Programa de Salud Bucodental en escolares de la Comunidad del Bajo Boulogne / Oral Health Program in children from Bajo Boulogne Community

Las afecciones bucodentales constituyen un problema de salud pública por su alta prevalencia y su fuerte impacto individual y colectivo en términos de dolor, malestar y discapacidad social y funcional. El Centro de Medicina Familiar y Comunitaria San Pantaleón, ubicado en la provincia de Buenos Aires, brinda asistencia sanitaria gratuita a la comunidad. Un relevamiento documentó que el 97% de los concurrentes presentaba caries y no se lavaban los dientes por falta de cepillo y pasta dental. Se decidió llevar adelante un programa de promoción de la salud bucodental. El objetivo fue evaluar su implementación; que incluyó: a) rastreo de caries y problemas odontológicos; b) coordinación interinstitucional; c) entrega de cepillos y pasta dental; d) intervención educativa; e) extensión comunitaria. Participaron en forma irregular 120 niñas, niños y adolescentes entre 5 y 18 años del Centro de Apoyo Escolar Fundación Bajo Boulogne. Se realizaron dos encuentros educativos y entrega de cepillos y pasta dental. En la revisión odontológica inicial sobre 60 participantes se detectaron caries en 43 (71,6%), que fueron derivados para tratamiento odontológico, pero concurrieron solo 26 (60,4%). El conocimiento sobre salud bucodental mostró cambios entre los más pequeños luego de las intervenciones educativas. Se logró implementar el programa, cumplimentando las actividades propuestas. Pero surgieron barreras que dificultaron la cobertura. En cuanto a la eficacia de la intervención educativa, no se logró mostrar cambios en el conocimiento. Se consiguió la detección oportuna, la incorporación de hábitos como el cepillado dentro de la institución educativa, la articulación para mejorar el acceso a la atención y la vinculación entre los diferentes actores comunitarios. (AU)

Oral disorders are a public health problem due to their high prevalence and their strong individual and collective impact in terms of pain, discomfort, and social and functional disability. The San Pantaleón Family and Community Medicine Center, located in the province of Buenos Aires, provides free healthcare to the community. A survey documented that 97% of those present had cavities and did not brush their teeth due to a lack of brush and toothpaste. It was decided to carry out an oral health promotion program. The objective was to evaluate its implementation; which included: a) tracking of caries and dental problems; b) inter-institutional coordination; c) delivery of brushes and toothpaste; d) educational intervention; e) community extension. 120 girls and boys and adolescents between 5 and 18 years of age from the Bajo Boulogne Foundation School Support Center irregularly participated. Two educational meetings were held, handing out brushes and toothpaste. In the initial dental review of 60 participants, caries was detected in 43 (71.6%), who were referred for dental treatment, with only 26 (60.4%) concurring. Oral health knowledge showed changes among the youngest after educational interventions. It was possible to implement the program, completing the proposed activities. Barriers arose that made coverage difficult. Regarding the effectiveness of the educational intervention, it was not possible to show changes in knowledge. Timely detection was achieved, the incorporation of habits such as brushing within the educational institution, articulation to improve access to care and the link between the different community actors. (AU)

Grado de educación, prevención e importancia dental: realidad en padres de familia de León, Guanajuato / Education degree, prevention, and dental importance: reality in parents from Leon, Guanajuato

Objetivo: evaluar el grado de educación, prevención e importanciadental en caries y enfermedad periodontal en padres de familia de niños de primaria de la ciudad de León, Guanajuato. Material y métodos:En este estudio descriptivo, transversal y observacional se hizo una encuesta a 1,249 padres de familia de niños de seis diferentes escuelas primarias que constó de 18 preguntas enfocadas en la educación, prevención e importancia dental. Se estableció una comparación entre padres de familia con niños de escuelas públicas y privadas, así como entre el grado de estudios de los padres de familia con su propio grado de educación y prevención dental. Resultados: Se observó un grado moderado de prevención dental (48.04 por ciento de educación dental (49.48 por ciento), la mayoría da importancia a los dientes deciduos (87.43 por ciento); 65.89 por ciento de los padres consideró sus propios dientes como muy importantes, 8.02 por ciento, moderadamente importantes, 5.12 por ciento, poco importantes y 0.96 por ciento nada importantes. También afi rman que la salud dental tienela misma importancia que la salud sistémica (98.88 por ciento). Hubo máspadres de familia de niños de escuelas privadas en los niveles altos deprevención y educación dental que de escuelas públicas. Asimismo, seobservó que en el nivel alto de educación y prevención dental, cuantomayor era el grado de estudios de los padres de familia, mayor cantidadde ellos se encontraban en estos niveles. Conclusiones: Dado que hayun alto grado de educación dental y uno moderado de prevención, sedetectó que no se lleva a la práctica lo que se sabe, aun cuando se da gran importancia a los dientes, por lo que sería conveniente diseñar un método para asegurar que se apliquen las medidas preventivas e indagar las causas por las que se omiten.

