Virtual reality-based simulation learning on geriatric oral health care for nursing students: a pilot study.

BACKGROUND: There is a great need for training and education in the nursing curriculum to improve nurses' knowledge and skills to provide oral health care. METHODS: A pilot study was conducted to evaluate the use of a virtual reality (VR)-based Oral Health Care Learning System to train geriatric oral health care among nursing students. Fifty undergraduate nursing students were randomly assigned to experimental (n = 25) and control (n = 25) groups. The experimental group received the VR-based simulation training on geriatric oral health care and the training was implemented twice at two weeks apart from March to November 2021. The control group did not receive the training intervention. Knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adults were assessed at the beginning, second, and fourth weeks. Generalized estimating equations were used to analyze the effectiveness of the VR-based simulation training. RESULTS: After the first round of training, students in the experimental group had significantly greater improvements in knowledge and self-efficacy of geriatric oral health care than in the control group. After the second round of training, students in the experimental group had significantly greater improvements in knowledge, attitude, and self-efficacy of geriatric oral health care as well as the intention to assist oral health care for older adult than in the control group. CONCLUSIONS: The VR-based simulation training was effective to improve undergraduate nursing students' knowledge, attitudes and self-efficacy of geriatric oral health as well as the intention to assist oral health care for older adults. The VR-based simulation learning system is an effective tool to provide practice experiences to build confidence and skills and to bridge the gap of understudied geriatric oral health content in entry-level nursing curricula. TRIAL REGISTRATION: ClinicalTrials.gov (NCT05248542; registration date 21/02/2022).

Knowledge and attitudes on oral health of women during pregnancy and their children: an online survey.

BACKGROUND: Life-long healthy behaviors are established during pregnancy and the first years of life. In this cross-sectional survey, new mothers with a high level of schooling living in Northern Italy (Lombardy Region) were interviewed to assess their knowledge and attitudes towards their and child oral health. METHODS: A questionnaire (27 items) was developed to assess socio-demographic factors, knowledge, and attitudes towards maternal and child oral health. The questionnaire was disseminated in perinatal courses, private gynecological clinics, and via social media. Mothers aged ≥18 years, with at least a child aged 0-36 months, with a high school diploma or higher, were included in the survey. RESULTS: A total of 1340 women completed the questionnaire, 1297 of whom had a child aged 0-36 months, 792 lived in Lombardy, and 600 had a high level of education and were finally included. About half of the sample (44.67%) was aged between 31 and 35 years, 76.50% were employed, and the majority had only one child (81.50%). During pregnancy, 28.33% of the sample reported problems with teeth and gums, while only 36.00% visited a dentist. More than 40% of the sample said they were not aware of a possible link between oral health and pregnancy, and 73.17% had not received any advice about their oral health or the future health of their baby's mouth. Less than 20% of women were aware of the increased caries risk associated with prolonged or night-time breastfeeding. Better knowledge/attitude was associated with the age of the child (p < 0.05), the number of children (p < 0.05) and whether the mother had received advice during pregnancy (p < 0.05). CONCLUSIONS: The results of this survey show a lack of dental care during pregnancy, a lack of information about oral health from health professionals during and after pregnancy, and consequently gaps in the knowledge needed to care for the oral health of the woman and her child. There is a need for training in oral health for pregnant women and new mothers, but also a need for behavioural change among health professionals who care for pregnant women.

Oral Health Nursing Education and Practice Program: Ten-Year Outcomes.

The Oral Health Nursing Education and Practice Program (OHNEP), a core partner of the National Interprofessional Initiative on Oral Health, is a national initiative focused on implementing an interprofessional oral health workforce innovation to influence change in clinical education, practice, and policy. OHNEP aims to address oral health disparities by enhancing the nursing profession's role in integrating oral health and its links to overall health in both academic and clinical settings. Leveraging the opportunity to cultivate faculty, preceptors, and clinicians as oral health champions, OHNEP aims to integrate interprofessional oral health clinical content and competencies in undergraduate and graduate nursing programs through faculty and preceptor development, curriculum integration, and establishing oral health as a standard of care in clinical settings. Outcomes include widespread dissemination of OHNEP virtual products and resources used by a significant number of undergraduate and graduate programs nationwide. OHNEP has a notable impact on policy related to integrating oral health and its links to overall health in undergraduate and graduate nursing programs, thereby increasing interprofessional oral health workforce capacity and aiming to improve oral health equity.

