Development of interprofessional education programmes in nursing care and oral healthcare for dental and nursing students.

BACKGROUND: Interprofessional education (IPE) is essential for healthcare students to collaborate effectively in multidisciplinary teams. This study aimed to identify the effect of IPE programmes in nursing care and oral healthcare on dental and nursing students' perceptions of interprofessional collaboration. METHODS: The study included 101 third-year dental and 98 fourth-year nursing students. The participants were divided into mixed-professional groups of four (2 dental and 2 nursing students). They participated in nursing care and oral healthcare training programmes that included student-on-student training and discussion groups. Questionnaires regarding perceptions of interprofessional collaboration were distributed to the participants before and after the programmes to compare the programmes before and after and between the dental and nursing students. The Wilcoxon signed-rank test and chi-square test were used to compare the data. RESULTS: Data from 79 dental students (42 males and 37 females) and 89 nursing students (4 males and 85 females) who completed both questionnaires were used for the comparisons. Perceptions of the differences between the approaches of different health professionals to nursing care, the roles of other professionals, and the need for multiprofessional collaboration improved significantly among both dental and nursing students after the programmes. Although the perception of their ability to communicate with unfamiliar or new people improved significantly only among the nursing students, other perceptions of their ability to communicate did not improve for either group. More dental students than nursing students chose nursing trainings as good programmes to participate in with other professional students, while more nursing students than dental students chose oral care trainings as good programmes. Many students commented that they learned about nursing and oral healthcare skills as well as the importance of teamwork and communication with other professionals. Seven students commented that they were more motivated to become dentists and nurses. CONCLUSIONS: This study showed that IPE programmes for nursing care and oral healthcare might be effective at helping students understand other professionals and promoting multiprofessional collaboration. However, further studies are needed to develop IPE programmes to improve attitudes and abilities related to interprofessional communication skills.

Effects of oral health-related quality of life on total mortality: a prospective cohort study.

BACKGROUND: The effects of oral health on mortality have been reported; however, the association between mortality and Oral Health-Related Quality of Life (OHQOL) is unknown. We investigated the effect of OHQOL on total mortality in a cohort consisting of dentists. METHODS: In this cohort study, we analyzed data from the Longitudinal Evaluation of Multi-phasic, Odonatological and Nutritional Associations in Dentists study. We conducted a baseline survey of general and oral health factors. We called for 31,178 participants and collected responses from 10,256 participants. We followed up with 10,114 participants (mean age ± standard deviation, 52.4 ± 12.1 years; females, 8.9%) for 7.7 years, until March 2014, to determine the average total mortality. OHQOL was assessed using the General Oral Health Assessment Index (GOHAI). The total score was divided into quartiles (Q1 ≤ 51.6, Q2 = 51.7-56.7, Q3 = 56.8-59.9, and Q4 = 60.0), with higher GOHAI scores indicating better OHQOL (score range, 12-60). The association between OHQOL and total mortality was analyzed using the Cox proportional hazards model. RESULTS: We documented 460 deaths. Males with low GOHAI scores possessed a remarkably high risk of total mortality. The multivariate adjusted-hazard ratios (aHRs), were 1.93 (95% confidence interval [CI], 1.07 - 3.48) for Q1, 1.69 (95% CI, 0.90 - 3.17) for Q2, and 0.65 (95% CI, 0.29 - 1.46) for Q3, relative to Q4 (trend p = 0.001). The aHRs in the multivariate model with all background variables were 1.69 (95% CI, 1.15-2.46) for Q1, 1.53 (95% CI, 1.04-2.27) for Q2, and 1.09 (95% CI, 0.71-1.70) for Q3, relative to Q4 (trend p = 0.001). In females, there was no significant association between the quartiles, in both the multivariate-adjusted model (trend p = 0.52) and multivariate-adjusted model with all background variables (trend p = 0.79). CONCLUSIONS: A lower OHQOL indicated an increased risk of total mortality in dentists. OHQOL may be used as an indicator for selecting treatment plans and personalized care interventions, thus contributing to increased healthy life expectancy. TRIAL REGISTRATION: Aichi Cancer Center, Nagoya University Graduate School of Medicine, and Hiroshima University (Approval numbers: 33, 632-3, 8-21, and E2019-1603).

A Systematic Review of Reported Methods of Stimulating Swallowing Function and their Classification.

