Validity assessment of oral health promotion activities targeting the older population for community care in South Korea: A Delphi study.

OBJECTIVE: The purpose of this study was to establish an oral health activity assessment tool for older people and evaluate its validity. BACKGROUND: To provide reasonable and efficient oral health promotion services with limited medical resources, a tool including categories and items of oral health promotion activities for older people should be prepared. MATERIALS AND METHODS: The tool initially consisted of 76 items on oral health promotion activities for older people classified into assessment-performance-evaluation stages. Topics for each stage included general and oral health, daily health, oral health status, behaviour, and awareness. In addition, two Delphi surveys were conducted on 10 experts who met the selection criteria, and the final items were derived based on the review opinions. RESULTS: As a result of the first and second Delphi surveys, the content validity for all items was ≥0.60 and the content validity index was ≥0.80. In the first survey, the degree of convergence in some items was 0-0.88. After modifying the contents according to expert opinions, the degree of convergence was improved from 0 to 0.50 in the second survey. The degree of agreement ranged from 0.75 to 1.00, indicating that experts agreed. Finally, a total of 65 items were derived. CONCLUSION: A 65-item tool was derived through two Delphi surveys for the assessment of oral health activities for older people. The use of the tool developed in this study would likely contribute to better prevention of oral diseases and the promotion of oral health among older people.

Association Between Serum Vitamin D Levels and Periodontal Conditions According to Sleep Duration Using Data from Korea National Health and Nutrition Examination Survey.

PURPOSE: This study aimed to investigate the association between vitamin D levels and periodontitis according to sleep duration in a representative sample of Korean adults. MATERIALS AND METHODS: A total of 3535 subjects who participated in the sixth (2013-2014) Korea National Health and Nutrition Examination Survey were examined. Vitamin D deficiency was defined as a 25-hydroxyvitamin D serum concentration of 20 ng/ml. Periodontal status was assessed with the community periodontal index (CPI). A high CPI was defined as a score ≥ 3. Multivariable logistic regression analyses were adjusted for sociodemographic variables, oral and general health behaviors, and systemic health status. All analyses used a complex sampling design, and a subgroup analysis was performed to determine estimates following stratification for sleep duration (≤ 5, 6, 7-8, and ≥ 9 h per day). RESULTS: Multivariable regression analysis indicated that among participants who slept for ≥ 9 h per day, those with vitamin D deficiency were 5.51 times (95% confidence interval = 2.04-14.89) more likely to have periodontitis than those with sufficient vitamin D levels. This association was not statistically significant in the other sleep duration groups. CONCLUSION: The findings of this study indicate that people with vitamin D deficiency who sleep 9 h or longer may also be statistically significantly more likely to have periodontitis.

Definition and Classification of Dental Hygiene Interventions Based on the Dental Hygiene Process of Care: A Delphi Study.

This study aimed to conceptualize the dental hygiene intervention performed by dental hygienists based on the dental hygiene process of care. The dental hygiene intervention classification was conducted on the qualitative content analysis method. The contents of the primary dental hygiene intervention classification were refined after review by three internal experts. The final classification of dental hygiene interventions was derived through an expert Delphi survey conducted twice with 15 professors in charge of clinical dental hygiene. In the Delphi survey, the content validity and clarity were evaluated. As a result of the first and second expert Delphi surveys, the content validity ratio for all dental hygiene interventions and definitions was ≥0.60, and the content validity index was ≥0.80. The degree of agreement was a minimum of 0.80 and a maximum of 1.00. Thirty-eight dental hygiene interventions were conceptualized, and the essence of the dental hygienist was confirmed. Dental hygienists are oral health experts who help in preventing oral diseases and promoting oral health by providing evidence-based comprehensive preventive management through interaction with their clients, and they are a primary care worker who could contribute to health promotion. In the future, dental hygienists are expected to be actively involved in the primary care system and dental clinical sites and contribute to health promotion through practical discussions for this purpose.

Effects of Problem-Based Learning on the Problem-Solving Ability and Self-Efficacy of Students Majoring in Dental Hygiene.

This study developed a problem-based learning (PBL) module to improve integrated thinking and problem-solving ability in students of dental hygiene. After applying PBL, the study tested the improvement in the problem-solving ability and self-efficacy of students. The subjects were 31 fourth-year students of the Department of Dental Hygiene at G University. The PBL process was applied to three topics for 15 weeks, and the tools for evaluating problem-solving ability and self-efficacy were reconstructed and used before and after the application to examine the effects of the module. The result indicates that the mean of problem-solving ability (32 detailed items) increased from 3.37 to 3.65 (an increase of 0.28) after classes (p < 0.001). Alternatively, the average for self-efficacy (22 detailed questions) increased from 0.21 to 2.89 (p < 0.05; an increase of 2.67). The study also confirmed the correlation between problem-solving ability and the total posttest score for self-efficacy (p < 0.001). Thus, the problem-solving ability and self-efficacy of learners were improved in the class to which PBL was applied. These improvements exerted a significant effect on the improvement of problem-solving ability. This finding confirmed the effect of the PBL method on dental hygiene education.

