[Problems of dental services in closed administrative units assessed by a survey of dentists].

The article presents the results of the survey of 150 dentists from 10 closed administrative units of FMBA health care system of Russia in connection with the dynamics of dental staff withdrawal and reduce of volume of preventive work in schools and factories. These problems were found to be associated with the lack of regulations on mandatory preventive dental examinations of workers with occupational hazards, low tariffs for dental services in obligatory medical insurance program, poor wages an lack of apartments for young dentists.

[Evaluation of dental care coverage in the State Military Police in Salvador, Bahia, Brazil]. / Avaliação da cobertura do Serviço Odontológico da Polícia Militar da Bahia em Salvador, Bahia, Brasil.

This study seeks to evaluate dental care coverage in the State Military Police in Salvador, Bahia State, Brazil, from 2002 to 2004, estimating potential and real coverage rates. A single descriptive study was performed. Calculations were made of potential coverage rates considering hourly workloads of staff dentists and the real rates resulting from actual outpatient treatment. Potential human resources coverage was adequate (1 dentist per 1,618 policemen), while the real coverage rate was considered below the standard proposed by the Brazilian Ministry of Health (0.39 procedures per policeman per year). The low real coverage rate could be related to low productivity, the reasons for which should be investigated in greater depth in future studies, and might include organizational problems and lack of a management system to improve the quality of professional practice, with specifically defined targets.

Effectiveness of an oral health promotion programme at the workplace.

The purpose of the study was to evaluate the effectiveness of an oral health promotion programme at the workplace. The programme was given once a year at offices or factories, which was voluntary and free for all employees. The programme consisted of clinical examinations followed by oral health guidance, oral hygiene instruction and oral prophylaxis of anterior lower teeth. Oral health status was compared by the times of participation in the programme. It was shown that three times or more participants in the programme had fewer decayed, missing and filled teeth (DMFT) and lower percentage of Community Periodontal Index (CPI) sextants 3 and 4. The oral health promotion programme was effective in keeping or maintaining good oral health among workers. In addition to current activities, the programme should include education to motivate subjects to receive regular check-ups.

Can a workplace preventive programme affect periodontal health?

AIM: To evaluate an oral health awareness campaign in an adult population. DESIGN/SETTING: Four workplaces in north-east London were selected, matched in two pairs and randomly allocated to test and control groups. Completion occurred in 1995. SUBJECTS: 98 volunteer employees in good general health. INTERVENTIONS: Two oral examinations were carried out, six weeks apart. The test group received the programme immediately after baseline examination and the controls after the second visit. MAIN OUTCOME MEASURES: Gingival bleeding on probing (BOP) and probing depths (PD) were measured on each occasion using a controlled pressure probe. RESULTS: The mean percentage of sites with BOP per subject reduced from 56% to 25% in the test group, while remaining static in the control group at 46% to 48%. The mean percentage of sites probing 4 mm and above per subject reduced from 38% to 25% in the test group and from 28% to 25% in the control group. These differences between groups were statistically significant when submitted to analysis of covariance (P < 0.001). CONCLUSIONS: The study showed the clinical effectiveness of a workplace-based oral health awareness campaign, which is ideally suited to the skills and resources of the primary care dental team.

[Effect of worksite dental health program on periodontal status--evaluation by CPITN and bleeding on probing at each tooth].

A dental health promotion program which aimed to prevent periodontal disease was carried out at a shipyard in Nagasaki Prefecture. Repeated tooth cleaning instruction and prophylaxis were conducted in order to adopt proper oral hygiene habits. The first 3 months of this program included 'Initial instruction,' and 'Regular instruction' were given every 6 months in following 2 years. The oral examination was carried out before and after Initial instruction, and at each Regular instruction. The effect of this program was evaluated by 2 measures: CPITN and Bleeding on probing. After this program, the rate of teeth with pockets 4 -5 mm deep or deeper (CPITN 3, 4) was decreased. In contrast, the rate of teeth with no sign of periodontal disease (CPITN 0) was increased remarkably: the percentage increased from 8% preinitial instruction to 40% with regular instruction. Both the rate and grade of teeth with bleeding on probing were decreased. These results indicated that this program was helpful in improving the periodontal status. CPITN and Bleeding on probing at each tooth as an evaluation measure made our analysis more detailed.

[Promotion of orodental health in adolescents in Africa]. / Promotion de la santé bucco-dentaire des adolescents en Afrique.

