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1.
Br Dent J ; 230(9): 605-610, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33990748

RESUMO

Introduction Very little is known about the knowledge and attitudes of dental students and educators regarding environmental sustainability in dentistry (ESD), the presence of ESD in dental curricula, and barriers and enablers to embracing ESD in dental education.Methods A cross-sectional survey using piloted online questionnaires for students and educators was carried out at the Institute of Dentistry, Queen Mary University of London and at Harvard School of Dental Medicine. Data analysis included descriptive statistics and thematic analysis.Results ESD does not exist formally in the dental curricula at either institution. Despite poor knowledge, students and educators had very positive attitudes to embracing ESD in the curricula. The most noted barriers were lack of knowledge about ESD, lack of time for preparing ESD content, lack of ESD educational materials and infection control regulations. Enablers included embedding ESD in UK and US dental education standards, having institutional backing and support in terms of providing training, educational materials, capacity and incentives, as well as adopting a critical evidence-informed approach in reforming current infection control regulations.Conclusions Dental education and infection control regulatory bodies, as well as dental institutions, can embed ESD in UK and US dental curricula by supporting the implementation of identified enablers.


Assuntos
Currículo , Faculdades de Odontologia , Estudos Transversais , Humanos , Estudantes , Inquéritos e Questionários , Reino Unido
2.
Public Health Nutr ; 23(16): 2941-2949, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-31957630

RESUMO

OBJECTIVE: To investigate the relationships between children's food and drink choices at school lunch for children who consume high and low sugar intakes at home. DESIGN: Children's food and drink consumption at home was assessed using diet diaries over three consecutive days. Children were classified as 'high' or 'low' sugar consumers at home using the WHO recommendation that free sugars should be less than 10 % of their daily total energy intake. A purposive sample of children was then selected and observed during school lunch, recording food selections, food left on plates and content of packed lunches. SETTING: Six primary schools in Newham and Kent, England. PARTICIPANTS: Parents and children aged 6-7 years. RESULTS: Seventy-one parents completed diet diaries. From the seventy-one, thirty-nine children were observed during school lunch. Twenty children were high sugar consumers, nineteen children were low sugar consumers; thirty-one children had a school meal. Eleven of the fifteen children (73 %) who had school meals and who were high sugar consumers selected a high-sugar dessert rather than fruit. Only five of the sixteen (31 %) children who had school meals and were low sugar consumers at home chose a high-sugar dessert. Most of the children who had packed lunches had sweet items, despite school policies. CONCLUSIONS: Children who consumed high sugar intake at home tended to select foods high in sugar for school meals or had packed lunches containing high-sugar foods. The implications for public health programmes include healthy eating workshops and implementing school food policies.


Assuntos
Açúcares da Dieta/administração & dosagem , Preferências Alimentares , Serviços de Alimentação , Almoço , Criança , Dieta , Ingestão de Energia , Inglaterra , Feminino , Humanos , Masculino , Instituições Acadêmicas , Açúcares
3.
BMJ Open ; 8(2): e020771, 2018 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-29490969

RESUMO

OBJECTIVES: To assess the number of parents who visited community pharmacies in London seeking pain medications for their children's pain and specifically for oral pain, to identify which health services parents contacted before their pharmacy visit and to estimate the cost to the National Health Service (NHS) when children with oral pain who visit pharmacies also see health professionals outside dentistry. DESIGN: A cross-sectional study. SETTING: 1862 pharmacies in London in November 2016-January 2017. PARTICIPANTS: Parents, carers and adolescents purchasing over-the-counter pain medications or collecting pain prescriptions for children (0-19 years). BRIEF INTERVENTION: A survey administered by pharmacy staff to participants and a guidance pack. MAIN OUTCOME MEASURES: The number of parents who visited pharmacies seeking pain medications for their children's pain and oral pain and the number of parents who contacted health professionals outside dentistry before their pharmacy visit. Estimated costs of visits by children with oral pain to health professionals outside dentistry. RESULTS: One in two (951) pharmacies participated collecting information from 6915 parents seeking pain medications for their children. The majority (65%) of parents sought pain medications to relieve their children's oral pain. Only 30% of children with oral pain had seen a dentist before the pharmacy visit, while 28% of children had seen between one and four different health professionals. The cost to the NHS of children contacting health professionals outside dentistry was £36 573, extrapolated to an annual cost of £373 288. Replicating these findings across all pharmacies in England could mean that the NHS spends an estimated £2.3 million annually when children with oral pain inappropriately use multiple health services. CONCLUSION: Most parents who visited pharmacies for children's pain medications in London sought pain medications for children's oral pain. Children's inappropriate contact with multiple health services when they have oral pain adds significant costs to the NHS.