Recent advances in dysphagia treatment have given us many methods of stimulating swallowing function, but no attempt has been made to systematically classify them all. In this review, we provide an exhaustive description of all the techniques and stimulatory substances that stimulate swallowing that have so far been reported in the scientific literature, irrespective of their level of evidence, and we have tried to classify them with the objective of encouraging the future development of research in this direction. The Preferred Reporting Items for Systematic Reviews and Meta-analysis were followed for retrieval of relevant research. A total of 237 records were screened for this literature review. One record was excluded for being published in a language other than English, and 59 articles were excluded for having no original data. Of the 177 records that were assessed for eligibility in this review, 31 were excluded for reasons related to other inclusion and exclusion criteria. Finally, 146 records were classified. We found stimuli related to swallowing published in the literature could be divided into physical and chemical stimuli. Each stimulus had both peripheral and central stimuli when we assessed the main site of action. Physical stimuli included electric, magnetic and thermal stimulations and acupuncture. Chemical stimuli included spices activating transient receptor potential channels, several categories of medications, taste and flavor, and olfactory stimulants. Medications modifying substance P and the dopaminergic system are thought to be peripheral and central stimuli, respectively. This classification may pave the way to discover means to improve swallowing.

Changes in oral and cognitive functions among older Japanese dental outpatients: A 2-year follow-up study.

BACKGROUND: The relationship between oral and cognitive functions among older people is highly debated. OBJECTIVE: To examine whether oral functions are related to changes in the levels of mild cognitive impairment (MCI) biomarkers in older Japanese outpatients. METHODS: This observational study included 52 outpatients aged ≥65 years who underwent dental examinations at the Fukuoka Dental College Hospital. The Mini-Mental State Examination (MMSE) was performed, and MCI blood biomarker levels were assessed at baseline and after 2 years. The present dental and periodontal conditions and the oral functions (tongue pressure and masticatory performance) were evaluated. Changes in parameters from baseline to follow-up were compared using the Wilcoxon signed-rank test, McNemar test or chi-squared test. Associations among changes in the parameters were analysed using Spearman's rank correlation coefficient. RESULTS: The follow-up rate in this study was 67%. The masticatory performance was improved (p < 0.001), whereas gingival inflammation was decreased (p < 0.001) over the 2-year period. A significant increase in the MMSE score (p < 0.001) and a decrease in MCI risk (p < 0.001) were noted. The decrease in MCI risk was correlated with the increase in both masticatory performance (ρ = -0.34; p < 0.05) and MMSE score (ρ = -0.56; p < 0.01). CONCLUSION: A decrease in MCI risk, as demonstrated by the levels of the blood biomarkers, was correlated with an increase in the masticatory performance in Japanese outpatients.

Comparison of attitudes, awareness, and perceptions regarding oral healthcare between dental and nursing students before and after oral healthcare education.

BACKGROUND: Oral healthcare education for health professional students is important to promote collaborative oral healthcare practice among health professionals. The purpose of this follow-up, cross-sectional study was to investigate attitudes, awareness, and perceptions regarding oral healthcare among dental and nursing students and to compare them both between baseline and the completion of the education programme and between dental and nursing students to identify problems with oral healthcare programmes in dental education. METHOD: The subjects included 88 dental and 119 nursing students. The dental students participated in geriatric and preventive dentistry courses for oral healthcare education. The nursing students participated in independent oral healthcare courses comprising 45 h of training with case-based learning and were taught and instructed by multiple health professionals, including dentists. Questionnaires were distributed to the participants to compare attitudes, awareness, and perceptions regarding oral healthcare between baseline and the completion of the education programme and between dental and nursing students. A chi-square test, Wilcoxon signed-rank test, and Mann-Whitney U test were used to compare the data. RESULT AND CONCLUSION: The data of 48 (28 male and 20 female) dental students and 103 (9 male and 94 female) nursing students who completed the questionnaires both at baseline and after the education programme were used for the comparisons. After the education programme, more than 90% of the students were interested in oral healthcare practice; hoped to practise oral healthcare post-qualification; and perceived oral healthcare to be effective for preventing dental caries, periodontal diseases, and aspiration pneumonia. These attitudes and perceptions were statistically significantly improved after the education. However, the level of awareness of oral healthcare and the level of perception of the importance of collaboration with healthcare workers in oral healthcare practice after education were lower in the dental students than in the nursing students. Multi-professional oral healthcare education with case-based learning has the potential to improve awareness of oral healthcare and perceptions of the importance of collaborative oral healthcare practice.