Bad dental hygiene in adults is usually the result of bad care during childhood. Within the framework of Health for All, WHO and the International Dental Federation defined global objectives for dental health which allow for monitoring progress in different countries. The most common dental problems, such as dental cavities, can be prevented by simple and inexpensive methods. Dental health is based on dental hygiene, nutrition, fluoride intake and dental service utilisation. Dental health promotion aims to create an environment favourable to the adoption of these healthy behaviours. The principle recommended dental health measures are through fluoridation of water, salt, and milk, a low consumption of sweets, and modification of the amount of sugar in the diet; implementation of monitored dental hygiene activities in schools; the organisation of regular dental services in schools/workplaces; and adopting legislative texts or laws requiring certain measures of prevention. In the past several years, certain African countries have set up national dental health programmes (there were 12 in 1993), However, the implementation of dental health promotion generally doesn't result from a national initiative, but from a regional or local scale. This is largely due to the lack of integration of dental health in activities of education and health promotion in general. Programmes planned at a national level and then implemented at a local level on a multisectoral base have had more success. This article presents examples of dental health promotion activities in several African countries, mainly focusing on programmes aimed at 12-13 year olds in primary school. Programmes from Morocco, Kenya, Madagascar, Côte d'Ivoire, Benin, and Tanzania are briefly presented and show that in Africa, dental health promotion has mostly consisted of the implementation of health education actions and that there are no consistent policies, unlike in other developing countries, for fluoridation of water, salt, and milk. In terms of dental health promotion, WHO recommends the promotion of traditional methods of dental hygiene (such as plants or sticks for cleaning), especially among adolescents living in rural and low income communities. In turn, the identification and promotion of the positive aspects of hygiene and traditional care will allow for the implementation of more culturally acceptable approaches.

Comparison of modes of oral hygiene instruction in improving gingival health.

195 Hong Kong Chinese employees from a single company participated in a 10-month longitudinal study on the effects of various modes of delivery of oral hygiene messages on their gingival health. Subjects were allocated to one of the following modes of oral hygiene education: (1) personal instruction; (2) self-education manual; (3) video; (4) a combination of 2 or more of these modes of instruction. Scaling or any other form of periodontal treatment was not given throughout the study period. Full mouth clinical examinations were carried out using a Williams Periodontal probe to examine for the presence or absence of plaque and bleeding on probing from the gingival sulcus. At 2 weeks, 4 months and 10 months, results showed significant reductions in the mean % of plaque and bleeding when compared with baseline. No significant differences were found between the groups given the various modes of oral hygiene education. The study does confirm the effectiveness of oral hygiene alone in improving gingival health, but the lack of difference in the outcome of various oral hygiene education approaches indicates that the mode of instruction is not crucially important to the end result. However, it has to be acknowledged that improvement in oral hygiene may be related to factors other than the oral hygiene programme itself. The findings have significant implications in oral health promotion programmes to improve the periodontal status of the local community.

Oral mucosal screening as an integral part of routine dental care.

The principal aim of this study was to assess the feasibility of conducting a systematic examination of the oral mucosa, as an integral part of the routine dental check-up and in conditions comparable with those in NHS dental practice. A total of 1949 individuals, who were already registered as patients with an industrial dental clinic, were invited to attend for an oral screen as part of their dental examination. Of these, 1947 patients agreed to participate and were also asked to complete a 'habits' questionnaire relating to their tobacco and alcohol use. A systematic examination of the oral mucosa was undertaken as part of the routine dental inspection and mucosal lesions were recorded as either a positive or negative screening result. Lesions included as a positive result were those which may be associated with early cancer or precancer. Four patients (0.2%) were considered to have a positive screening result and these were referred for specialist evaluation. Of these, two had tobacco-related leukoplakia, one had oral lichen planus and the other had an early squamous cell carcinoma. This study has confirmed that a systematic and thorough examination of the oral mucosa can realistically be carried out as part of the routine dental inspection in NHS dental practice.

Evaluation of screening for oral cancer and precancer in a company headquarters.

Oral cancer and precancer appear to fulfil many of the criteria for a disease suitable for mass screening. Several commercial organisations in the UK have introduced screening for their employees. One program has been formally evaluated over the course of 1 yr. Of 553 company headquarters staff aged > or = 40 yr, 292 (53%) responded to the well-publicised screening invitation and received a simple clinical examination of the oral mucosa from one of two company dentists. In addition, 17 staff were screened from a separate company work-site. After screening, subjects were examined independently by an oral medicine specialist with access to the relevant diagnostic aids. The dentists' screening decisions were validated against the specialist's definitive diagnoses (the 'gold standard'). The true prevalence of subjects with lesions diagnosed as positive (white patch, red patch or ulcer of greater than 2 weeks' duration) was 17 (5.5%). Overall, sensitivity was 0.71 and specificity, 0.99. The compliance rate to screening among headquarters subjects in seven occupational categories did not differ significantly from the occupational profile for all headquarters personnel. Estimates of relative risk of a positive diagnosis were calculated by logistic regression for five independent variables; gender, age, moderate smoking, heavy smoking, and smoking combined with greater than low risk alcohol consumption. Only heavy smoking (> or = 20 cigarettes per day) produced a significant odds ratio (3.43, P < 0.05).