Objective: to evaluate the level of dental education, prevention, andthe importance of caries and periodontal disease in parents of primarylevel children in the city of León, Gto. Material and methods: Inthis descriptive, cross-sectional and observational study, a surveywas applied to 1,249 parents whose children study in six diff erentprimary schools. The survey had 18 questions about dental education,prevention, and importance. A comparison was made between parentswhose children study in private and public schools and between thelevel of studies of parents in the level of dental education and dentalprevention. Results: It was found a moderate level of dental prevention(48.04%) and a high level of dental education (49.48%), almost allparents think that temporal teeth are important (87.43%); 65.89% ofthe parents considered their own teeth as «very important¼, 28.02%as «moderately important¼, 5.12% as «little important¼ and 0.96% as«no important¼. They also affi rm that dental health is as important assystemic health (98.88%). There were more parents with children fromprivate schools with high levels of dental prevention and education thanchildren from public schools. It was also observed that in the high levelof dental education and prevention, the higher the level of studies werein parents, the most of them were found in those levels. Conclusions:Due to the high level of dental education, and a moderate level ofprevention, it was observed that people don’t practice what they know,even though they think teeth are important, so it would be convenientto design a method to assure that preventive measures are done andfi nd out the reasons why they are not taking place.

Content analysis of nutritional information in paediatric oral health education leaflets.

BACKGROUND: The aim of this study was to determine if paediatric oral health education leaflets with a food and nutritional focus provide messages that are clear and consistent with the current Australian Dietary Guidelines and the Infant Feeding Guidelines. METHODS: Forty-three leaflets aimed at parents were sourced from Australian state and territory Health Departments, oral health industry partners and commercial organisations, and a content analysis was performed. Recommendations on food and drink type, consumption frequency and general diet and nutrition advice were considered and cross-referenced with the Australian Dietary Guidelines and the Infant Feeding Guidelines to identify areas of consistency and discrepancy. RESULTS: Twenty leaflets recommended reducing the consumption of sugary and/or acidic food, while 23 leaflets recommended reducing the consumption of sugary and/or acidic drinks. The majority of the leaflets advised water (n = 35) and milk (n = 23) to drink. Although 33 leaflets encouraged a healthy diet, seven of these did not specify what a healthy diet was. Twenty-eight leaflets provided early childhood-related (0-2 years) feeding advice. Confusing messages were found in nine leaflets, with ambiguous recommendations that were open to individual interpretation. CONCLUSIONS: There were some inconsistencies between the leaflets and the dietary and infant feeding guidelines in Australia; and across the leaflets, as not all important messages were included in any one leaflet. Government Health Departments and other relevant agencies should ensure that advisory messages regarding diet, particularly those with dental implications, are clear, complete and consistent across all dental educational leaflets.

Oral Health Prevention and Toddler Well-Child Care: Routine Integration in a Safety Net System.

BACKGROUND AND OBJECTIVE: Applying topical fluoride varnish (FV) to young children's teeth is an effective therapeutic strategy for preventing early childhood caries (ECC). In 2008, the pediatricians at Contra Costa Regional Medical Center and Health Centers became concerned that our low-income pediatric patients had high rates of ECC and very limited access to dental care. We formed an interdisciplinary safety net-academic partnership with the University of California San Francisco to implement routine FV applications, along with oral health education, screening, and referral during well-child exams for children aged 1 to 5 years. METHODS: Over 3 years, the team developed clinical policies, educational materials, billing, and support systems to facilitate implementation in the primary care setting. A pilot study was performed in 2 health centers; improvements to the implementation plan were made. A team of local providers and academic partners performed system-wide didactic and hands-on trainings and spread this intervention to the remaining 6 health centers. Continued improvement strategies and provider feedback were pursued with each measurement cycle. RESULTS: In August 2012, 95% of all children aged 1 to 5 years who were seen for well-child checkups received a FV application and oral health education during their primary care well visit. Repeat measurement in April 2014 showed a sustained rate of 97% application of FV for children in this age group seen for well-child visits. CONCLUSIONS: With institutional commitment and an academic partnership, a safety net institution can integrate routine FV applications and oral health interventions into well-child visits to reduce ECC.