Associations of Oral Health-Related Quality of Life with age, oral status, and oral function among psychiatric inpatients in Japan: a cross-sectional study.

BACKGROUND: As the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients. METHODS: The subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥ 3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level. RESULTS: A total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means ± SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6 ± 6 and 49.7 ± 7.9, respectively. The GOHAI score in the older age group (≥ 65 years) was significantly lower than that in the younger age group (< 65 years). The mean ODK scores were less than 3 times/s for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (ß = - 0.725, 95% CI - 0.97, - 0.64). CONCLUSIONS: In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.

Factors associated with nurses' performance of oral assessments and dental referrals for hospital inpatients.

BACKGROUND: Nurses' oral assessment and dental referral performance for inpatients are important to provide appropriate oral care services in hospitals. The purpose of this study was to investigate the knowledge, attitudes, and performance of oral assessments and dental referrals for their inpatients among nurses and to identify factors associated with that performance to promote oral health care in hospitals. METHODS: All nurses (n = 919) who worked at five hospitals in Japan were recruited as responders. A questionnaire regarding their performance of oral assessments and dental referrals was distributed to the subjects in each hospital. The data were collected from August 2018 to September 2018. RESULTS: A total of 757 (82.4%) nurses (82 males and 675 females) responded to the questionnaire. With respect to each of the 8 oral assessment categories, 16.2-41.2% of the nurses performed oral assessments for more than 50% of their inpatients, and 20.3-29.9% had encouraged more than one inpatient to see a dentist within the previous 3 months. Significant differences were found by ward and hospital in their performance of oral assessments for inpatients. Additionally, their oral assessment performance, knowledge of the usage of oral assessment tools, wards, and hospitals were significantly associated with their dental referral performance. CONCLUSIONS: The performance of oral assessment and dental referral was not developed sufficiently in the hospitals. Thus, oral health professionals should support oral assessment education for nurses, including usage of assessment tools, to promote dental referral by nurses. These results may contribute to promotion of dental referral performance by nurses and provision of oral health care by oral health professionals for hospital inpatients.

Association between subjective well-being and presence of primary care dentists in community-dwelling elderly people: A cross-sectional study.

OBJECTIVE: The aim was to investigate the relationships between subjective well-being and the existence of primary care dentists in community-dwelling elderly people. BACKGROUND: Some studies have reported subjective well-being focusing on oral health, but no studies have examined the relationship between subjective well-being and primary care dentists. METHODS: This cross-sectional study used data from community-dwelling elderly people aged ≥70 years (n = 624). The Philadelphia Geriatric Center Morale Scale (PGCMS; range = 0 [low morale]-17) was used to assess subjective well-being. Additional information regarding age group, sex, medical consulting situation (ambulatory care/home care), primary care dentists, family structure, economic status, health status was collected via questionnaire. RESULTS: The average PGCMS score in ambulatory care patients (ACP) group who have primary care dentists was highest among community-dwelling elderly people. In a logistic regression model, a low PGCMS score (0-11) was independently correlated to 80-89 age group (OR = 1.70; 95% CI, 1.13-2.54; P = 0.008), ≥90 age group (OR = 3.86; 95% CI, 1.83-8.18; P < 0.001), unsatisfied for economic status (OR = 2.68; 95% CI, 1.59-4.53; P < 0.001), unsatisfied for health status (OR = 3.94; 95% CI, 2.60-5.98; P < 0.001) and having no primary care dentists (OR = 1.81; 95% CI, 1.09-3.01; P = 0.021) in ACP group. CONCLUSIONS: The subjective well-being of ACP who have primary care dentists was higher than in other people. Primary dentists contributed to the subjective well-being of elderly people.

Comparison of Practices, Knowledge, Confidence, and Attitude toward Oral Cancer among Oral Health Professionals between Japan and Australia.