[Certain behavior and attitudes of workers associated with dental care provided in the workplace]. / Niektóre zachowania i postawy pracowników zwiazane z funkcjonowaniem opieki stomatologicznej w miejscu pracy.

Dental care at places of employment was assessed under the Polish edition of the International Collaborating Studies of Oral Health Outcomes. The study was focused particularly on the use of primary conservative dental care (accessibility of dental care in polyclinics provided by institutions), reasons why workers are not willing to see dentists in their polyclinics as well as the judgement of the quality of primary dental care (the degree to which this kind of care is available for and approved by workers, the extent of positive judgements of primary conservative dental care). The analysis indicated rather strong disapproval of dental care rendered by polyclinics with view to ill-functioning of polyclinics rather than to their existence.

Appropriate dental care for employees at the workplace.

The data from a dental health survey of an Australian employee group in Brisbane were used to test the value of dental health programmes at the workplace as a means of improving general dental health. The amount and complexity of treatment needs were investigated. Although both dental caries and periodontal disease were widespread, few of the employees had major treatment needs, most requiring minimal, simple dental care. Because of the minor treatment needs of a relatively static group of employees, the viability of a dental practice at work with emphasis on restorative dental care was questioned. Given the disease levels, the treatment needs indicated that a system based on prevention and maintenance care would be more appropriate.

A preventive dental care programme at the workplace.

Employees from an industrial group in Brisbane were examined at the workplace and found to have generally low levels of dental disease. At the same time, the Australian Bureau of Statistics suggests that less than 45 per cent of Australians attend a dentist annually. This low attendance for regular dental care reduces the effectiveness of any preventive dental service. A pilot scheme of preventive dental care was provided for employees at the workplace in Brisbane. The aim of the programme was to provide regular health counselling and reinforcement of oral health activities, general dental information, regular prophylaxis, scaling and cleaning, and referrals for restorative care. The preventive programme was appropriate given the disease levels. The services were effective in improving the periodontal status and restorative care which resulted from referrals. As well, the preventive dental care programme proved to be readily acceptable to both employees and management.

[Professional consciousness of dentists in occupational health care]. / Swiadomosc zawodowa lekarzy stomatologów pracujacych w przemyslowej sluzbie zdrowia.

The specific nature of activities of dentists employed in occupational health care (OHC) has often been questioned. At the same time, there is a general opinion that the status of OHC dentists is superior in respect of dental surgery equipment, room space, relations with patients, etc. Based on the results of the Polish episode of international comparative study on dental care effectiveness, an attempt was made to answer the question about the professional characteristics of dentists employed in OHC units. The study referred both to OHC dentists and those who work primarily in the public health service. It was assumed that the professional consciousness of the respondents would be reflected in their opinions on: 1. professional satisfaction, 2. compatibility of professional duties, 3. disadvantages of the profession, 4. prospects for hereditary continuation of the profession, 5. patient behaviour, 6. significance of preventive activities in dental health care, 7. dental health care in Poland. The results of the study indicate that there is some sense of professional distinctiveness among the OHC dentists. This can be traced to different technical, organizational and economic conditions under which that group of dentists performs their duties.

Dental public health: new opportunities--new responsibilities.

Major changes affecting oral health in the United States have provided new leadership challenges for public health dentistry. Two new roles for dental public health are proposed: leadership in the incorporation of expanded public health skills into the education of every clinical dentist; and a broadening of the specialty in a manner similar to that of preventive medicine, involving the creation of subspecialties in public health dentistry, occupational environmental dentistry, and management policy dentistry. The current status of community dentistry departments in dental schools and programs of public health education for dental personnel in schools of public health are reviewed. Content is suggested for the incorporation of expanded public health skills into the education of every clinical dentist.

[Health problems of the stomatognathic system in the Polish population covered by stomatological health care. Place of residence and work]. / Problemy zdrowotne narzadu zucia Polskiej populacji korzystajacej z opieki stomatologicznej. 3. Srodowisko zamieszkania i pracy.

The condition of the stomatognathic system was studied in 5682 adult patients attending stomatological care services in regional outpatient clinics, health service centres, and industrial health service units in 6 provinces. Most frequently, the patients came to these services with emergency symptoms. Poor state of teeth was observed in all these service units, but the worst oral hygiene and the highest percent of parodontal diseases were found in industrial health service institutions. In this group tooth loss was most frequent. These results indicate that the stomatological health care in industrial service units despite an above average equipment of dental care rooms, better availability of dental care, and sufficient staffing is not better than in the stomatological care units available to the general population.