Assuntos
Serviços Comunitários de Farmácia/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Comportamento de Busca de Ajuda , Pais , Odontalgia/epidemiologia , Adolescente , Criança , Pré-Escolar , Serviços Comunitários de Farmácia/economia , Estudos Transversais , Feminino , Pessoal de Saúde/economia , Humanos , Lactente , Recém-Nascido , Londres/epidemiologia , Masculino , Medicamentos sem Prescrição/uso terapêutico , Inquéritos e Questionários , Odontalgia/tratamento farmacológico , Adulto Jovem
4.
Nutr Rev ; 76(2): 88-107, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29281069

RESUMO

Context: Consumption of sugar-sweetened beverages (SSBs) among children has been associated with adverse health outcomes. Numerous behavioral interventions aimed at reducing the intake of SSBs among children have been reported, yet evidence of their effectiveness is lacking. Objective: This systematic review explored the effectiveness of educational and behavioral interventions to reduce SSB intake and to influence health outcomes among children aged 4 to 16 years. Data Sources: Seven databases were searched for randomized controlled trials published prior to September 2016. Studies identified were screened for eligibility. Study Selection: Trials were included in the review if they met the PICOS (Population, Intervention, Comparison, Outcome, and Study design) criteria for inclusion of studies. Data Extraction: Data were extracted by 2 reviewers following Cochrane guidelines and using Review Manager software. Results: Of the 16 trials included, 12 were school based and 4 were community or home based. Only 3 trials provided data that could be pooled into a meta-analysis for evaluating change in SSB intake. Subgroup analyses showed a trend toward a significant reduction in SSB intake in participants in school-based interventions compared with control groups. Change in body mass index z scores was not statistically significant between groups. Conclusions: The quality of evidence from included trials was considered moderate, and the effectiveness of educational and behavioral interventions in reducing SSB intake was modest. Systematic Review Registration: PROSPERO registration number CRD42014004432.


Assuntos
Bebidas , Açúcares da Dieta/administração & dosagem , Edulcorantes/administração & dosagem , Adolescente , Controle Comportamental , Bebidas/efeitos adversos , Criança , Açúcares da Dieta/efeitos adversos , Educação em Saúde , Humanos , Sobrepeso/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Edulcorantes/efeitos adversos
5.
BMC Oral Health ; 17(1): 65, 2017 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-28327110

RESUMO

BACKGROUND: Previous surveys have indicated that a majority of Indonesian children have poor oral health. However, little detailed information is available on underlying causation and none that examine impacts of oral health on child self-esteem, school performance and perceived employability. The aim of this study was to determine levels of child oral health in primary school children in Indonesia, the prevalence of key causal factors; and, to determine relationships between oral health, self-esteem and school academic performance. METHODS: Cross-sectional epidemiological study in a sample (n = 984) of children aged 6-7 and 10-11 years old attending three public schools in Indonesia. A dental visual impact study was conducted, in which teachers reported their perceptions of the impact of child oral health on school academic performance. Oral health behaviors, self-esteem, and school performance were assessed. The children were clinically examined to measure dental caries and oral cleanliness. RESULTS: Teachers believe that children with visually poor oral health and impaired smiles are more likely to perform poorly at school, be socially excluded and have lower job prospects than their peers with visually good oral health and healthy smiles. The percentages of children with decayed teeth were 94 and 90% in the 6-7- and 10-11-year age groups, respectively. Families reported high levels of child consumption of sugar-containing foods and drinks; many had irregular use of fluoride toothpaste. Children with substantial plaque on their teeth achieved significantly lower levels of school performance than their peers with clean teeth. Significant associations were found between school performance and self-esteem for these children. CONCLUSIONS: The study findings highlight the need for preventive care programs to improve the oral health of children in Indonesia and prospective determination of associations between child oral health; self-esteem and school academic performance.


