Using patients' oral photographs for oral hygiene motivation promotes periodontal health: a prospective randomized controlled trial.

OBJECTIVES: The aim of this prospective, randomized, controlled, single-centered, examiner-blinded clinical trial was to evaluate the effectiveness of a personalized and visual oral health education program in addition to conventional oral hygiene education. MATERIALS AND METHODS: Fifty-six non-smoker, right-handed participants (aged 30.34 ± 11.46 years) without clinical signs of periodontitis were randomly grouped: the intervention group (n = 28) received a personalized visualized oral health education combined with conventional oral hygiene education, and the control group (n = 28) received conventional oral hygiene education only. All participants were assessed for improved periodontal parameters (PI, GI, BOP, and PPD) at baseline, first month, and third month. RESULTS: A significant reduction (p < 0.001) was observed in PI, GI, and BOP during two follow-up sessions compared to the baseline for the two groups. No differences were found for inter-group (p > 0.05) or intra-group (p = 1) comparison of PPD. PI (p = 0.012), GI (p = 0.032), and BOP (p = 0.024) scores were significantly reduced at the third-month follow-up assessment in the intervention group compared to the control group. CONCLUSIONS: Clinical outcomes of periodontal health were significantly enhanced by the personalized and visual oral health education program applied in this study compared to the conventional oral hygiene education program. CLINICAL RELEVANCE: Numerous studies reported additional interventions to the oral hygiene education program. However, we did not find any published studies investigating the role of patients' intra-oral photographs in oral care. This study's results demonstrated that a visually aided education program for oral hygiene motivation may help improve oral health. CLINICAL TRIAL REGISTRATION: Registration number is "NCT06316505" and date of registration is 18/03/2024.

Effectiveness of two educational interventions based on the theory of planned behavior on oral cancer self-examination in adults: a randomized controlled trial.

BACKGROUND: The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022. METHODS: This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17. RESULTS: Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (ß = 1.47), attitude (ß = 0.66), subjective norm (ß = 2.82), and perceived behavioral control (ß = 1.19) in both groups (p < 0.001). CONCLUSIONS: The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer. TRIAL REGISTRATION: The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).

A music- and game-based oral health education for visually impaired school children; multilevel analysis of a cluster randomized controlled trial.

BACKGROUND: Visually impaired children encounter some challenges for their oral health. We aimed to compare the effectiveness of oral health education using Audio Tactile Performance (ATP) technique alone, ATP combined with oral health education for mothers, and ATP along with art package on the oral health status of visually impaired children. MATERIALS AND METHODS: This cluster, randomized trial, included visually impaired children from preschool to 10th grade (32 classes, n = 200), in Tehran, Iran, in 2018-2019. A questionnaire was filled out through face to face interviews at baseline regarding age, gender, status of visual impairment, and place of residence. The Simplified Oral Hygiene Index (OHI-S) and Bleeding on Probing (BOP) were examined afterward. Classes were randomly assigned to three groups through simple randomization: 1. Art group (ATP, game-based, and music-based education (11 classes, n = 66); 2. Mothers group (children received ATP and their mothers received education by telephone (10 classes, n = 73); and 3. Control group (children received ATP (11 classes, n = 61). Children received reinforcement after 1 and 2 weeks. Follow-up oral examinations were performed after 1 and 2 months by a blind calibrated examiner. Descriptive statistics were performed using Chi-Square, and ANOVA tests by SPSS (version 22). In analytic statistics, two-level mixed-effects models for BOP and OHI-S were fitted using the Statistical Analysis Software (SAS) version 9.4. Both models fitted with the grouping variable and time (baseline, 1, and 2 months after interventions) as the fixed effects. RESULTS: The mean age (SD) of the children was 12.29 (3.45) years (range: 6-17). Male children (67%) more than female children (33%) participated in the study. Also, 35.5% were blind, and 12% resided at the dormitory. The art and mothers groups had no statistically significant difference compared with the control group, in terms of OHI-S (P = 0.92, and 0.39, respectively) and BOP (OR = 0.64, and 0.66, respectively). The time effect was statistically significant in both BOP and OHI-S models (P < 0.0001). CONCLUSIONS: ATP technique is an effective method to improve the oral health status of visually impaired school children. Oral health promotion programs can be done using this method to tackle oral hygiene problems in visually impaired children. TRIAL REGISTRATION: (https://www.irct.ir/trial/34676: Nov 29th, 2018).

Hygienic and nutritional habits in dental caries prevention in 5-year-old children from Biala Podlaska.