Comparing the effectiveness of two educational methods for oral health management in COVID-19 pandemic among dental professionals.

AIM. The aim of this study was to train dentists on the different oral hygiene measures to be followed by COVID-19 patients via Webinar and Information Education Communication (IEC) Materials and compare the effectiveness of both. METHODOLOGY. A total of 100 dental professionals were included by non-probability convenience sampling. Webinar and IEC Materials on oral hygiene measures, oral symptoms, and management strategies during COVID-19 were created and training was conducted for all dental professionals who registered themselves. An online version of the self-administered questionnaire (English) was created on the official Edantseva website and circulated to all the registered participants to obtain the pre and post-training data. RESULTS. Out of the total 80 participants in the Webinar group, 47 were females and 33 were males. Comparing the mean total scores obtained by the participants in the webinar and IEC groups in the pre and post-test showed that there is a significant difference in the scores obtained by the participants in the two groups in the pre and post-test (p<0.01). CONCLUSION. Educating dentists via IEC Materials was effective in improving their knowledge regarding oral health management during the COVID-19 pandemic. IEC materials being handy and referable at any time was found to be more effective.

Impact of oral health literacy and psychoactive substances on tooth loss in adolescents.

The aim of the present study was to investigate associations between tooth loss, and oral health literacy, the use of multiple psychoactive substances, and the reason for the last dental appointment in adolescents. A cross-sectional study was conducted with a representative sample of 746 adolescents aged 15-19 years in Campina Grande, Brazil. Parents/guardians answered a sociodemographic questionnaire. The adolescents answered the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), the alcohol, smoking, and substance involvement screening test, and an oral health questionnaire from the National Oral Health Survey. The adolescents were then examined by two examiners who had undergone training and calibration exercises for the diagnosis of tooth loss due to caries (K > 0.80). Associations between variables were investigated using robust logistic regression analysis for complex samples (α = 5%). The prevalence of tooth loss was 17.4%. Oral health literacy (OR = 0.93; 95% CI: 0.89-0.97) was inversely associated with tooth loss, while multiple psychoactive substance use (OR = 2.01; 95% CI: 1.09-3.69) and last dental visit for treatment/symptoms (OR = 3.05; 95% CI: 1.73-5.36) were directly associated with tooth loss. Oral health literacy, multiple psychoactive substance use, and reason for last dental appointment exerted an influence on tooth loss among adolescents.

Promoting openness to autism amongst dental care professional students.

INTRODUCTION: Autism spectrum disorders (ASD) is a lifelong condition affecting communication and social interaction, characterised by repetitive or repeated patterns of behaviour. People with ASD experience poor systemic and oral health. They face reduced access to dental care related to provider barriers associated with lack of understanding of ASD, lack of training and a consequent reluctance to treat people with ASD. MATERIALS AND METHODS: The effectiveness of training given by a person with autism to student dental care professionals was evaluated by measuring change in 62 students' openness to autism scale scores and confidence treating a person with autism. These students included third year dental students and second year dental nursing and hygiene students. This cohort was recruited as part of their curriculum and opted in for inclusion in the study. Data were analysed using SPSS®. RESULTS: An increase in openness scale scores of 7.6% (p < .05) and in confidence of 4.9% (p < .05) between pre- and post-training was observed. Openness scale score predicted level of confidence at baseline (OR = 0.21 (95% CI = 0.02-0.39)). CONCLUSION: An educational intervention delivered by a person with autism promoted modest increases in openness towards autism and confidence amongst dental care pre-service professionals. Whilst the results suggest that peer-led dental care professional teaching by people with autism may be beneficial, more research is needed.

