, which also showed high frequencies of sealings. Mean def-s/DMF-S showed substantial inter-municipality variations, while the caries location in both dentitions was rather stable. The three background factors explained less than 25% of the variation in mean def-s/DMF. CONCLUSIONS: The caries distribution within the primary and permanent dentition among 3-, 9-, 15- and 18-year-olds followed definite patterns concerning location on teeth and surfaces. Background factors only explained a minor part of the variation.

Incorporating Experiential Learning Techniques to Improve Self-Efficacy in Clinical Special Care Dentistry Education.

The New York University College of Dentistry has introduced a clinical rotation for fourth-year dental students that focuses on treating people with special health care needs (PSN). The aim of this study was to investigate the hypothesis that clinical experience in treating patients with special health care needs during predoctoral education is associated with increased self-assessed student ability and comfort and therefore self-efficacy. The study also investigated whether other characteristics, such as prior personal or volunteer experience with this population, service-mindedness, and/or the inclination to treat underserved populations, were associated with comfort in treating PSN. A survey was used to assess changes in students' perceived knowledge, beliefs, and attitudes regarding treating PSN before and after the clinical experience for July 2012-June 2013. The survey included questions about students' service-mindedness, comfort, perceptions of abilities of PSN and educational importance of learning to treat PSN, desire for clinical experience, and future intent or interest in treating PSN. Out of 364 students invited to participate, 127 surveys were returned, for a response rate of 34.9%. The results showed statistically significant increases on six items following training: impressions about the importance of oral health among PSN, comfort in treating people with cognitive disabilities and with medical complexities, intent to treat PSN in future practice, interest in including PSN in postgraduate training, and belief that PSN could be treated in the private practice setting. These students reported preferring to learn in the clinical setting over didactic instruction. This clinical experience was associated with improved self-efficacy in treating PSN and increased intentions to treat this population in future practice. Improvements were particularly evident among those with the least prior experience with PSN and were independent of other aspects of the students' past experience, future goals, or personality characteristics.

Attitudes of Korean Dental Students Toward Individuals with Special Health Care Needs.

The purposes of this study were to ascertain the attitudes of dental students toward individuals with special health care needs (SHCNs) in Korea and to elucidate the characteristics associated with these attitudes. The authors recruited students from four of the 11 dental schools in Korea to participate in a survey; these schools were selected for regional balance. The Scale of Attitudes toward Disabled Persons (SADP) was used as the primary survey instrument, and ten independent variables were included. Of the 1,100 possible participants, 1,057 responded to the survey, for a response rate of 96.1%. The results showed that although the students' attitudes did not differ significantly by gender, their attitudes did show statistically significant differences on nine other variables: age, year, religion, self-esteem, friends with a disability, volunteering, admission course, concern for individuals with SHCNs, and intention to treat individuals with SHCNs (all p<0.05). The attitudes of these Korean dental students toward individuals with SHCNs were relatively unfavorable, showing lower SADP scores than reported in Western countries and likely reflecting Eastern cultural values in general. Future efforts should place greater emphasis on special care dentistry education and encourage the development of more favorable attitudes regarding the treatment of individuals with SHCNs.

Características associadas ao uso de serviços odontológicos públicos pela população adulta brasileira / Characteristics associated with the use of dental services by the adult Brazilian population

O objetivo deste estudo foi investigar os fatores associados ao uso de serviços odontológicos públicos pela população adulta brasileira. Foram utilizados dados coletados junto a 13.356 adultos (35-44 anos), em um inquérito epidemiológico de saúde bucal, de abrangência nacional (Projeto SB-Brasil 2003). A análise dos dados baseou-se na regressão de Poisson, que produziu estimativas de Razões de Prevalências como medida de associação. A análise dos dados mostrou que o uso de serviços odontológicos públicos por adultos esteve associada com: sexo feminino, baixa escolaridade e renda, residência nas regiões Nordeste e Sul e em municípios de menor porte, queixas de dor de dente ou gengival, necessidades de prótese parcial e total, maior quantidade de dentes permanentes demandando tratamento, procura por serviço motivada por algum problema bucal e avaliação do tratamento recebido como regular. Esses resultados mostraram que a população atendida pelo serviço público era menos favorecida socioeconomicamente e apresentava maiores necessidades de tratamento. A grande necessidade acumulada reflete o histórico apartamento desse segmento populacional da atenção à saúde bucal em nosso país e coloca um grande desafio ao SUS, considerando o seu papel na redução das desigualdades e de provimento de acesso universal ao cuidado integral.