Avaliação do conhecimento de professores do ensino fundamental da rede pública de Ouro Preto do Oeste ­ RO sobre saúde bucal / Evaluation Of public elementary education teachers' knowledge about oral health In Ouro Preto do Oeste ­ RO

Introdução: Sendo as escolas locais de reunião de crianças em faixas etárias propícias à aquisição de hábitos, o professor se torna um importante aliado na educação em saúde bucal para os alunos e, para isso, é importante que esses professores conheçam bem esse tema. Objetivo: Assim, este estudo objetivou avaliar o conhecimento de professores do ensino fundamental da rede pública de Ouro Preto do Oeste ­ RO sobre saúde bucal. Materiais e Métodos: A amostra consistiu de 30 professores, entrevistados através de um questionário autoaplicável de múltipla escolha, abordando o ensino sobre saúde bucal nas escolas, odontologia preventiva e o conhecimento da etiologia da doença cárie. A partir da quantidade de respostas certas, o conhecimento dos professores sobre saúde bucal foi classificado como "Bom" ou "Ruim". Os dados coletados foram analisados através de estatística descritiva simples e apresentados em gráficos. Resultados: 73% dos professores tiveram conhecimento considerado Bom e 27% Ruim. Conclusões: Os professores apresentaram alto interesse no assunto e mais da metade teve o conhecimento sobre saúde bucal considerado Bom. Porém, observaram-se dúvidas com relação a conceitos importantes, que devem ser sanadas através de uma maior abordagem do assunto nos cursos de pedagogia, capacitação dos professores já atuantes nas escolas e uma formalização do tema nos currículos escolares.(AU)

Introduction: The schools are strategic spots for a child's health education because they reunite children of favorable ages to acquire habits. Therefore, since the teacher becomes an important partner in diffusing information about oral health to the students, it is important that they know about this subject. Objective: So this study evaluated the level of public elementary education teachers' knowledge about oral health in Ouro Preto do Oeste ­ RO. Methods: The sample consisted of 30 teachers interviewed by a self-administered multiple-choice questionnaire that consisted of questions regarding oral health teaching at schools, preventive dentistry and knowledge about caries. From the amount of correct answers, the teachers' oral health knowledge was classified as "Good" or "Bad". The data collected were analyzed using simple descriptive statistics and presented in graphs. Results: 73% of the teachers had their knowledge classified as Good and 27% Bad. Conclusions: The teachers showed high level of interest about the subject and most had a good knowledge about oral health. However, they showed doubts regarding important concepts that must be elucidated by a greater approach of the subject in pedagogy courses, qualification of teachers already working at schools and a formal inclusion of this subject in the educational curricula.(AU)

[Evaluation of an Intensified Dental Preventive Programme Aimed at Children with Increased Caries Risk]. / Evaluation eines zahnmedizinischen Präventionsprogramms für Kinder mit erhöhtem Kariesrisiko.

Our study investigated the effect of a selective intensive prevention (SIP) programme on dental health of pupils in comparison to a control group. While no differences were observed in respect to dental health of first graders, the DMF-T values of fourth and 6 graders participating in SIP were significantly lower. Concerning the psychometric variables only few differences were found. The fourth and 6 graders in the test group reported less dental fear than the pupils in the control group.

Treatment fidelity of brief motivational interviewing and health education in a randomized clinical trial to promote dental attendance of low-income mothers and children: Community-Based Intergenerational Oral Health Study "Baby Smiles".

