Oral health knowledge, attitude and behaviour of dental students in a private university.

INTRODUCTION: The positive attitude and behaviour of dental students can be improved during their undergraduate studies and is considered an essential factor in promoting the oral self-care habits of their patients and society in general. AIM: This study was conducted to evaluate the oral health knowledge, attitudes and behaviours among undergraduate dental students at a private university, based on the year of undergraduate studies. MATERIAL AND METHODS: A self-administered questionnaire based on the Hiroshima University-Dental Behavioural Inventory was distributed among 783 undergraduate dental students from 1st to 5th year. Statistical analysis was performed using SPSS version 20. The Mann-Whitney U test and one-way ANOVA tests (Kruskal-Wallis test) were used. RESULTS: The scores of oral health knowledge, attitude and behaviour between preclinical and clinical dental students were found to have statistically significant differences (P < 0.001). The variation of knowledge, attitude and behaviour scores from 1st to 5th year undergraduate studies was shown to be statistically significant with the year of study (P < 0.001). The study showed significant improvement in the knowledge, attitude and behaviour of the final year dental students as compared with the 1st year dental students. CONCLUSION: Preclinical students need properly designed oral health educational programs to increase their attitude and behaviour toward oral health.

Bovine milk fermented with Lactobacillus rhamnosus L8020 decreases the oral carriage of mutans streptococci and the burden of periodontal pathogens.

AIM: The aim of this study was to find the oral isolate of lactobacilli, which has the potential to inhibit either periodontal, cariogenic, or fungal pathogens in vitro, and to examine the effects of bovine milk fermented with the isolate on the oral carriage of cariogenic and periodontal pathogens. METHODS: The inhibitory effects of the supernatant of Man-Rogosa-Sharpe broth, in which each of 42 oral isolates of lactobacilli grown, was examined. One isolate, Lactobacillus rhamnosus L8020, that showed the potential to inhibit either periodontal, cariogenic, or fungal pathogens in vitro, was used to examine the effects of fermented milk on the oral carriage of cariogenic and periodontal pathogens, which was examined by a placebo-controlled and cohort trial using 50 participants. RESULTS: Edible yogurt containing Lactobacillus rhamnosus L8020 significantly reduced the oral carriage of mutans streptococci (P < 0.01) and four periodontal pathogens examined: Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Fusobacterium spp. (P < 0.01), but the phenomenon were not observed with the placebo yogurt (P > 0.05). CONCLUSION: These results suggest that yogurt with Lactobacillus rhamnosus L8020 could reduce the risk of dental caries and periodontal disease.

PRECEDE-PROCEED model modification in community-based oral health promotion by using the linear structural relations programme.

PURPOSE: The PRECEDE-PROCEED (P-P) model is a framework for designing health education/promotion programmes. While the P-P model has been used to design community-based oral health programmes, outcome assessments of the model are seldom reported. The aim of the present study was to explore whether pathways in the P-P model accurately reflect the current status of environmental/behavioural assessment in a Japanese community and to examine whether using the linear structural relations (LISREL) programme would improve the model. MATERIALS AND METHODS: In a community health centre in Japan, a questionnaire with 29 items regarding oral health was distributed to 824 mothers with 3-year-old children. The items were compiled into eight variables that were tested using the LISREL programme. Goodness-of-fit index (GFI), adjusted goodness-of-fit index (AGFI) and root mean square error of approximation (RMSEA) were statistically analysed before and after P-P model modification. RESULTS: The GFI, AGFI and RMSEA were 0.913, 0.776 and 0.161 before, and 0.975, 0.939 and 0.075 after P-P model modification, respectively. Indirect effects on the quality of life from the predisposing, reinforcing and enabling factors became stronger than those in the initial P-P model. The overall fit of the modified P-P model was significantly better than that of the P-P model without modification, which did not accurately reflect the status of environmental/behavioural assessment in the community. CONCLUSIONS: The modified P-P model reflected the current status of environmental/behavioural assessment in the community. Health education models should be tested rigorously to ensure that they fit the reality of people's behaviour.

Japanese dental trainees' perceptions of educational environment in postgraduate training.

BACKGROUND: Compulsory postgraduate dental training was introduced in April 2006 to meet social requirements in Japan. AIM: The aim of the present study was to identify the difference in trainees' perception of the educational environment in two different training settings in the Hiroshima University Hospital postgraduate training program: (1) main hospitals, in Hiroshima's case, the University Hospital: (2) community dental hospitals or offices (cooperating hospitals). METHODS: In order to determine how trainees perceive their educational environment, the Postgraduate Hospital Educational Environment Measure (PHEEM) Inventory was administered to 50 vocational dental trainees for two different training settings, both of which all trainees had experienced. RESULT: The mean total PHEEM score in the main hospital was 102.4, and that in cooperating hospitals was 108.5. The scores for each of the three subscales were as follows: 'Perception of role autonomy': 33.9/56 (main hospital), 36.8/56 (cooperating hospitals); 'Perception of teaching': 38.1/60 (main hospital), 41,9/60 (cooperating hospitals), and 'Perception of social support': 30.4/44 (main hospital), 29.8/44 (cooperating hospitals) respectively. CONCLUSIONS: PHEEM provided meaningful diagnostic information on the educational environment, and showed that cooperating hospitals met trainees' needs more than main hospitals.