LESSONS LEARNED FROM the FIRST STEPS of IMPLEMENTING VALUE-BASED ORAL HEALTH CARE: A CASE STUDY FROM the MEDICAL UNIVERSITY of VIENNA.

BACKGROUND: Value-based oral healthcare (VBOHC) has two fundamental components, the assessment of patients' dental outcomes and the measurement of the costs to achieve those outcomes. The aim of this article is to describe challenges and opportunities of implementing dental patient-reported outcomes (dPROs) in clinical care at the University Clinic of Dentistry, Medical University of Vienna, in Austria, to determine lessons learned and describe next steps forward to VBOHC implementation. METHODS: A case study determining lessons learned based on an implementation process to incorporate a dental patient-reported outcome measure (dPROM) in routine clinical care was conducted. The German version of the five items Oral Health Impact Profile (OHIP-5), a dPROM was selected and integrated into the general anamnesis including dental and medical history for patients aged ≥16 years. The anamnesis is paper based and is to be completed by each new patient during the registration process. Thereafter, it is uploaded to the patients' dental record via scan by the main central admission. However, it is then the treating dentist's task to transfer the data into the digital system. Data accuracy between digital and paper forms was investigated, and lessons learned regarding the first steps of implementing VBOHC were summarized based on the implementation process findings. RESULTS: To date, 8,147 patients were approached to fill in OHIP-5. However, only 266 patients´ OHIP- 5 files were transferred into the digital system by the dentist. To explore the accuracy between the manual transfer of data from paper forms to digital format, the data of 89 randomly selected patients was compared. Of this sample, 74 (83.1%) patient's data sets were found to be identical. Lessons learned included the importance of institutional dedication, stakeholders' engagement, dPROMs integration in follow up visits, the significance of digital solutions, and the continuous monitoring and evaluation. CONCLUSION: Integrating dPROMs in clinical settings is achievable and is the first important step to move forward with VBOHC implementation.

The Impact of Oral Health Training on the Early Year's Workforce Knowledge, Skills and Behaviours in Delivering Oral Health Advice: A Systematic Review.

OBJECTIVES: To determine the effectiveness of training the early year's workforce on their knowledge, skills and/or behaviours in delivering oral health advice. METHODS: Four databases: PubMed, Web of Science, Embase and Scopus were searched to evaluate the effectiveness of oral health training on knowledge, skills and behaviour of the early year's workforce with a minimum of one-month follow-up. Randomised or quasi-randomised trials and before and after studies were included. RESULTS: All six included studies showed improved knowledge and one of the five studies showed significant changes in behaviours of participants post oral health training. None of the included studies addressed changes in skills as an outcome. CONCLUSION: This systematic review found evidence that oral health training of the early year's workforce is effective in improving their knowledge but not necessarily their behaviours delivering oral health advice. Although training of the wider workforce on oral health is recommended, high quality research is required with longitudinal follow-up to assess changes in behaviours and ultimately impacts on oral health.

Bridging gaps in oral health education in a medical school in the United States: a pilot study.

BACKGROUND: Oral health is an important component of medical education given its connection to overall health and quality of life; however, oral health is infrequently incorporated into medical school curricula in the United States. The aim of this study was to pilot a novel oral health care clerkship for United States medical students that implemented the Smiles for Life (SFL) curriculum, in-person clinical activities, and pre and post curricula assessments to assess knowledge acquisition, attitude change, and clinical skill development. METHODS: Third year medical students at Albert Einstein College of Medicine, Bronx, New York, volunteered (n = 37) for a clerkship in oral health. Students completed the Smiles For Life National Oral Health Curriculum and participated in three half-day clinical sessions in a hospital-based dental clinic. The participants were evaluated on knowledge acquisition, attitude change, and clinical skill development through a pre and post clerkship assessment in order to assess the efficacy of the intervention. RESULTS: There was a 23.4% increase in oral health knowledge (p < 0.001) following participation in the online modules and clerkship. Additionally, attitudes in the following domains showed improved familiarity and proficiency: causes and prevention of dental caries (78.4%, p < 0.001) and periodontal disease (83.8%, p < 0.001), provision of oral health information to patients (67.6%, p < 0.001), and ability to conduct an oral examination (62.2%, p < 0.001). CONCLUSIONS: Third year medical students who participated in a novel oral health clerkship demonstrated significant increases in basic oral health knowledge and reported increased comfort in providing oral examinations and anticipatory guidance to patients. The results support the feasibility of this approach to incorporating oral health education into a medical school curriculum in the United States.