BACKGROUND: Fidelity assessments are integral to intervention research but few published trials report these processes in detail. We included plans for fidelity monitoring in the design of a community-based intervention trial. METHODS: The study design was a randomized clinical trial of an intervention provided to low-income women to increase utilization of dental care during pregnancy (mother) or the postpartum (child) period. Group assignment followed a 2 × 2 factorial design in which participants were randomly assigned to receive either brief Motivational Interviewing (MI) or Health Education (HE) during pregnancy (prenatal) and then randomly reassigned to one of these groups for the postpartum intervention. The study setting was four county health departments in rural Oregon State, USA. Counseling was standardized using a step-by-step manual. Counselors were trained to criteria prior to delivering the intervention and fidelity monitoring continued throughout the implementation period based on audio recordings of counselor-participant sessions. The Yale Adherence and Competence Scale (YACS), modified for this study, was used to code the audio recordings of the counselors' delivery of both the MI and HE interventions. Using Interclass Correlation Coefficients totaling the occurrences of specific MI counseling behaviors, ICC for prenatal was .93, for postpartum the ICC was .75. Participants provided a second source of fidelity data. As a second source of fidelity data, the participants completed the Feedback Questionnaire that included ratings of their satisfaction with the counselors at the completion of the prenatal and post-partum interventions. RESULTS: Coding indicated counselor adherence to MI protocol and variation among counselors in the use of MI skills in the MI condition. Almost no MI behaviors were found in the HE condition. Differences in the length of time to deliver intervention were found; as expected, the HE intervention took less time. There were no differences between the overall participants' satisfaction ratings of the HE and MI sessions by individual counselor or overall (p > .05). CONCLUSIONS: Trial design, protocol specification, training, and continuous supervision led to a high degree of treatment fidelity for the counseling interventions in this randomized clinical trial and will increase confidence in the interpretation of the trial findings.

Estética em odontologia: percepções de acadêmicos de odontologia e pacientes / Dental aesthetics: perceptions of patients and dental students, University of São Paulo

O objetivo deste estudo foi avaliar o conhecimento de estética facial e bucal adquirido pelos alunos no curso de odontologia da Faculdade de Odontologia da Universidade de São Paulo (FOUSP) e comparar com o que os pacientes que frequentam a Clínica Odontológica da FOUSP almejam como estética. Esse estudo foi realizado com 200 indivíduos de 18 a 50 anos, sendo: 100 (cem) pacientes, 50 (cinquenta) acadêmicos de primeiro ano e 50 (cinquenta) do último ano do curso de odontologia. Foram aplicados dois questionários aos grupos, um questionário sobre o perfil socioeconômico e um sobre a percepção estética. Os questionários são do tipo Escala Visual Analógica (VAS). Para medir a percepção do indivíduo sobre a estética foram abordados os seguintes aspectos: estética facial, como tipo de cabelo, tamanho dos olhos, forma da boca; e estética bucal, como posição, tamanho e forma dos dentes, gengiva e lábios. De acordo com os resultados obtidos por meio dos questionários foi possível comparar e correlacionar os grupos analisados utilizando os testes ANOVA e qui-quadrado. Após a análise estatística observou-se que não houve diferença estatisticamente significante (p=0,49) entre as respostas apresentadas pelos alunos tanto em relação à estética bucal, quanto em relação à estética facial. Na análise comparativa entre alunos e pacientes, pode-se observar que houve diferença entre à percepção bucal (p<0,001), mas não quanto à facial (p=0,26). Na amostra estudada observou-se que a resposta do grupo de pacientes comparada a dos estudantes divergiu significantemente.

Este resultado pode ser atribuído ao fato dos estudantes observarem com mais rigor a questão da estética dental/bucal, enquanto o grupo de pacientes valorizarem mais a estética facial, buscando a harmonia do conjunto. Cabe ressaltar que os fatores que influenciaram nas respostas apresentadas nos questionários foram à idade, classe econômica e grau de escolaridade. Entender como o paciente enxerga estética e o que ele almeja quando se submete a um procedimento é importante para que o profissional realize um trabalho que satisfaça e eleve a autoestima deste paciente. Tendo isso em mente, o presente trabalho pode contribuir para nortear os profissionais da área quanto ao foco que devem ter ao realizar um procedimento estético, ou seja, entender o que o paciente busca e, concomitantemente, realizá-lo com as necessidades funcionais.