Assuntos
Escolaridade , Emprego , Saúde Bucal , Autoimagem , Criança , Feminino , Humanos , Indonésia , Masculino , Instituições Acadêmicas , Inquéritos e Questionários
6.
Health Psychol ; 36(2): 152-159, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27831705

RESUMO

OBJECTIVE: Methods for reducing dental disease have traditionally focused on health education rather than targeting psychosocial determinants of the core behaviors through behavior change strategies. This study tested a novel intervention in the form of a children's story (Kitten's First Tooth) embedded with behavior change techniques (Abraham & Michie, 2008) with the aim of investigating how effective the intervention was at improving parents' efficacy and intention to enact oral health behaviors for their child. METHOD: A controlled before and after study conducted in a deprived area of England (n = 149; child mean age 4 years) with an intervention and control group. Changes in task specific parental self-efficacy (PSE) and intention were measured using the Oral Health Behaviors Questionnaire (OHBQ; Adair et al., 2004) at baseline and 3 months following intervention. RESULTS: Of the 149 participants, 129 returned both baseline and evaluation questionnaires (retention 86.6%), 125 of these pairs of questionnaires were used in the analysis (83.4%). The OHBQ was analyzed using a general linear model (ANCOVA). A significant difference was found in favor of the intervention group for PSE related to child tooth brushing behaviors, F(1,1) = 12.04, p = .001, however no change was observed for PSE related to control of dietary sugars. CONCLUSIONS: A theorized children's story can be effective as an oral health promotion intervention by supporting parents to improve their child's oral health-related behavior. Change was observed for child tooth brushing but not sugar control. This may reflect story contents or may be indicative of difficulties of changing dietary behavior. (PsycINFO Database Record


Assuntos
Comportamento Infantil/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Intenção , Saúde Bucal , Poder Familiar/psicologia , Autoeficácia , Animais , Criança , Pré-Escolar , Inglaterra , Feminino , Promoção da Saúde , Humanos , Masculino , Pais/psicologia , Inquéritos e Questionários , Escovação Dentária/psicologia
7.
Trials ; 17(1): 103, 2016 Feb 20.
Artigo em Inglês | MEDLINE | ID: mdl-26897029

RESUMO

BACKGROUND: Oral health behaviours such as establishing twice-daily toothbrushing and sugar control intake need parental self-efficacy (PSE) to prevent the development of childhood dental caries. A previous study has shown that behaviour change techniques (BCTs) delivered via a storybook can improve parental self-efficacy to undertake twice-daily toothbrushing. OBJECTIVE: to determine whether an intervention (BBaRTS, Bedtime Brush and Read Together to Sleep), designed to increase PSE; delivered through storybooks with embedded BCTs, parenting skills and oral health messages, can improve child oral health compared to (1) an exactly similar intervention containing no behaviour change techniques, and (2) the BBaRTS intervention supplemented with home supply of fluoride toothpaste and supervised toothbrushing on schooldays. METHODS/DESIGN: A 2-year, three-arm, multicentre, cluster randomised controlled trial. PARTICIPANTS: children (estimated 2000-2600) aged 5-7 years and their families from 60 UK primary schools. INTERVENTION: Test group 1: a series of eight children's storybooks developed by a psychologist, public health dentist, science educator, children's author and illustrators, with guidance from the Department for Education (England). The books feature animal characters and contain embedded dental health messages, parenting skills and BCTs to promote good oral health routines focused on controlling sugar intake and toothbrushing, as well as reading at bedtime. Books are given out over 2 years. Test group 2: as Test group 1 plus home supplies of fluoride toothpaste (1000 ppmF), and daily supervised toothbrushing in school on schooldays. Active Control group: series of eight books with exactly the same stories, characters and illustrations, but without BCTs, dental health messages or parenting skills. Annual child dental examinations and parental questionnaires will be undertaken. A sub-set of participants will be invited to join an embedded study of the child's diet and salivary microbiota composition. PRIMARY OUTCOME MEASURE: dental caries experience in permanent teeth at age 7-8 years. DISCUSSION: A multi-disciplinary team was established to develop the BBaRTS Children's Healthy Teeth Programme. The books were developed in partnership with the Department for Education (England), informed by a series of focus groups with children, teachers and parents. TRIAL REGISTRATION: ISRCTN21461006 (date of registration 23 September 2015).