Interprofessional clinical training based in a federally qualified health center: a short report.

A.T. Still University and HealthPoint, a federally qualified health center, worked together to develop novel interprofessional educational clinical experiences for dental and medical students. This short report is focused on evaluating outcomes related to student and patient experiences. Dental and medical faculty designed the program to be as hands on as possible while minimizing disruption to clinic flow. Second-year medical and fourth-year dental students worked together to assess the physical and oral health of the patients. One hundred forty-eight students participated. Of 429 total patients assessed, 83 were referred from the medical clinic to the dental clinic. Caries was present in 24.9% of patients. Overwhelmingly, the patients enjoyed having teams of students care for them. These types of clinical interprofessional experiences give students valuable opportunities to learn with, from, and about each other while providing hands-on care to patients.

Interprofessional peer-led learning in oral health training.

Research on peer-led interprofessional learning in oral-health training for pediatric nurse practitioner (PNP) students is sparse. Therefore, we conducted a mixed-methods pilot study to assess the feasibility and impact of a student-led interprofessional training program centered on pediatric oral-health with PNP and dental students. Eleven PNP students rotated through the dental clinic to receive an oral-health education from 12 second-year dental students. These students learned how to treat avulsed teeth, apply fluoride varnishes, detect caries, and to do lap-to-lap baby dental exams. A reflection and a self-report survey-measure were used to elucidate what the students gained from the experience, their satisfaction with the training, how it may be improved, and how they see future collaboration of PNPs and dentists. PNP students felt dental students were well equipped to teach them, felt confident in their ability to conduct an oral evaluation/apply fluoride varnishes, and felt the experience to be valuable to their future practices. Dental students learned the scope of practice of PNPs and ideated ways the two professions overlap and complement each other. While some may find it challenging to envision dentistry regularly collaborating with other healthcare providers, clinical interprofessional education can be one way to break down these barriers.

Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran.

INTRODUCTION: The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran. METHODS: This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05). RESULTS: The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4). CONCLUSION: It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.

Oral health status and practices of 6- to 7-year-old children in Amman, Jordan: a cross-sectional study.