The aim of this study was to evaluate the knowledge of facial and oral aesthetics acquired by students in the course of Dentistry Faculty of Dentistry, University of São Paulo (FOUSP) and compare it with what the patients attending the Dental Clinic aims FOUSP as aesthetics. This study was conducted with 200 subjects aged 18 to 50 years, as follows: one hundred (100) patients, fifty (50) students of first year and fifty (50) of the final year of dentistry. Two questionnaires to groups, a questionnaire on socioeconomic and one on the aesthetic perception were applied. Questionnaires are the type Visual Analogue Scale (VAS). To measure the individual's perception of aesthetics the following aspects were addressed: facial aesthetics such as hair type, eye size, mouth shape; and oral aesthetics, such as position, size and shape of the teeth, gums and lips. According to the results obtained through the questionnaires was possible to compare and correlate the groups analyzed using ANOVA and chi-square tests. After statistical analysis revealed that there was no statistically significant difference (p = 0.49) between the responses given by students in relation to both oral aesthetics, and in relation to facial aesthetics. The comparative analysis between students and patients, it can be observed that there were differences between the oral perception (p < 0.001), but not regarding facial (p = 0.26). In this sample we observed that the response of the patient group compared to the students diverged significantly.

This result can be attributed to the fact that students observe more strictly the issue of dental/oral aesthetics, while the group of patients give greater facial aesthetics, seeking the harmony of the whole. Note that the factors that influenced the answers given in the questionnaire were age, economic status and educational level. Understand how the patient sees aesthetics and he craves when it undergoes a procedure is important for the provider performs a job that fits and raise the self-esteem of the patient. Keeping this in mind, the present study may contribute to guide the professionals about the focus that should have when performing an aesthetic procedure, ie, to understand what the patient looks and concomitantly performing it with operational requirements.

Promoting oral health of children through schools--results from a WHO global survey 2012.

This paper reviews the range of school-based approaches to oral health and describes what is meant by a Health Promoting School. The paper then reports the results of a World Health Organization global survey of school-based health promotion. Purposive sampling across 100 countries produced 108 evaluations of school oral health projects spread across 61 countries around the globe. The Ottawa Charter for Health Promotion noted that schools can provide a supportive environment for promoting children's health. However, while a number of well-known strategies are being applied, the full range of health promoting actions is not being used globally. A greater emphasis on integrated health promotion is advised in place of narrower, disease- or project-specific approaches. Recommendations are made for improving this situation, for further research and for specifying an operational framework for sharing experiences and research.

[Oral health of pregnant women and their awareness of oral hygiene]. / Die Mundgesundheit von Schwangeren und deren Mundgesundheitsbewusstsein.

AIM: Pregnancy is related with changes in oral health. While the medical care of pregnant women in Germany is well-regulated, there are no structured recommendations for dental examinations. During an "Oral Health Awareness Week" the periodontal conditions of pregnant women in the Federal State of Thuringia (Germany) were examined. METHODS: 85 pregnant women participated in this study. Oral health indices (PSI, BoP and DMFT) were recorded. 61 of the 85 women followed the invitation to repeat the investigations after parturition. Additionally, birth weight and height of the newborn were recorded. RESULTS: There were no correlations between periodontal condition and birth weight. However, pregnant women demonstrated in high levels periodontal inflammation (only 1.2% showed periodontal health). Pregnant woman with periodontitis (PSI 3 and 4) demonstrated clear deficiencies in health education regarding oral health and adverse pregnancy outcomes. CONCLUSIONS: These findings implicate the importance of periodontal care in pregnant women. An association between periodontitis and reduced birth weight was not observed in the studied Thuringian cohort.

Prática da promoção e educação em saúde bucal nos hospitais de grande porte da região metropolitana de Belo Horizonte, Minas Gerais / Practice of promotion and education of oral health in major hospitals within the metropolitan region of Belo Horizonte, Brasil