Assuntos
Livros Ilustrados , Comportamento Infantil , Cárie Dentária/prevenção & controle , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Serviços de Odontologia Escolar/métodos , Instituições Acadêmicas , Fatores Etários , Criança , Pré-Escolar , Protocolos Clínicos , Cárie Dentária/diagnóstico , Cárie Dentária/microbiologia , Cárie Dentária/psicologia , Sacarose Alimentar/efeitos adversos , Comportamento Alimentar , Feminino , Humanos , Masculino , Saúde Bucal , Higiene Bucal , Pais/psicologia , Educação de Pacientes como Assunto , Projetos de Pesquisa , Autoeficácia , Fatores de Tempo , Escovação Dentária , Cremes Dentais , Reino Unido
8.
Trials ; 16: 505, 2015 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-26537725

RESUMO

BACKGROUND: In England and Scotland, dental extraction is the single highest cause of planned admission to the hospital for children under 11 years. Traditional dental services have had limited success in reducing this disease burden. Interventions based on motivational interviewing have been shown to impact positively dental health behaviours and could facilitate the prevention of re-occurrence of dental caries in this high-risk population. The objective of the study is to evaluate whether a new, dental nurse-led service, delivered using a brief negotiated interview based on motivational interviewing, is a more cost-effective service than treatment as usual, in reducing the re-occurrence of dental decay in young children with previous dental extractions. METHODS/DESIGN: This 2-year, two-arm, multicentre, randomised controlled trial will include 224 child participants, initially aged 5 to 7 years, who are scheduled to have one or more primary teeth extracted for dental caries under general anaesthesia (GA), relative analgesia (RA: inhalation sedation) or local anaesthesia (LA). The trial will be conducted in University Dental Hospitals, Secondary Care Centres or other providers of dental extraction services across the United Kingdom. The intervention will include a brief negotiated interview (based on the principles of motivational interviewing) delivered between enrollment and 6 weeks post-extraction, followed by directed prevention in primary dental care. Participants will be followed up for 2 years. The main outcome measure will be the dental caries experienced by 2 years post-enrollment at the level of dentine involvement on any tooth in either dentition, which had been caries-free at the baseline assessment. DISCUSSION: The participants are a hard-to-reach group in which secondary prevention is a challenge. Lack of engagement with dental care makes the children and their families scheduled for extraction particularly difficult to recruit to an RCT. Variations in service delivery between sites have also added to the challenges in implementing the Dental RECUR protocol during the recruitment phase. TRIAL REGISTRATION: ISRCTN24958829 (date of registration: 27 September 2013), Current protocol version: 5.0.


Assuntos
Assistência Odontológica para Crianças/métodos , Cárie Dentária/prevenção & controle , Entrevista Motivacional , Odontologia Preventiva/métodos , Atenção Primária à Saúde/métodos , Prevenção Secundária/métodos , Fatores Etários , Anestesia/métodos , Criança , Comportamento Infantil , Pré-Escolar , Protocolos Clínicos , Assistentes de Odontologia , Assistência Odontológica para Crianças/enfermagem , Cárie Dentária/diagnóstico , Cárie Dentária/psicologia , Cárie Dentária/cirurgia , Suscetibilidade à Cárie Dentária , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pais/psicologia , Educação de Pacientes como Assunto , Recidiva , Projetos de Pesquisa , Fatores de Risco , Fatores de Tempo , Extração Dentária , Resultado do Tratamento , Reino Unido
9.
Int J Environ Res Public Health ; 11(7): 6808-26, 2014 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-24992485