BACKGROUND: Dental caries affects the majority of children in Jordan, with some evidence of its prevalence steadily increasing. Previous studies have shown that families struggle to establish good oral health practices. The aim of this study was to evaluate the current oral health status and practices of 6- to7-year-old children in Amman, Jordan.r METHODS: A cross-sectional cohort study. The sample consisted of 6- to 7-year-old children attending six randomly selected schools in Amman, Jordan. Measures collected were: I) Caries experience (d3mft/D3MFT), II) Oral hygiene, measured using the Simplified Oral Hygiene Index, III) Dietary, toothbrushing, and dental attendance practices, measured using diaries and parental questionnaires, IV) Participants' basic characteristics: age, education and employment. Data were analysed using SPSS20. RESULTS: In total, 942 children were recruited. Four hundred and fifty-seven were boys, 485 were girls. Their average age was 6.5 years. Eighty-nine percent had decay in their primary teeth. Mean d3mft was 5.1(1 (range = 0-12, SD = 2.9). Only 8% of carious teeth were restored. Mean DMFT score was 0.3 (range = 0-4, SD = 0.8). Mean debris score was 1.07 (range = 0-3, SD = 0.37). Children indicated that they brush their teeth 1.6 times a day (range = 0-3, SD = 0.6). The majority (81%) were unsupervised. Sixty-seven percent of parents did not know the appropriate fluoride toothpaste concentration. Children were having 1.5 sugary snacks in-between their meals (Range = 1-6, SD = 1.1). They scored a mean of 2.5 (Range = 0-5.87, SD = 1.7) in sweetened drinks intake (recommended ≤ 1) and 2.8 (Range = 0-18.57, SD = 1.5) in non-core food intake (recommended ≤ 2) on a dietary questionnaire. Most parents (84%) indicated that their child attends the dentist only when in pain, and 18% indicated that their child is extremely afraid of dentists. Only 32% and 18% were familiar with fluoride varnish and fissure sealants, respectively. Regression analysis revealed that debris score and dental attendance were reliable predictors of caries experience. CONCLUSIONS: Six- to seven-year-old children in Amman, Jordan have a high caries experience. Most show signs of poor oral hygiene, excessive intake of cariogenic foods, and symptomatic dental attendance. Their parents lack knowledge on fluoride varnish and fissure sealants. There is a need for oral health promotion tailored to this cohort's need.

A randomized controlled trial of an educational intervention to promote oral and dental health of patients with type 2 diabetes mellitus.

BACKGROUND: Diabetes is the most prevalent disease resulted from metabolic disorders. This study aimed to investigate the effect of training based on health belief model (HBM) on oral hygiene-related behaviors in patients with type 2 diabetes mellitus. METHODS: This study was conducted as an educational randomized controlled trial (single blind) on 120 patients with type 2 diabetes referring to a diabetes clinic selected through systematic sampling, who were assigned to two groups of control (N = 60) and intervention (N = 60). The data collection tool was a valid and reliable questionnaire based on HBM which was completed by both groups before the intervention. Then, the intervention group received 4 sessions of educational program based on HBM in 1 month, and the same questionnaire was completed again after 3 months and the data were analyzed through SPSS version 20 software with inferential statistics, t-test, paired t-tests, Chi square, Mann-Whitney test, and Wilcoxon test analysis. RESULTS: Three months after the intervention, awareness of the patients and perceived susceptibility, benefits, self-efficacy, internal cue to action, and performance in oral and dental hygiene-related behaviors had a significant increase in the intervention group (p < 0.05). So that the performance of oral and dental hygiene in the intervention group increased from 2.16 ± 0.71 to 3.25 ± 0.49 (p = 0.001) after the education. CONCLUSION: Our results suggest that training patients with diabetes based on HBM as well as through active follow-up can enhance their skills in oral and dental hygiene-related behaviors. Controlling, monitoring and follow-up during the program are also recommended. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT 2017050733847N1. Prospectively registered 14 June 2017, http://en.irct.ir/trial/26011.

Pregnancy, oral health and dental education: an overview on the northeast of Italy.

Objectives To evaluate the level of knowledge of pregnant women and puerpers about oral health and prevention during and after gestation. Methods One hundred women aged 18-49 years (mean age 33±6 years) were included in this cross-sectional study. An anonymous questionnaire with 24 items related to oral health has been administered during or just after pregnancy. Firstly, answers have been analyzed on the full population and then subdividing the sample on the base of age ranges (G1: 18-25 years, G2: 26-35 years and G3: >35 years) and number of pregnancies (FP: first pregnancy; SP: second or more pregnancies). Parametric tests have been chosen for the statistical analysis; in particular, Anova test for independent samples was used to evaluate differences of baseline demographic characteristics among subgroups G1, G2, G3 while chi-square test was used for FP and SP subgroups. Anova test was also used to intercept differences on answers given to the questionnaire among G1, G2 and G3 group; for FP and SP group was used t-test. Results Level of information and knowledge of the full sample was medium-low and no significant differences have been observed between groups regarding awareness of the own level of the oral hygiene and knowledge of oral care. Conclusions Results of this survey underline the high necessity of educational programs regarding oral care in pregnant and puerpers women. A strict collaboration between medical figures (dentist, oral hygienist, gynecologist and obstetric) is strongly encouraged to spread the concept of prevention.

