Providing Daily Oral Infection Control to Persons Dependent on others for Activities of Daily Living: A Semi-Qualitative Descriptive Study.

BACKGROUND: The purpose of this study is to evaluate caregiver assessment of the ease of use of a specially designed toothbrush for providing daily oral infection control (toothbrushing) to persons dependent upon others for activities of daily living. METHOD: Eighty-eight caregivers accepted surveys and multi-surface toothbrushes to provide daily oral infection control to the person to whom they assisted. They were asked to evaluate the ease of use of the multi-surface toothbrush, and provide comments about it. RESULTS: There were 30 surveys returned (34.1% response rate). In terms of the ease of use, 90.0% of the caregivers agreed (63.3% strongly agreed, and 26.7% agreed) that the multi-surface toothbrush was easier to use than their previous toothbrush. Comments about the toothbrush were predominantly positive. CONCLUSION: It is difficult to provide daily oral infection control to another individual. Having an efficient oral health aid which makes it easier to do so is important to caregivers. With the overwhelming positive response to the multi-surface toothbrush, it is important to disseminate the information about its ease of use.

The Oral Health Self-Care Behavior and Dental Attitudes among Nursing Home Personnel.

The need for nursing home care will increase for the next several decades. Rural areas will be impacted in particular, as many older adults live in rural areas. Daily oral infection control changes when a person moves from independent living to institutional living. Oral care to dependent individuals is influenced by many factors. The purpose of this study is to determine the association of oral health self-care behavior with dental attitudes in nursing home personnel in a rural state. A survey was provided to attendees at an oral health conference. Questions were asked to determine dental knowledge, oral health self-care behavior, and dental care attitudes. Of 128 long term care health care facilities' personnel invited, there were 31 attendees, and 21 of the attendees participated (67.7%). Nursing home personnel had a high level of dental knowledge. Oral health self-care behavior was independently influenced by dental knowledge (ß=0.17; p=0.0444) and dental attitudes (ß=0.55; p=.0081). Further investigation is needed to determine if oral health self-care attitudes and oral self-care behavior of nursing home personnel are factors in the provision of quality daily oral infection control for dependent nursing home residents living in rural areas.

Dentists' attitudes, behaviors, and barriers related to tobacco-use cessation in the dental setting.

OBJECTIVE: This study assessed attitudes, behaviors, and barriers among general dentists in California, Pennsylvania, and West Virginia, related to patient tobacco cessation counseling. METHODS: From 2004 to 2008, a baseline survey was mailed to 271 study dentists randomly selected from a master Delta Dental Insurance Company provider list in each state who had agreed to participate in a tobacco cessation randomized clinical trial. Four backward logistic regression models assessed correlates of the five As related to tobacco cessation: Asking about tobacco use, Advising users to quit, Assessing readiness to quit, Assisting with quitting, and Arranging follow-up. RESULTS: Most respondents (n=265) were male, had practiced dentistry for over 15 years, asked about tobacco use (74%), and advised tobacco users to quit (78%). Only 19% assessed readiness to quit; 39% assisted with quitting; 4% arranged follow-up; and 42% had formal training in tobacco cessation. Believing that tobacco cessation counseling was an important professional responsibility, practicing <15 years, and asking about tobacco use significantly related to advising users to quit. Providing cessation advice and feeling effective intervening related to assessing readiness to quit. Advising users to quit, assessing readiness to quit, feeling effective intervening, and having had formal tobacco cessation training related to assisting with quitting. Barriers to cessation counseling were perceived patient resistance (66%), lack of insurance reimbursement (56%), not knowing where to refer (49%), and lack of time (32%). CONCLUSION: Study dentists reported not fully performing the five As. Advising, assessing, having formal training, and feeling effective increased the likelihood of cessation counseling.

The effect of training on the use of tobacco-use cessation guidelines in dental settings.

BACKGROUND: An increase in the number of dentists conducting tobacco-use cessation treatment is needed. The authors assessed the effects of high-intensity training (HIT) or low-intensity training (LIT) and reimbursement on general dentists' tobacco-use-related attitudes and treatment behaviors. METHODS: The authors randomly selected 265 dentists in three states and assigned them to one of five groups: HIT workshop groups with and without tobacco-use cessation counseling reimbursement, LIT mailed self-study groups with and without reimbursement or a control group. Outcomes at follow-up were dentists' self-reported tobacco-use-related attitudes and behaviors and patients' reports of dentists' behaviors. RESULTS: Significantly more dentists in the intervention groups reported having positive attitudes and behaviors at follow-up than did dentists in the control group. Dentists in the HIT groups, however, reported assessing patients' willingness to quit and assisting them with the quitting process significantly more often than did dentists in the LIT groups. Significantly more patients of dentists in the intervention groups who used tobacco reported receiving advice and assistance from their dentists than did patients of dentists in the control group. Adding reimbursement to HIT or LIT conditions did not provide additional intervention effect. CONCLUSION: Dentists trained by means of a workshop or self-study program used components of a recommended guideline more frequently and felt more positive toward tobacco-use cessation counseling than did dentists in the control group. CLINICAL IMPLICATIONS: Although the workshop training was more successful than the self-study training, the latter's reach among dentists could have a more significant public health impact. The effect of reimbursement needs further study.