RESUMO

Establishing effective toothbrushing routines using fluoridated toothpaste in infancy has been suggested as important to dental health throughout childhood and into adulthood. However, previous studies have revealed a number of potential barriers to, and facilitators of caregivers ability to establish early dyadic toothbrushing routines with pre-schoolers. However, as yet no qualitative research has been conducted to ascertain potential barriers and facilitators of the earliest dyadic toothbrushing in infancy, and nor has any previous research specifically focused on how novice mothers of first-born infants and preschoolers manage this task. This study therefore outlines findings from a qualitative interview study with first-time mothers of children aged 24-30 months (n = 16) exploring perceived barriers to and facilitators of early dyadic toothbrushing routines with infants and preschoolers. A number of key themes were identified from interview transcripts and an 'ecological' approach conceptualised maternally perceived barriers to and facilitators of dyadic toothbrushing. Proximal influences were found to be located within the caregiver-child relationship ('micro-system'), including parental cognitions (e.g., PSE), parental behaviours (e.g., parenting practices) and infant and preschooler temperament and behaviours (e.g., tantrums). Distal factors were also identified as relevant to the establishment and maintenance of these routines, such as social support ('exosystem') and family history of tooth-brushing ('chronosystem').


Assuntos
Atitude Frente a Saúde , Mães/psicologia , Escovação Dentária/psicologia , Adulto , Comportamento Infantil , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Adulto Jovem
12.
Cochrane Database Syst Rev ; (5): CD009378, 2013 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-23728691

RESUMO

BACKGROUND: Dental caries is one of the most common global childhood diseases and is, for the most part, entirely preventable. Good oral health is dependent on the establishment of the key behaviours of toothbrushing with fluoride toothpaste and controlling sugar snacking. Primary schools provide a potential setting in which these behavioural interventions can support children to develop independent and habitual healthy behaviours. OBJECTIVES: To assess the clinical effects of school-based interventions aimed at changing behaviour related to toothbrushing habits and the frequency of consumption of cariogenic food and drink in children (4 to 12 year olds) for caries prevention. SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 18 October 2012), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 4), MEDLINE via OVID (1948 to 18 October 2012), EMBASE via OVID (1980 to 18 October 2012), CINAHL via EBSCO (1981 to 18 October 2012) and PsycINFO via OVID (1950 to 18 October 2012). Ongoing trials were searched for using Current Controlled Trials (to 18 October 2012) and ClinicalTrials.gov (to 18 October 2012). Conference proceedings were searched for using ZETOC (1993 to 18 October 2012) and Web of Science (1990 to 18 October 2012). We searched for thesis abstracts using the Proquest Dissertations and Theses database (1950 to 18 October 2012). There were no restrictions regarding language or date of publication. Non-English language papers were included and translated in full by native speakers. SELECTION CRITERIA: Randomised controlled trials of behavioural interventions in primary schools (children aged 4 to 12 years at baseline) were selected. Included studies had to include behavioural interventions addressing both toothbrushing and consumption of cariogenic foods or drinks and have a primary school as a focus for delivery of the intervention. DATA COLLECTION AND ANALYSIS: Two pairs of review authors independently extracted data related to methods, participants, intervention design including behaviour change techniques (BCTs) utilised, outcome measures and risk of bias. Relevant statistical information was assessed by a statistician subsequently. All included studies contact authors were emailed for copies of intervention materials. Additionally, three attempts were made to contact study authors to clarify missing information. MAIN RESULTS: We included four studies involving 2302 children. One study was at unclear risk of bias and three were at high risk of bias. Included studies reported heterogeneity in both the intervention design and outcome measures used; this made statistical comparison difficult. Additionally this review is limited by poor reporting of intervention procedure and design. Several BCTs were identified in the trials: these included information around the consequences of twice daily brushing and controlling sugar snacking; information on consequences of adverse behaviour and instruction and demonstration regarding skill development of relevant oral health behaviours.Only one included study reported the primary outcome of development of caries. This small study at unclear risk of bias showed a prevented fraction of 0.65 (95% confidence interval (CI) 0.12 to 1.18) in the intervention group. However, as this is based on a single study, this finding should be interpreted with caution.Although no meta-analysis was performed with respect to plaque outcomes (due to differences in plaque reporting between studies), the three studies which reported plaque outcomes all found a statistically significant reduction in plaque in the intervention groups with respect to plaque outcomes. Two of these trials involved an 'active' home component where parents were given tasks relating to the school oral health programme (games and homework) to complete with their children. Secondary outcome measures from one study reported that the intervention had a positive impact upon children's oral health knowledge. AUTHORS' CONCLUSIONS: Currently, there is insufficient evidence for the efficacy of primary school-based behavioural interventions for reducing caries. There is limited evidence for the effectiveness of these interventions on plaque outcomes and on children's oral health knowledge acquisition. None of the included interventions were reported as being based on or derived from behavioural theory. There is a need for further high quality research to utilise theory in the design and evaluation of interventions for changing oral health related behaviours in children and their parents.