Chronic Disease Counseling and Screening by Dental Professionals: Results From NHANES, 2011-2016.

INTRODUCTION: Dental visits may provide an opportunity to counsel and screen for chronic disease prevention. However, few studies have used nationally representative data to assess the potential role of dental professionals in chronic disease prevention. We examined the percentage of US adults who reported chronic disease counseling and screening by dental professionals. METHODS: We analyzed data from the National Health and Nutrition Examination Survey 2011-2016 for 5,541 participants aged 30 or older who reported seeing a dental professional in the past year and estimated the percentage who reported receiving counseling about selected chronic disease prevention during the visit. We used logistic regressions to examine associations between risk factors and counseling. RESULTS: Overall, 4.0% (standard error [SE], 0.3) of adults were told by a dental professional about the benefits of checking blood glucose, 42.4% (SE, 2.9) giving up tobacco (among tobacco users), 26.6% (SE, 1.2) about checking for oral cancer, and 43.0% (SE, 1.8) had an oral cancer examination. Groups with risk factors were more likely to receive health behavior counseling than those without (eg, those previously told they had diabetes risk factors were more likely to receive blood glucose counseling than those without [8.1% vs 3.3%, P < .05]). The pattern for oral cancer counseling and receiving an oral cancer examination was different: adults without oral cancer risk factors (no tobacco use, normal/underweight, and/or excellent/very good health) were more likely to receive oral cancer counseling or screening. Adjusted analyses did not change these associations. CONCLUSION: Most adults were not counseled about chronic disease prevention during a visit with a dental professional. Current tobacco users and those with overweight or obesity were more likely to report receiving counseling.

Improving oral health in nursing home residents: A process evaluation of a shared oral care intervention.

AIMS AND OBJECTIVES: To evaluate the process of implementing an oral care intervention in nursing homes in a Danish municipality. BACKGROUND: Older people with aged natural dentition require preventive and curative oral health care. An intervention based on principles of situated learning was implemented to establish closer cooperation between dental and nursing staff in nursing homes, leading to improved oral hygiene in nursing home residents. DESIGN: An embedded multiple-case study combined with principles of realist evaluation unfolded in three phases: Formulation of initial programme theory, Testing and Refining the programme theory. The COREQ checklist is followed in reporting. METHODS: Observations, six group interviews and 22 face-to-face interviews with dentists, dental practitioners, nursing home managers, care professionals and residents were conducted in three nursing homes (n = 41). RESULTS: Three main outcomes of a programme theory were identified, relating to (a) residents, in the form of new oral care routines; (b) interdisciplinary working, in the form of professional pride in performing sufficient oral care; (c) organisational level changes, in the form of increased interdisciplinary knowledge sharing. The overarching supportive mechanisms were the creation of relationships between residents, dental practitioners and care professionals as well as nursing home management taking responsibility for structure, planning and knowledge sharing. CONCLUSION: The situated learning perspective supported residents and care professionals' competencies in performing sufficient oral care. The shared oral care intervention supports an individual and multidisciplinary assessment of nursing home residents' ability to self-care concerning oral care. Contextual factors, supportive and restraining mechanisms influence the intervention's success. RELEVANCE TO CLINICAL PRACTICE: Understanding the complexity within interdisciplinary cooperation in primary nursing and unravelling the necessary properties to enhance nursing home residents' oral health care are areas of improvement for care service in nursing homes.

A context analysis on how oral care is delivered in hospitalised patients: A mixed-methods study.