Objetivo: O objetivo deste estudo foi verificar o estágio atual das práticas de promoção e educação em saúde bucal no contexto da Odontologia Hospitalar em hospitais de grande porte da Região Metropolitana de Belo Horizonte-MG (RMBH). Materiais e Métodos: Este é um estudo quantitativo, descritivo e transversal. Para a determinação do grupo amostral foi utilizado os critérios de inclusão: hospitais localizados na Região Metropolitana de Belo Horizonte, ser categorizado como de grande porte, oferecer algum tipo de especialidadeodontológica, independente do vínculo empregatício do cirurgião-dentista. A pesquisa foi realizada por meio deum questionário estruturado, realizado por apenas uma pesquisadora, dirigido ao cirurgião-dentista responsáveldo setor odontológico. Após utilização dos critérios, dos 21 hospitais de grande porte da RMBH, apenas 14 possuem cirurgião-dentista em seu corpo clínico. Os dados coletados foram tabulados no em banco de dados Excel 2003 (Microsoft) em frequências absolutas e relativas. Resultados: Verificou-se em 2008 que 71,4% dos hospitais com cirurgiões-dentistas realizavam procedimentos educativos. Sobre os métodos de educação em saúde encontraram-se as ações individuais como as mais utilizadas (80,0%), as palestras e as técnicas de escovação ocorrem na maioria deles (60,0%) e, em menor proporção, mas não menos importante, em 20,0% dos hospitais aplica-se a técnica de escovação supervisionada. Os temas mais abordados em atividades educativas foram: uso da escova e fio dental em 100,0% dos casos, dieta cariogênica, uso de antissépticos bucais e interferência das condições bucais sobre a saúde geral do paciente em 90,0%. Conclusão: Verificou-se que a maioria dos hospitais da RMGV realizam educação e promoção de saúde bucal. Estas práticas independentes do tipo de procedimento educativo executado devem estar consolidadas no contexto hospitalar, afim de, fortalecer e justificar a necessidade deste profissional nos hospitais.

How much information is remembered by the patients? A selective study related to health education on a Swedish public health survey.

The purpose of this study was to investigate the degree to which patients have perceived that they got questions or advice about eating habits and smoking habits at their last visit at the dental clinic and if this information was differently distributed between different age groups. A further aim was to study whether there were differences in the proportions of questions and advice given to individuals who perceived problems regarding caries and gum bleeding compared to those that did not feel they had problems. The results are based on a postal questionnaire survey,"Life and Health 2008". The study was conducted in a population of women and men aged 18-84 years in 5 counties in Sweden. A total of 68,710 questionnaires were sent out and the response rate was 59.2%. Substantial differences in proportions existed between age groups regarding who received questions and advice related to dental caries and periodontal disease. The differences between age groups regarding information were statistically significant since it was less common that older people got questions and advice than younger.These differences also exist, but less pronounced, between those with disease related problems and those without.Three factors were statistically significantly associated with information. Age, education level and problems with caries or bleeding gums had statistical effect on the prevalence of questions and advice related to eating habits or smoking habits respectively. In conclusion, it is an urgent need of education in methods for dental staff if they want to contribute to changes in life style behaviors for their patients since most patients today don't perceive that they got important disease relevant information at the last dental visit.

Do public health nurses in Norway promote information on oral health?

BACKGROUND: (i) to describe oral health counselling in Norway to parents with infants and toddlers, ii) to assess existing collaboration and routines in oral health matters between nurses and personnel in the PDS, iii) to evaluate to what extent oral health was integrated in the basic educational curriculum of public health nurses. METHODS: This study was based on two separate surveys: the sample of Study I was 98 randomly selected child health clinics. A questionnaire covering oral health promotion counselling of parents with young children was returned by 259 nurses. Study II was a telephone survey addressing teachers of public health nurses at the eight educational institutions in Norway. RESULTS: The response rate in Study I was 45%. Nutrition (breast feeding, diet) was the health subject most often prioritized in the counselling targeting parents of young children (by 60% of the nurses). Oral health was not among the first priority counselling subjects. The subject was seldom spontaneously mentioned by parents. Seventy percent of respondents reported (agreed or totally agreed) that they managed to provide information parents needed and 72% believed that the information they gave influenced parents' health behaviours. Seven nurses (5.2%) responded that they agreed with the statement that the information they gave only slightly influenced parents' health behaviour. Lack of time was mentioned as being a problem. Approximately half of the nurses (48%) had regular contact with the PDS for the 0-3 year-old children, but only a quarter of the nurses claimed that children's teeth were routinely examined at the child clinics. Some forms of previously established contact with the PDS enhanced the likelihood of nurses' referrals. Oral health was a minor part of the educational curriculum for public health nurses; at three institutions, the subject was totally absent. CONCLUSION: Collaboration between nurses and the PDS in Norway could be improved. Oral health should have a bigger place in the basic educational curriculum.