The purpose of this study was to investigate the practices, knowledge, confidence, and attitude toward oral cancer among Japanese oral health professionals (J-OHPs) and to identify Japanese-specific problems in oral cancer practices by comparing them between Japan and Australia. A questionnaire survey regarding oral cancer practices among Australian oral health professionals (Au-OHPs) was conducted in Australia in 2014-2015. The questionnaire was translated into Japanese, and a Web-based questionnaire survey was conducted among 131 Japanese dentists (J-Dentists) and 131 dental hygienists (J-DHs) in 2016. To compare the J-OHPs' findings with the Au-OHPs', the data of Australian dentists (Au-dentists) and Australian dental hygienists (Au-DHs) were extracted from the Australian survey. Those findings were then compared via a statistical analysis. Eighty-two J-Dentists, 55 J-DHs, 214 Au-Dentists, and 45 Au-DHs participated in this study. Only 34.1 % of J-Dentists and 36.4 % of J-DHs performed oral cancer screenings on their patients; J-OHPs were significantly less likely to perform them than Au-OHPs. The level of knowledge and confidence regarding oral cancer among JOHPs were significantly lower than among Au-OHPs. About 90 % of J-OHPs felt that they needed additional training in oral cancer practices. Less than 40 % of J-OHPs performed oral cancer screenings in their patients. The low level of knowledge and confidence regarding oral cancer among JOHPs may contribute to their low performance of oral cancer practices. Therefore, further education and training programs for oral cancer practices should be provided to Japanese OHPs for the prevention and early detection of oral cancer.

Practices, Attitudes, and Confidence of Nurses in the Performance of Oral Health Checkups for Elderly Patients in a Japanese Hospital.

PURPOSE: To investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups in order to develop an educational oral health checkup training programme for nurses. MATERIALS AND METHODS: A cross-sectional questionnaire survey was distributed to nurses (n = 184) who worked in a hospital and an affiliated long-term care facility in Japan from September to October in 2016. The questionnaire survey investigated their practices, attitudes and confidence in the performance of oral health checkups for elderly patients who were in their care and the factors that were associated with the performance of oral health checkups. RESULTS: A total of 143 (77.7%) nurses participated in this study. Almost half (51.7%) performed oral health checkups for elderly patients. More than 60% examined the lip, tongue and tongue coating, gingiva and oral mucosa, and oral cleanliness; however only 32.4% examined the present teeth and 8.1% examined the saliva. Approximately 90% of the nurses felt that all health professionals should perform oral health checkups for elderly patients who were in their care. Their confidence of the oral examination was statistically significantly associated with their performance of oral health checkups for elderly patients. CONCLUSIONS: This is the first survey to investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups. These findings will contribute to the development of a training programme for nurses who perform oral health checkups in elderly patients.

Fluoride supplementation (with tablets, drops, lozenges or chewing gum) in pregnant women for preventing dental caries in the primary teeth of their children.

BACKGROUND: Dental caries (tooth decay) is one of the most common chronic childhood diseases. Caries prevalence in most industrialised countries has declined among children over the past few decades. The probable reasons for the decline are the widespread use of fluoride toothpaste, followed by artificial water fluoridation, oral health education and a slight decrease in sugar consumption overall. However, in regions without water fluoridation, fluoride supplementation for pregnant women may be an effective way to increase fluoride intake during pregnancy. If fluoride supplements taken by pregnant women improve neonatal outcomes, pregnant women with no access to a fluoridated drinking water supply can obtain the benefits of systemic fluoridation. OBJECTIVES: To evaluate the effects of women taking fluoride supplements (tablets, drops, lozenges or chewing gum) compared with no fluoride supplementation during pregnancy to prevent caries in the primary teeth of their children. SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 January 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 11) in the Cochrane Library (searched 25 January 2017); MEDLINE Ovid (1946 to 25 January 2017); Embase Ovid (1980 to 25 January 2017); LILACS BIREME Virtual Health Library (Latin American and Caribbean Health Science Information database; 1982 to 25 January 2017); and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 25 January 2017). We searched the US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 25 January 2017. No restrictions were placed on the language or date of publication when searching the electronic databases. SELECTION CRITERIA: Randomised controlled trials (RCTs) of fluoride supplements (tablets, drops, lozenges or chewing gum) administered to women during pregnancy with the aim of preventing caries in the primary teeth of their children. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the titles and abstracts (when available) of all reports identified through electronic searches. Two review authors independently extracted data and assessed risk of bias, as well as evaluating overall quality of the evidence utilising the GRADE approach. We could not conduct data synthesis as only one study was included in the analysis. MAIN RESULTS: Only one RCT met the inclusion criteria for this review. This RCT showed no statistical difference on decayed or filled primary tooth surfaces (dfs) and the percentage of children with caries at 3 years (risk ratio (RR) 1.46, 95% confidence interval (CI) 0.75 to 2.85; participants = 938, very low quality of evidence) and 5 years old (RR 0.84, 95% CI 0.53 to 1.33; participants = 798, very low quality of evidence). The incidence of fluorosis at 5 years was similar between the group taking fluoride supplements (tablets) during the last 6 months of pregnancy and the placebo group. AUTHORS' CONCLUSIONS: There is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries in their offspring.