Assuntos
Cárie Dentária/prevenção & controle , Higiene Bucal/métodos , Instituições Acadêmicas , Doces/efeitos adversos , Bebidas Gaseificadas/efeitos adversos , Cariogênicos/efeitos adversos , Criança , Pré-Escolar , Cárie Dentária/etiologia , Placa Dentária/etiologia , Placa Dentária/prevenção & controle , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Escovação Dentária/métodos
13.
Int Dent J ; 61 Suppl 2: 11-21, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21770936

RESUMO

UNLABELLED: Partnerships for health promotion are between two or more partners to work co-operatively towards a set of shared health outcomes; few public-private partnerships in oral health promotion have been established. AIM: To undertake a detailed analysis of a unique global public-private partnership to promote oral health between a global company, Unilever and the Féderation Dentaire International (FDI), a membership organisation representing more than one million dentists worldwide. METHODS: Qualitative and quantitative, including: collating and analysing a wide range of partnership documents (n =164); reviewing film and pictorial records; undertaking structured interviews (n=34) with people who had a critical role in establishing and delivering the aims of the partnership, and external experts; and site visits to selected global projects active at the time of the evaluation. RESULTS: Over 1 million people have been reached directly through their engagement with 39 projects in 36 countries; an oral health message about the benefits of twice daily tooth brushing has appeared with the authority of the FDI logo on billions of packs of Unilever Oral Care's toothpastes worldwide; many individual members of National Dental Associations have participated in health promotion activities within their communities for the first time; some organisational challenges during the development and delivery of the partnership were recognised by both partners. CONCLUSIONS: The first phase of this unique global partnership has been successful in making major progress towards achieving its goals; lessons learned have ensured that the next phase of the partnership has significant potential to contribute to improving oral health globally.


Assuntos
Indústria Farmacêutica , Cooperação Internacional , Saúde Bucal , Parcerias Público-Privadas , Sociedades Odontológicas , Objetivos , Educação em Saúde Bucal , Promoção da Saúde , Humanos , Estudos de Casos Organizacionais , Avaliação de Programas e Projetos de Saúde , Projetos de Pesquisa , Escovação Dentária/estatística & dados numéricos
14.
Int Dent J ; 61 Suppl 2: 22-9, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21770937

RESUMO

UNLABELLED: The partnership between the Féderation Dentaire International (FDI), and Unilever Oral Care, aims to raise awareness of oral health globally; to enable FDI member associations to promote oral health; and to increase the visibility of the FDI and authority of Unilever oral care brands worldwide. Country Projects between National Dental Associations (NDAs), the member associations of FDI, and Unilever Oral Care local companies have been established as a key strand of the partnership. AIM: This paper reports on the evaluation of an in-depth sample of Country Projects (n=5) to determine their potential to impact on oral health. METHOD: Five country sites were selected as being indicative of different programme delivery types. Each site received a two-day visit during Spring-Summer 2009, which enabled the evaluators to audit what was delivered in practice compared with the original written project briefs and to undertake interviews of study site staff. RESULTS: 39 projects in 36 countries have been initiated. In those examined by site visits, clear evidence was found of capacity building to deliver oral health. In some countries, widespread population reach had been prioritised. Effectiveness of partnership working varied depending on the strength of the relationship between the NDA and local Unilever Oral Care representatives and alignment with national marketing strategy. The quality of internal evaluation varied considerably. CONCLUSIONS: Over a million people had been reached directly by Country Projects and this public-private partnership has made a successful start. To move towards improving oral health rather than only awareness raising; future Country Projects would benefit from being limited to certain evidence-based intervention designs, and using an agreed core indicator set in order to allow cross-country comparison of intervention outcomes.