BACKGROUND: Preschool children are particularly susceptible to dental caries development. Due to the fact that deciduous teeth are less mineralised, they are more likely to be affected by this condition. Therefore, preschool age is a significant period in shaping positive health-oriented attitudes regarding dental caries prevention. OBJECTIVE: The aim of this study was to analyse hygienic and nutritional habits in children aged 5 from Biala Podlaska in the context of dental caries prevention. MATERIAL AND METHOD: The study included 454 preschool children (251 boys and 203 girls) from Biala Podlaska. Their hygienic and nutritional habits were examined with a diagnostic survey using the authors' own anonymous questionnaire. Mean consumption of nutrients (calcium, phosphorus and vitamin D) was estimated on the basis of average daily consumption calculated as a mean from three 24-hour interviews (conducted by the authors in a kindergarten or at children's houses). A nutritional value of a daily portion was calculated with the use of "Dieta 5.0" software (National Food and Nutrition Institute). RESULTS: Research results revealed that in the case of only one in three children, parents began toothbrushing within the first year of a child's life. Approximately 90% of preschool children brushed their teeth at least twice a day. Half of the children under examination brushed their teeth for 1-2 minutes usually with a traditional toothbrush. Toothbrushing was supervised by 62.5% of the boys' parents and 38.9% of the girls' parents (p<0.05). Almost 66% of the parents took their children to a dentist for regular (once or twice a year) dental check-ups. Analyses of daily food rations revealed insufficient amounts of calcium (25%) and vitamin D (over 80%). Moreover, an excessive intake of phosphorus (twice as high as the norm) was noted. CONCLUSIONS: Developing appropriate hygienic and nutritional habits in children is an indispensable element in the prevention of lifestyle diseases, including dental caries.

A community-based pragmatic, controlled trial for preventing and reducing oral diseases among 1-6-year-old children visiting Anganwadi centers, under the Integrated Child Development Scheme, India.

BACKGROUND: Early childhood caries (ECC) has reached epidemic proportions affecting millions of children worldwide. Its prevention becomes imperative owing to the significant morbidity and financial implications involved with its treatment. The Integrated Child Development Scheme (ICDS), launched in India to provide mid-day meals, pre-school education and primary healthcare to children, can be utilised to counsel and deliver oral health education to mothers. The purpose of the study is to compare the effect of an oral health care package (OHCP) with usual care on the change in dental disease status among 1 to 3-year-old children at Anganwadi centres (AWC) in periurban areas of Chandigarh and rural areas of Cuttack, Orissa over a follow-up period of three years. METHODS: Two geographically distant ICDS blocks would be selected at each of the two study sites and would be randomly allocated to intervention and control group. Closely located AWCs under each of the selected blocks shall constitute the study setting. OHCP would be delivered to the mothers of the 1-6-year-old children enrolled in the AWCs of the experimental group whereas mothers under control group would receive usual care advice available at the AWCs. DISCUSSION: ECC prevention had conventionally focused upon testing effectiveness of programs targeting behaviour change among the caregivers and children, but surprisingly minimal efforts have been made to seek translation of these efforts into reduction of ECC at the community level. The present study has two components; testing effect of altering maternal and child behavioral aspects on ECC incidence through cohort follow up of 1-3-year-old children for three consecutive years and cross-sectional follow up of all available 1-6-year old children at the selected AWCs at regular intervals to look for change in prevalence of ECC at community level. In other regions of the world surveys of ECC prevalence before and after the intensive educational programs have shown a significant reduction in ECC prevalence. A similar decline can be anticipated through this program. TRIAL REGISTRATION: This trial has been prospectively registered at Clinical Trials Registry, India (CTRI/2019/02/017556, 08 February 2019).

Behavioural interventions that have the potential to improve self-care in adults with periodontitis: a systematic review.

AIM: To evaluate behavioural and educational interventions used to improve self-care in adult periodontitis patients in comparison with conventional instruction. METHODS: A systematic electronic search of empirical studies that were published up to June 2017 using the MEDLINE database was performed. The reference lists of all of the included studies and articles from six separate journals were manually searched. RESULTS: A total of 1806 articles were identified. Six articles fulfilled the inclusion and exclusion criteria. The interventions used in periodontal treatment had theoretical backgrounds of cognitive behavioural approach, self-regulation theory of Leventhal, motivational interviewing and a client self-care commitment model. The control group in each study was described receiving conventional information. The outcomes of the interventions were classified into three categories: 1) clinical findings 2) self-reported self-care and 3) patient evaluations of the intervention. The behavioural intervention groups seemed to perform slightly better than the control groups when clinical outcome measures such as the presence of plaque or number of periodontal pockets were used. Furthermore, behavioural interventions increased patient reported compliance (e.g. effectiveness of self-care and frequency of interdental cleaning). The different behavioural techniques all seemed to work more effectively than conventional instruction. No behavioural technique could be identified superior to the other. CONCLUSIONS: The behavioural interventions seem to be beneficial for patient adherence and may therefore improve periodontal treatment success. However, there is a need to further explore the use of different methods in studies with larger sample sizes, longer follow-up times and both behavioural and clinical outcome measures.