Teenagers' oral health attitudes and behavior in Japan: comparison by sex and age group.

We investigated sex and age group differences in attitudes to oral health among school-age children using an Oral Self-Care Appraisal (OSCA) to systematically determine changes in oral health knowledge, attitude, and behavior across developmental stages. The subjects (n = 1584) were stratified after random sampling so that each school grade analyzed contained 88 boys and 88 girls. Factor analysis was undertaken to identify a set of underlying factors, with 10 factors considered in the cross-sectional study. Our results showed that the factors toothbrushing, persistence, and sociability were more predominant in primary school children than in junior high and senior high school students. Furthermore, postponement of visiting the dentist and resignation to one's own dental cavities became more predominant in proportion to the level of school education. Girls had significantly higher scores than boys for desire to improve oral care, dental anxiety, dependency on snacks, toothbrushing, concern over number of cavities, and sociability. Together, the results indicated that the oral health care behavior of girls was better than that of boys, and that the tendency to postpone visiting the dentist and resignation to one's own dental cavities increased markedly with age.

A comparative study of oral health attitudes and behaviour using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) between dental students in Britain and China.

The aim of this study was to compare oral health attitudes and behaviour between British and Chinese dental students. A cross-national survey using the Hiroshima University - Dental Behavioural Inventory (HU-DBI) was completed at the University of Leeds in Britain and West China University of Medical Sciences in China. In Britain and China, 192 of 266 and 180 of 303 dental students answered English and Chinese versions of the HU-DBI questionnaire, respectively. Data were statistically analyzed by logistic regression and the following results were obtained: 1) Self-reported gingival bleeding was more prevalent in Chinese students than in British students, although the number of students who had professional oral hygiene instruction was higher in China than in Britain; 2) 29% of Chinese students believed wearing dentures in old age was inevitable, whereas 7% of British students believed so; 3) Chinese students were substantially more concerned about the appearance of their teeth, gums and halitosis; and 4) 54% of Chinese students seek dental care only when symptoms arise, as compared to 13% of British students. In conclusion, bilateral comparison of countries using HU-DBI revealed interesting differences in oral health attitudes and behaviour, while the logistic regression model made it possible to differentiate British from Chinese students with a probability of nearly 95%.

Assessing communication skills for medical interviews in a postgraduate clinical training course at Hiroshima University Dental Hospital.

The study was conducted to investigate and clarify the effectiveness of our method of teaching communication and interview skills for medical interviews. Subjects were 18 first-year residents, enrolled in a postgraduate clinical training course at Hiroshima University Dental Hospital. Subjects underwent two objective structured clinical examinations (OSCEs), and the results of instructor and resident assessments of various elements dealing with necessary communication skills for conducting medical interviews were analysed. A statistically significant correlation between assessments of instructors and residents was observed in one element: confirming patient identity and introducing self (r = 0.812, p < 0.001) in the first interview. However, a statistically significant correlation between assessments of instructors and residents was observed in four elements in the second interview: greeting the patient (r = 0.548, p < 0.05), maintaining physical distance (r = 0.582, p < 0.05), showing empathy (r = 0.601, p < 0.05), summarizing and reconfirming patient complaints (r = 0.628, p < 0.01). Total scores given by instructors in the second OSCE were higher than those in the first OSCE (p < 0.001). The correlation coefficients of the total score in the first and second interviews were r = 0.020 and 0.679 (p < 0.01), respectively. These results may suggest the educational effectiveness of OSCE on the acquisition of communication skills for medical interviews. However, the results of resident self-assessments reveal that OSCE should be performed at least twice in order for residents to acquire the necessary communication skills for medical interviews.

A three-dimensional model for the tooth-loss patterns by multi-plane regression analysis.

The construction of dental condition models is one of the useful methods for analysis of epidemiological surveys. The purpose of this investigation was to make a simple model with clear turning points for the longitudinal tooth-loss patterns of Japanese adults by means of multi-plane regression analysis. Since 1957, the Japanese Ministry of Health and Welfare has carried out national surveys of dental conditions every six years. The data of present tooth numbers by age (24-79 years) and sex from these surveys were used for this study. When there are turning points between two variables, intersecting straight lines regression is a valid means. However, a new method was developed so that the data of this study had three variables. The new three-dimensional model by multi-plane regression analysis seemed to fit tooth-loss patterns of Japanese adults within three phases. Younger subjects are represented in the first phase followed by the third phase of elders, where tooth loss was rather slow. However, in the second phase, middle-aged subjects, people lost their teeth rapidly. Thus, prolongation of the first phase could be an important factor to improve overall dental health.