Assuntos
Indústria Farmacêutica , Cooperação Internacional , Saúde Bucal , Estudos de Casos Organizacionais , Parcerias Público-Privadas , Sociedades Odontológicas , Criança , Creches , Assistência Odontológica para Crianças , Inquéritos de Saúde Bucal , Educação em Saúde Bucal , Promoção da Saúde , Humanos , Indonésia , Quênia , Pais/educação , Filipinas , Polônia , Avaliação de Programas e Projetos de Saúde , Escovação Dentária/estatística & dados numéricos
15.
Int J Paediatr Dent ; 19(2): 84-90, 2009 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19207736

RESUMO

BACKGROUND: In many countries, restorative treatment in primary teeth is suboptimal. AIM: Thus, this study tried to detect barriers for dentists to restore primary teeth in kindergarten children (3-6 years). DESIGN: For a representative survey, 320 dentists (184 West, 136 East Germany) were randomly selected from the dental associations' registers and asked to answer a questionnaire on their profile, their view of the National Health System, and possible barriers for restoring primary teeth. RESULTS: The analysis (response rate 57.7%) showed that the parents were no barrier and the dentists felt the need of restoring primary teeth. In addition to the children's anxiety, the inadequate reimbursement for fillings were perceived as clear barrier. The comparison of West and East German dentists detected statistically significantly higher barriers in West Germany, where - in contrast to the German Democratic Republic - no structured training in paediatric dentistry was compulsory before unification. Only 35% of the East German dentists rated restorative treatment in 3- to 6-year-olds as stressful in contrast to 65% in West Germany, where especially male dentists found no time to treat children. CONCLUSION: This study reveals that dentists can also be a considerable barrier to restorative treatment in small children, especially without adequate training in dental schools.


Assuntos
Atitude do Pessoal de Saúde , Ansiedade ao Tratamento Odontológico/complicações , Assistência Odontológica para Crianças/psicologia , Cárie Dentária/terapia , Odontólogos/psicologia , Adulto , Criança , Pré-Escolar , Ansiedade ao Tratamento Odontológico/psicologia , Assistência Odontológica para Crianças/estatística & dados numéricos , Cárie Dentária/complicações , Cárie Dentária/prevenção & controle , Cárie Dentária/psicologia , Restauração Dentária Permanente/psicologia , Relações Dentista-Paciente , Odontólogos/estatística & dados numéricos , Feminino , Alemanha Oriental , Alemanha Ocidental , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Odontopediatria/educação , Padrões de Prática Odontológica/estatística & dados numéricos , Dente Decíduo
16.
BMC Oral Health ; 9: 3, 2009 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-19146677

RESUMO

BACKGROUND: Healthy Schools programmes may assist schools in improving the oral health of children through advocating a common risk factor approach to health promotion and by more explicit consideration of oral health. The objectives of this study were to gain a broad contextual understanding of issues around the delivery of oral health promotion as part of Healthy Schools programmes and to investigate the barriers and drivers to the incorporation of oral health promoting activities in schools taking this holistic approach to health promotion. METHODS: Semi-structured telephone interviews were carried out with coordinators of Healthy Schools programmes in the Northwest of England. Interview transcripts were coded using a framework derived from themes in the interview schedule. RESULTS: All 22 Healthy Schools coordinators participated and all reported some engagement of their Healthy Schools scheme with oral health promotion. The degree of this engagement depended on factors such as historical patterns of working, partnerships, resources and priorities. Primary schools were reported to have engaged more fully with both Healthy Schools programmes and aspects of oral health promotion than secondary schools. Participants identified healthy eating interventions as the most appropriate means to promote oral health in schools. Partners with expertise in oral health were key in supporting Healthy Schools programmes to promote oral health. CONCLUSION: Healthy Schools programmes are supporting the promotion of oral health although the extent to which this is happening is variable. Structures should be put in place to ensure that the engagement of Healthy Schools with oral health is fully supported.