The scope of this study was to investigate the factors related to the use of dental services by Brazilian adults. Data were collected from 13,356 adults (35 to 44 years of age), participating in a nationwide epidemiological survey of oral health (SB-BRASIL 2003 Project). Data analysis was based on Poisson regression, which produced estimates of Prevalence Ratios as a measure of association. Data analysis showed that the use of dental services by adults was associated with: female gender, low education and income, living in the Northeastern and Southern regions and in small cities, complaints of toothache or gum pain, need for partial/total prosthesis, a greater amount of permanent teeth requiring treatment, demand for service due to some dental problems and evaluation of dental care received on a regular basis. These results showed that the population attended by the public service was socio-economically less privileged and had greater need for treatment. This situation reflects an historical abandonment of the adult population by the dental healthcare system in Brazil and poses a major challenge to the Unified Health Service, in light of its intended role to reduce inequalities and provide universal access to comprehensive care.

Influence of self-perceived oral health and socioeconomic predictors on the utilization of dental care services by schoolchildren

The influence of socioeconomic factors and self-rated oral health on children's dental health assistance was assessed. This study followed a cross-sectional design, with a multistage random sample of 792 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. A dental examination provided information on the prevalence of dental caries (DMFT index). Data about the use of dental service, socioeconomic status, and self-perceived oral health were collected by means of structured interviews. These associations were assessed using Poisson regression models (prevalence ratio; 95 percent confidence interval). The prevalence of regular use of dental service was 47.8 percent. Children from low socioeconomic backgrounds and those who rated their oral health as "poor" used the service less frequently. The distribution of the kind of oral healthcare assistance used (public/private) varied across socioeconomic groups. The better-off children were less likely to have used the public service. Clinical, socioeconomic, and psychosocial factors were strong predictors for the utilization of dental care services by schoolchildren.

Avaliação dos alunos do programa de pós-graduação em odontologia da UNESP (Araçatuba) na elaboração e execução de programas de saúde bucal em seus municípios / Evaluation of students graduate program in dentistry UNESP (Araçatuba) in the preparation and implementation of dental health programs in their cities

O projeto de saúde bucal tem como sua maior importância levar conhecimento, prevenção e tratamento para a população dos municípios que possuem este importante meio de promoção de saúde em geral. Estes programas são baseados em projetos sócio-educativos, tais como, escovação supervisionada, palestras educacionais, projetos preventivos como, utilização flúor, aplicação de selantes em fóssulas e fissuras e até mesmo a prevenção do câncer bucal. Na área curativa, os centros de especialidades odontológicas (CEO), associado ao PSF são responsáveis pela execução de tratamentos de doenças periodontais, de traumas, restauração de dentes afetados pela doença cárie, confecção de próteses para reabilitação funcional do paciente, biopsias de lesões bucais, dentre outras especialidades. Este trabalho visa avaliar os alunos do Programa de Pós-Graduação em Odontologia da Universidade Estadual Paulista “Júlio de Mesquita Filho”, Campus de Araçatuba, no intuito de coordenar um programa de promoção de saúde em seus municípios. O resultado baseado em parâmetros da OMS nos mostrou que a maioria dos Pós-Graduandos da Faculdade de Odontologia Araçatuba adquiriram conhecimento razoável para um programa de saúde bucal em sua cidade como coordenador

The design of oral health has as its most important to bring knowledge, prevention and treatment for the population of municipalities that have this important means of promoting health in general. These programs are based on socio-educational projects, such as tooth brushing, educational lectures, projects, preventive and, fluoride use, application of sealants in pits and even the prevention of oral cancer. In the area of healing, the centers of dental specialties (CEO) associated with the PSF are responsible for implementing treatment of periodontal diseases, trauma, restoration of teeth affected by dental caries, prosthesis design for functional rehabilitation of the patient, biopsies of oral lesions , among other specialties. This study aims to evaluate the students of the Graduate Program in Dentistry, Universidade Estadual Paulista Julio de Mesquita Filho, Campus de Araçatuba, in order to coordinate a program to promote health in their communities. The result based on parameters in the OMS showed that the majority of graduate students of the Faculty of Dentistry Araçatuba acquired knowledge to a reasonable oral health program in their city as a coordinator