Associations of social and behavioural factors with early childhood caries in Xiamen city in China.

BACKGROUND: Early childhood caries (ECC) is the presence of caries in primary teeth in children 71 months of age or younger. Despite a decreasing prevalence of caries in China, ECC and related risk factors in China have not been well studied. AIMS: This study aimed to investigate the status of ECC in children living in Xiamen city in China and to analyse the associated social and behaviour determinants. DESIGN: A stratified random sample consisted of 1523 children with normal birth records. Clinical examination was performed to record caries at the surface level. Parents filled in questionnaires regarding eating habits, family status, childcare provider, and oral intervention. RESULTS: Prevalence of ECC in studied child population was 56.8-78.31%, with an increasing tendency with age. The following factors were found to be significantly associated with ECC: age, candy, carbonated drink, bedtime eating, late start of brushing, low education of parents, private childcare, increased number of siblings, rural residence, and lack of oral health knowledge. Using a stepwise forward logistic regression analysis, a prediction model was established. CONCLUSION: Early childhood caries in children living in Xiamen city was strongly associated with eating habits, family- and childcare-related factors and tooth-brushing. The ECC-high-risk group is children in rural private childcare facilities.

The dental health of three-year-old children in Greater Glasgow, Scotland.

OBJECTIVE: To report on the dental health of three-year-old children in Greater Glasgow, and to examine the amount of dental caries associated with deprivation in this young age group. DESIGN: Dental inspections in nursery schools. SUBJECTS AND METHODS: The national inspection programme using BASCD criteria was extended to include an additional group of nursery attending three-year-olds in Greater Glasgow in 2006/7 and 2007/8. Caries experience was analysed by logistic regression models and ROC plots. RESULTS: Fourteen percent of this population was sampled in 2006/7 and 19% in 2007/8 (usable data n = 1,711 in 2006/7, 2,428 in 2007/8). Mean d(3)mft was 1.1 in 2006/7 and 1.0 in 2007/8. The prevalence of caries experience was 26% in 2006/7 and 25% in 2007/8 (33% and 32%, respectively, for children in deprived areas). The adjusted odds-ratio for caries experience for children living in the most deprived areas was 2.90 (2.31, 3.64), p <0.001. There was a high rate of caries in the upper anterior teeth. CONCLUSION: It was feasible to conduct large scale caries surveys of three-year-olds in a nursery setting. Poor dental health and inequality commence early in life. Caries prevention should be targeted toward deprived families from birth.

Tooth loss in Brazilian middle-aged adults: multilevel effects.

OBJECTIVE: To examine the link between tooth loss and multilevel factors in a national sample of middle-aged adults in Brazil. MATERIAL AND METHODS: Analyses were based on the 2003 cross-sectional national epidemiological survey of the oral health of the Brazilian population, which covered 13 431 individuals (age 35-44 years). Multistage cluster sampling was used. The dependent variable was tooth loss and the independent variables were classified according to the individual or contextual level. A multilevel negative binomial regression model was adopted. RESULTS: The average tooth loss was 14 (standard deviation 9.5) teeth. Half of the individuals had lost 12 teeth. The contextual variables showed independent effects on tooth loss. It was found that having 9 years or more of schooling was associated with protection against tooth loss (means ratio range 0.68-0.76). Not having visited the dentist and not having visited in the last > or =3 years accounted for increases of 33.5% and 21.3%, respectively, in the risk of tooth loss (P < 0.05). The increase in tooth extraction ratio showed a strong contextual effect on increased risk of tooth loss, besides changing the effect of protective variables. CONCLUSIONS: Tooth loss in middle-aged adults has important associations with social determinants of health. This study points to the importance of the social context as the main cause of oral health injuries suffered by most middle-aged Brazilian adults.