17.
Bull World Health Organ ; 83(9): 677-85, 2005 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16211159

RESUMO

Schools provide an important setting for promoting health, as they reach over 1 billion children worldwide and, through them, the school staff, families and the community as a whole. Health promotion messages can be reinforced throughout the most influential stages of children's lives, enabling them to develop lifelong sustainable attitudes and skills. Poor oral health can have a detrimental effect on children's quality of life, their performance at school and their success in later life. This paper examines the global need for promoting oral health through schools. The WHO Global School Health Initiative and the potential for setting up oral health programmes in schools using the health-promoting school framework are discussed. The challenges faced in promoting oral health in schools in both developed and developing countries are highlighted. The importance of using a validated framework and appropriate methodologies for the evaluation of school oral health projects is emphasized.


Assuntos
Promoção da Saúde/organização & administração , Saúde Bucal , Instituições Acadêmicas , Adolescente , Criança , Pré-Escolar , Saúde Global , Humanos , Lactente , Recém-Nascido
18.
Community Dent Health ; 21(1 Suppl): 71-85, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15072476

RESUMO

OBJECTIVE: To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries. METHOD: Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design. RESULTS: 1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries. CONCLUSION: There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Muttans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non-cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of 'good' habits by way of maintaining good plaque control and 'bad' habits by way of having a cariogenic diet, the development of caries may be controlled.


Assuntos
Cárie Dentária/etiologia , Dente Decíduo/patologia , Criança , Pré-Escolar , Cárie Dentária/microbiologia , Suscetibilidade à Cárie Dentária , Dieta , Humanos , Higiene Bucal , Fatores de Risco , Streptococcus mutans/fisiologia
19.
Community Dent Health ; 21(1 Suppl): 86-95, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15072477

RESUMO

OBJECTIVE: Long-term aim is to determine optimum interventions to reduce dental caries in children in disadvantaged communities and minimise the effects of exclusion from health care systems, of ethnic diversity, and health inequalities. DESIGN: Generation of initial explanatory models, study protocol and development of two standardised measures. First, to investigate how parental attitudes may impact on their children's oral health-related behaviours and second, to assess how dentists' attitudes may impact on the provision of dental care. SUBJECTS: Core research team, lead methodologists, 44 consortium members from 18 countries. To complete the development of the questionnaire, the initial set of items was administered to parents (n = 23) with children in nursery schools in Dundee, Scotland and sent to the same parents one week later. A standardised measure examining barriers to providing dental care for children aged 3 to 6 years was developed. 20 dentists working in primary dental care in Scotland completed the measure on two different occasions separated by one week. RESULTS: Explanatory models were developed. Family questionnaire: test-retest reliability excellent (r = 0.93 p < or = 0.001) with very good internal reliability (alpha = 0.89). Dentists questionnaire: excellent test-re-test reliability r = 0.88, (alpha = 0.90). CONCLUSIONS: Interaction between consortium members enhanced the validity of the questionnaires and protocols for different cultural locations. There were challenges in developing and delivering this multi-centre study. Experience gained will support the development of substantive trials and longitudinal studies to address the considerable international health disparity of childhood dental caries.


Assuntos
Assistência Odontológica para Crianças , Cárie Dentária/prevenção & controle , Acessibilidade aos Serviços de Saúde , Populações Vulneráveis , Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Criança , Desenvolvimento Infantil , Pré-Escolar , Estudos Transversais , Odontólogos/psicologia , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Pais/psicologia , Reprodutibilidade dos Testes , Meio Social , Inquéritos e Questionários
20.
Community Dent Health ; 21(1 Suppl): 102-11, 2004 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-15072479

RESUMO

UNLABELLED: OBJECTIVE; The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. CLINICAL SETTING: Nurseries, health centres and dental clinics in 17 countries. PARTICIPANTS: 2822 children aged 3 to 4 years and their parents. MAIN OUTCOME MEASURES: Dental examination of children and questionnaire to parents. RESULTS: Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group. CONCLUSIONS: This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.


Assuntos
Atitude Frente a Saúde , Cultura , Etnicidade , Família , Comportamento Alimentar , Higiene Bucal , Adulto , Comportamento Infantil , Pré-Escolar , Carência Cultural , Cárie Dentária/prevenção & controle , Sacarose Alimentar/administração & dosagem , Família/etnologia , Família/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Relações Pais-Filho , Poder Familiar , Fatores Socioeconômicos , Escovação Dentária
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