AIMS AND OBJECTIVES: To analyse oral care delivery in one hospital through exploring experiences from both nurses' and patients' perspectives and examining patients' oral health. BACKGROUND: Oral health problems are associated with undernutrition and other general health outcomes. Although oral care belongs to the essentials of nursing, it is often neglected. Improving oral health may require behaviour change of both nurses and patients. Defining tailored strategies need a clear view on the context. DESIGN: A context analysis in one hospital using a convergent parallel mixed-methods design was reported following the EQUATOR guidelines using two checklists: COnsolidated criteria for REporting Qualitative research (qualitative research) and STROBE (observational research). METHODS: Semi-structured interviews were conducted with 19 nurses and 11 patients. The topic list was based on the Integrated Change Model. Prospective oral examination was performed among 91 surgical patients using the Oral Health Assessment Tool (OHAT). RESULTS: Nurses acknowledged that they did not prioritise oral care in daily practice. Furthermore, they lacked knowledge and skills to identify and provide care for oral problems. Nurses mentioned helpful resources to perform oral care, like standardised language and instruments. However, they had no access to or were unaware of them. Patients admitted that they did not prioritise oral care due to their sickness during hospitalisation, were unaware of the importance of oral care, but felt responsible for their oral care. The most prominent oral problems identified with the OHAT were unclean mouths (n = 75, 82%), unhealthy gum and tissues (n = 55, 60%) and dry mouth (n = 42, 46%). CONCLUSIONS: This context analysis identified inadequate oral care due to lack of positive attitude and knowledge in both nurses and patients, skills for nurses, and resources. RELEVANCE TO CLINICAL PRACTICE: The behavioural factors indicate strategies for development of a multicomponent intervention to improve oral care in this hospital, nutritional status and general health outcomes.

Senior Oral Health: A Community-Based, Interprofessional Educational Experience for Nursing and Dental Students.

The current article highlights an interprofessional, older adult oral health community program, created through an Accelerating Interprofessional Community-Based Education and Practice grant from the National Center for Interprofessional Practice and Education, designed to address the gap between older adult health education and care delivery. This project developed an advanced practice, nurse-led partnership among The Hartford Institute for Geriatric Nursing and the Oral Health Nursing Education and Practice Program (both located at New York University Rory Meyers College of Nursing), New York University College of Dentistry, and Regional Aid for Interim Needs (RAIN), a community service organization for older adults in the Bronx. Teams of nursing (n = 26), nurse practitioner (n = 16), and dental (n = 64) students provided oral health education and oral hygiene instruction using Tooth Wisdom® educational materials to older adults, home health aides (HHAs), and volunteers in nine RAIN senior centers. Students demonstrated increases in their self-reported interprofessional competencies based on the Interprofessional Collaborative Competency Attainment Survey. Results also revealed that older adults (n = 500), HHAs (n = 142), and volunteers (n = 21) at the RAIN senior centers who attended the Tooth Wisdom presentation demonstrated an increase in oral health knowledge. [Journal of Gerontological Nursing, 46(8), 37-45.].

Impact of oral hygiene instructions on plaque index in adolescents.

OBJECTIVE: The objective of the study, which consisted of a motivational lecture and hands-on training, was to evaluate the role of oral hygiene education for adolescents. METHODS: The study population included sixty-two high school students between fourteen and fifteen years of age (thirty males and thirty-two females). The response rate was 76.5%. The measurement of oral hygiene level was performed using the modified Green Vermilion Index (GVI). The values were recorded at baseline, one week, three months, and six months after education through motivational lecture and hands-on training was performed. Descriptive and nonparametric statistical methods were used in statistical analysis. Level of significance was 0.05. RESULTS: At the beginning of the study, the GVI of all examined subjects was 3.52 (SD = 0.70). One week after the motivational lecture and training, it decreased to 2.64 (SD = 0.69). Three months later, the level of plaque index had the lowest value (1.44; SD = 0.66). At the end of the study the level of plaque index increased to 2.52 (SD = 0.86). CONCLUSIONS: A significant oral hygiene improvement in adolescents as a result of education was presented. However, due to a decline in oral hygiene level six months after the education, there is a need for educational programmes continuity.