A qualitative study on the background of long-term maintenance patients at a private Japanese dental clinic.

BACKGROUND: Continued periodontal maintenance after active therapy is highly important for maintaining a healthy oral function. In Japan, the rate of consultation for periodontal maintenance is remarkably low compared to other developed countries. This study analyzed the relationship between long-term maintenance and patient background characteristics in an effort to identify ways to increase the rate of consultation for periodontal maintenance in Japan. METHODS: Thirty-three long-term maintenance patients were interviewed. The interviews were recorded on video. The conversation between the patient and the interviewer was converted to text, and the data were qualitatively analyzed using the Steps for Coding and Theorization (SCAT) method. RESULTS: The mean age of the patients was 61.4 years and the average duration of maintenance was 10.7 years. The majority (90.9 %) of patients cared about their dietary habits, and 72.7 % of the patients understood the importance of physical activity. All of the patients wished to continue the maintenance, and 72.7 % of patients had good feelings about the staff of the dental clinic. However, their recognition of the description of primary prevention was low, with a response rate of only 21.2 %. CONCLUSIONS: The long-term maintenance patients had a high level of consciousness regarding their health and good feelings about the staff of the dental clinic. Oral hygienists, who are the main staff involved in periodontal maintenance were suggested to be important for increasing the maintenance consultation rate.

Ca-channel blocker-induced gingival overgrowth that improved with non-surgical therapy during visiting care: a case report.

OBJECTIVES: To present a case of gingival overgrowth during visiting care. BACKGROUND: Ca-channel blocker-induced gingival overgrowth is a well-known adverse event. However, only limited information on the treatment of calcium-channel blocker-induced gingival overgrowth during visiting care has been reported. CLINICAL REPORT: The patient was an 88-year-old female living in a nursing home since dementia. She had been taking a calcium-channel blocker and observed gingival overgrowth. Initial therapy was performed and changed the antihypertensive medication from a calcium-channel blocker to an angiotensin converting enzyme inhibitor. After initial therapy, the gingival overgrowth improved significantly. In addition, the defecation rate was improved. CONCLUSION: This case indicated that periodontal therapy is useful even for dementia patients during visiting dental care.

Characterization of the bone matrix and its contribution to tooth loss in human cadaveric mandibles.

OBJECTIVE: It is uncertain as to what extent the major bone matrix constituents, mineral and collagen, show inter-individual variation and dependence on age and sex in jawbones. The purpose of this study was to clarify this uncertainty using cadaveric mandibles and investigate the association of bone matrix with the number of existing teeth. MATERIALS AND METHODS: Cortical bone samples (1 × 1 cm) collected from the mental of 48 cadaveric mandibles (27 men and 21 women; age range = 56-93 years and 63-103 years, respectively) were used to quantify three bone matrix indices: mineral content, collagen content and extent of lysine hydroxylation of collagen. Associations with age and comparisons by sex were evaluated based on bone matrix indices and the numbers of existing teeth. The numbers of existing teeth were compared between the groups showing low and high bone matrix index values. RESULTS: A great amount of inter-individual variation was seen in all bone matrix indices. No bone matrix indices were associated with age, while the number of existing teeth was negatively associated with age. The bone matrix indices and number of existing teeth did not differ by sex. The number of existing teeth was nearly twice as high in the group showing high collagen content as in the low collagen group; however, an analysis of covariance showed a significant inter-group difference not from bone matrix indices, but rather from age. Interestingly, in comparison to femoral collagen, mandibular collagen showed lower lysine hydroxylation, which can represent an aspect of bone quality. CONCLUSIONS: Mandibular bone matrix shows great inter-individual variation and is independent of age and sex, but did not show as strong a relationship with tooth loss as age. Even so, mandibular collagen may represent a unique characteristic of bone matrix and deserves to be further investigated.