Types of Perception of Home Visiting Oral Health Care Services for Korean Older Persons: A Q Methodology Study.

This study was conducted using the Q methodology to categorize Korean older persons' subjective perceptions of home visiting oral health care services. Various opinions regarding home visiting oral health care services were collected based on related literature, and by conducting in-depth interviews with 12 people. Thirty-two statements were finally selected, and Q classification was applied. Based on data analysis with the PC-QUANL program, six factors (seven types) were derived, which accounted for 49.6% of the total variance. By comprehensive analysis of the types of subjective perceptions of home visiting oral health care services, the following two characteristics were identified. Korean older persons were expected to promote their own oral health activities, or improved access to expert health care services, through the home visiting oral health care services. Additionally, they had a need for social, economic, emotional, and informational support. Therefore, home visiting dental personnel should be able to provide customized visiting oral health care services based on evaluation of the need and type of perception of older persons. Thus, it is essential for visiting dental personnel to be trained in the knowledge of social welfare, and to develop diverse competencies.

Factors Affecting Preventive Dental Treatment of Adolescents in Korea.

We conducted a multilevel analysis to identify factors affecting adolescents' preventive dental treatment experience in South Korea. We sampled 72,435 students who participated in the 9th Korea Youth Risk Behavior Web-based Survey. The individual-level variables were divided into demographic factors, socioeconomic factors, oral health behavioral factors, and oral symptom experience factors. The regional-level variables included oral health resources, rate of students receiving oral health education at school by region, social deprivation index, and the number of private educational institutions. A higher rate of receiving oral health education in school by region was associated with increased fluoride application (1.04 times, p = 0.003). However, the number of private educational institutes per 1000 people was negatively associated with fluoride application experienced by students (0.64 times, p = 0.039). Students underwent more scaling when there were more dentists per 10,000 individuals (1.14 times, p = 0.008) and less scaling in areas with a higher social deprivation index (0.88 times, p = 0.024). To increase the access to preventive care for oral diseases among adolescents, a preventive system should be established in schools, and a primary dental care system should be established through the cooperation of the government, private dental clinics, and schools.

The effect of project-based learning modules on a community dental hygiene practicum in South Korea.

PURPOSE: The goal of this study is to develop and apply learning modules to help community dental hygienists acquire the necessary competencies and verify the effectiveness of the modules. METHODS: On the basis of 12 domestic and international reference papers, the concept of a community dental hygiene process of care was defined, and 393 learning goals were found to perform the primary and secondary categorization processes. The final 52 learning goals were assigned as a 15-week module series to develop project-based learning modules. The modules were used in 2018 during the first semester of the community dental hygiene practicum at G University (bachelor's degree) and H University (associate's degree). Surveys were performed before and after the application of the modules to evaluate the method's effectiveness. RESULTS: Confidence in problem-solving abilities, project value, teamwork competency, and community dental hygiene competency were compared before and after the application of the modules. Students at both G and H universities showed statistically significant improvements across all 4 indices. Project authenticity and learning outcomes were analyzed in students at G and H universities after applying the modules; the results demonstrated that project authenticity and learning outcomes were positive. CONCLUSION: The learning modules can be presented as systematic educational modules, which have inherent academic significance for dental hygiene, and in turn can strengthen students' competency in community practice areas.

Association of Periodontitis with the Concentration Levels of Germanium and Tin in Hair.

The purpose of this study was to investigate whether or not the concentration levels of certain kinds of trace elements in hair are associated with periodontitis. We studied a total of 109 participants, which are composed of 25 participants with periodontitis and 84 participants without periodontitis. Periodontal conditions were assessed by measuring the periodontal clinical attachment loss and pocket depth, which were determined at six sites of all teeth. Periodontitis was defined according to the criteria of periodontitis proposed by CDC-AAP. The hair samples were washed with acetone, water, and extran (1%v/v), and then aliquots of hair samples were wet-ashed. This sample solution was analyzed by Perkin-Elmer Mass Spectrometer. The odds ratios and 95% confidence intervals of the concentration levels of trace elements for periodontitis were calculated by multivariate logistic regression analysis. After adjusting all confounders, it was found that the higher concentration level of germanium in hair was significantly and positively associated with periodontitis (odds ratio [OR] 7.12; 95% confidential interval [CI] 2.03-25.00). The higher concentration level of tin in hair was significantly and negatively associated with periodontitis (OR 0.27; 95% CI 0.08-0.94). It was concluded that there was a significant relationship between periodontitis and the concentration level of germanium and tin in hair.