Os desafios dos agentes comunitários de saúde em relação à saúde bucal em município de pequeno porte / Challenges for community health agents concerning oral health in small towns

O objetivo dessa pesquisa foi conhecer ações desenvolvidas pelos Agentes Comunitários de Saúde (ACS) do município de Virgem da Lapa/MG acerca da saúde bucal, avaliar suas percepções e interesses sobre esta prática, além de identificar as formas de aquisição destes conhecimentos. Os sujeitos da pesquisa foram 25 agentes comunitários de saúde e cada um deles preencheu uma ficha de identificação para traçar o perfil do ACS do município, antes de responder a questões abertas, cujas respostas foram anotadas pela pesquisadora no momento da entrevista. O perfil desses trabalhadores aponta para uma predominância de ACS do sexo feminino, com idade média de 28 anos, em sua maioria casados e com média de 1,2 filhos. Possuem renda familiar de um salário mínimo e ensino médio completo. Residem na comunidade em que trabalham há aproximadamente 16 anos, com tempo de atuação como ACS de quatro anos, em média. Realizam por volta de 8 visitas diárias e são responsáveis por aproximadamente 115 famílias. Alegam, nas entrevistas, não possuírem capacitação acerca da saúde bucal, não desenvolvendo nenhuma ação referente ao assunto no município, pela falta de conhecimento sobre o tema. Nas visitas domiciliares, abordam o tema quando visualizam algum problema evidente na população ou quando as pessoas perguntam sobre o assunto. Não possuem nenhum recurso para trabalhar a saúde bucal com as famílias, encontrando como grande dificuldade na vivência do seu trabalho a falta de conhecimento sobre o tema saúde bucal. Por fim, poucos deles conseguem relacionar saúde bucal como parte integrante da saúde do indivíduo como todo, sendo muitas vezes relacionada com higiene oral e patologias bucais. Após os resultados encontrados nessa pesquisa, procedeu-se à realização de um curso de capacitação para os ACS do município sobre a organização da atenção básica em saúde bucal e sobre temas relevantes na odontologia.

Opportunities and challenges to promoting oral health in primary schools.

UNLABELLED: Inequalities in oral health in areas of socio-economic disadvantage are well recognised. As children spend a considerable proportion of their lives in education, schools can play a significant role in promoting children's health and oral health. However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. METHODS: A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. RESULTS: General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes wereimplemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. CONCLUSION: This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools. The paper also makes recommendations for further research.

Knowledge of lay people and dentists in emergency management of dental trauma.

The multidisciplinary nature of the follow-up evaluations of traumatic dental injuries (TDI) requires that both the lay public and practitioners possess knowledge of the treatment strategies involved. The aim of this paper was to assess the level of knowledge of elementary public schoolteachers, parents and dentists of the city of Joaçaba, Southern Brazil, about the emergency management of TDI. Three independent cross sectional studies were carried out involving samples of elementary public schoolteachers (n = 245), parents (n = 107) and dentists (n = 85) in the city in 2001. Data were collected through structured interviews for schoolteachers and dentists, and questionnaires for parents, containing questions about socio-demographic characteristics and about incidents resulting in TDI. The responses in the three studies showed a wide variability of indicated procedures for the situations of TDI proposed. The results of association studies showed that older schoolteachers (P = 0.003), older dentists (P = 0.013) and dentists who had graduated more recently (P = 0.032) chose significantly more correct answers in some TDI incidents. The answers of schoolteachers, parents and dentists showed a wide variability of indicated procedures for the situations proposed. The great majority of them would not follow the approaches most recommended in the literature. A greater importance should be placed on TDI through educational campaigns aiming schoolteachers and parents and also through undergraduation and postgraduation dental curricula in order of improving its management.

First-aid knowledge about tooth avulsion among dentists, doctors and lay people.

In avulsion, teeth are bodily displaced out of the bony socket. Boys, aged 7-9 years, are most prone to avulsion of maxillary central incisors. Tooth avulsion should ideally be treated with immediate replantation. Because of the urgency in treatment, personnel dealing with this injury should have knowledge about the first-aid treatment. This study was conducted to assess the first-aid knowledge about tooth avulsion among dentists, doctors, students, school teachers and the general public in Lahore, Pakistan. Data were collected using a form with one open-ended question about the first-aid treatment of traumatic avulsion. Immediate replantation of the avulsed tooth was suggested by 10.1% of 377 respondents. Among dentists, 45.8% suggested immediate replantation, with the rest suggesting transport of the tooth to a dentist for replantation. Among all other groups (non-dentists) immediate replantation was suggested by 4.6% and transport to a dentist by 3.3%. Non-dentists in Pakistan, including doctors, have insufficient knowledge about the immediate treatment of tooth avulsion. Dentists, in comparison, have significantly more knowledge, but may need training in selection of the appropriate treatment option and handling and care of the avulsed tooth.