Relationship Between Clinical Course of Treatment for Burning Mouth Syndrome in Early Period and Aggression Using Rosenzweig Picture Frustration Study: A Retrospective Observational Study.

OBJECTIVE: Burning mouth syndrome (BMS) is characterized by a chronic, ongoing sensation of intraoral burning or discomfort without causative lesions. This study sought to examine the relationship between personality traits in patients with BMS using the Rosenzweig Picture Frustration (PF) study, a projective psychological test, and their progress in treatment. METHODS: Data were collected from outpatients diagnosed with BMS at our clinic between April 2017 and March 2021. The data were analyzed for 28 patients with BMS, of which nine showed improvement earlier than three months (early responders; ER), and the others did not (non-early responders; NER). RESULTS: The mean visual analog scale (VAS scores for BMS pain at the first visit were 52.8 in the ER and 59.6 in NER (n.s.). No significant differences were detected in the type and direction of aggression between ER and NER in the PF study. In contrast, the group conformity score of the ER (63.7%) was significantly higher than that of the NER (51.4%). CONCLUSIONS: Personal traits reflected in the PF study may have affected the course of improvement in the BMS. To understand the characteristics of patients with BMS and achieve more favorable treatment outcomes, further study on their personality organization is necessary.

Evaluation of the Oral Health Education Programme for Nurses using an Oral Lesion Simulator.

PURPOSE: This study aimed to investigate the usefulness of a newly developed oral simulator for nursing students' oral assessment education on oral diseases and symptoms. MATERIALS AND METHODS: The participants were first-year students (n=105) at a nursing school in Japan. Ten identical oral simulators with angular cheilitis, missing teeth, dental caries, calculus, periodontitis, hypoglossal induration, food debris, and crust formation were created by a team of dentists. After a 45-minute lecture programme for oral assessment performance with the Oral Health Assessment Tool (OHAT), the ability test with the simulators and the OHAT as well as test feedback were conducted in a 30-minute practical programme. To evaluate the effectiveness of the programmes, questionnaires and ability tests with slides of oral images were conducted at baseline and after the programme. RESULTS: Ninety-nine students (94.3%) participated in this study. The results of the ability test with the simulators and the OHAT in the practical programme showed that the correct answer rates of assessing tongue, gingiva, present teeth, and oral pain were less than 40%. Their levels of confidence, perception, and oral assessment performance were statistically significantly higher after the programmes than they were at baseline. Their level of confidence in assessing the need for dental referral had the largest increase in scores compared to the lowest scores at baseline in the nine post-programme assessment categories. CONCLUSIONS: This study identified several problems with nursing students' oral assessment skills and improvements of their oral assessment confidence, perceptions and performance.

Implementation of peer-to-peer oral care objective structured clinical examination-based learning for nursing students.

AIM: Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer-to-peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). METHODS: A pre- and post-survey of 97 nursing students from a nursing school in Japan was conducted as a peer-to-peer oral health education training program that included an assessment and performance checklist. RESULTS: Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0-25) of the first, second, third, and fourth participants in the four-student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p < .01). Fifty-two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. CONCLUSIONS: This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE-style delivery.

Association between perception of dentist oversupply and expectations of dentistry: a survey of dental graduates in Japan.

BACKGROUND: The perception that there is a surplus of dentists may be an opportunity to explore attractive career options in dentistry in Japan. METHODS: A self-administered questionnaire was mailed to 2,114 graduates of a private dental school in Japan. We asked about the perception of oversupply, rated by a visual analogue scale, work environment factors, potential areas of dentistry and necessary medical subjects for their dental practice. The association of a strong perception of dentist oversupply with work environment factors, dental areas and medical subjects was examined by multivariate logistic regression analyses. RESULTS: The response rate was 66%, and data from 1,203 community dentists were analysed. Most respondents (76%) perceived either a strong or very strong surplus of dentists. A very strong perception was significantly associated with work environment factors, including practising in large cities and earning the second lowest of four levels of annual income, but no further associations were found with either the number of patients treated or with the other two ranges of income. This perception was negatively associated with the number of necessary medical subjects, specifically otorhinolaryngology, but no significant association was seen with the number of potential areas of dentistry. CONCLUSIONS: The negative correlation between the aspiration to acquire medical knowledge and the perception of dentist oversupply under the circumstance of the possibly excessive perception among community dentists invites further research on the benefits of teaching oral medicine to graduate entry students to build future working satisfaction.