Contribution of preventive methods in controlling caries among Saudi primary schoolchildren: a population-based cross-sectional study.

OBJECTIVE: This study assessed the association between caries preventive measures including regular dental checkups, twice a day tooth brushing using fluoridated toothpaste and pit and fissure sealants on one side and the presence of caries among primary schoolchildren in the Eastern Province of Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study was conducted in 2016 including 1198, 6-12-year-old children from 13 randomly selected schools. The outcome variable was caries presence. The explanatory variables were brushing twice a day using fluoridated toothpaste, the presence of sealant and regular dental checkups. Multivariable logistic regression model was conducted to assess the associations controlling for confounders (age, gender, ability to get treatment, being health insured and school) using SPSS version 20.0. RESULTS: Data of 921 participants (83.8%) were available. The prevalence of caries was 63.5%, whereas 67.6% brushed their teeth twice a day, 28.3% visited the dentist for regular checkups and 7.6% had sealant. In multivariable regression, out of the three main explanatory variables, only having regular checkups was significantly associated with caries presence (OR = 0.65, 95% CI = 0.48, 0.88). CONCLUSIONS: Lower odds of caries presence were associated with regular dental checkups but not with regular brushing or having sealant.

The impact of anticipatory guidance on early childhood caries: a quasi-experimental study.

BACKGROUND: This study evaluated the impact of anticipatory guidance on the caries incidence of 2-3-year-old preschool children and their 4-6-year-old siblings, as well as on their mothers' oral health literacy, as compared to the conventional Ministry of Health (MOH) programme. METHODS: This quasi-experimental study was conducted at two government dental clinics in Batu Pahat District, Malaysia. The samples comprised of 478 mother-child-sibling trios (233 families in the intervention group, and 245 families in the control group). An oral health package named the Family Dental Wellness Programme (FDWP) was designed to provide dental examinations and oral health education through anticipatory guidance technique to the intervention group at six-month intervals over 3 years. The control group received the standard MOH oral health education activities. The impact of FDWP on net caries increment, caries prevented fraction, and mother's oral health literacy was assessed after 3 years of intervention. RESULTS: Children and siblings in the intervention group had a significantly lower net caries increment (0.24 ± SD0.8; 0.20 ± SD0.7) compared to the control group (0.75 ± SD1.2; 0.55 ± SD0.9). The caries prevented fraction for FDWP was 68% for the younger siblings and 63.6% for the older children. The 2-3-year-old children in the intervention group had a significantly lower incidence of white spot lesions than their counterpart (12% vs 25%, p < 0.05). At three-year follow-up, there were significant increments in the oral health literacy scores of mothers in the intervention group compared to the control group. CONCLUSION: The FDWP is more effective than the standard MOH programme in terms of children's and siblings' caries incidence and mother's oral health literacy. TRIAL REGISTRATION: ClinicalTrials.gov NCT03478748 . Registered on March 26th 2018. Retrospectively registered.

An educational programme designed for the evaluation of effectiveness of two tooth brushing techniques in preschool children.

AIM: This study aimed to evaluate oral and dental health status of preschool children, to teach them two different brushing techniques, and to determine the effectiveness of such techniques. MATERIALS AND METHODS: One hundred sixty three healthy children from three preschools in Isparta (Turkey) that were willing to participate in the study were included. A questionnaire was distributed to the parents. All children were given an oral and dental health education. Examinations were done in the classrooms, and plaque index and dft-dfs values were recorded. In each preschool, the horizontal scrub technique was randomly taught to a group of children, and the Fones technique to other group, and children were asked to apply the technique taught. Plaque index scores were recorded again, measurements were repeated at 1 week, and 1, 3 and 6 months. Data were analysed statistically. RESULTS: The questionnaires showed children's and parents' inadequate oral hygiene behaviours. Plaque index values for both techniques decreased from baseline at 1 week, and 1, 3 and 6 months. Values at month 6 were closer to baseline. The horizontal scrub technique was applied more easily and it provided an effective decrease on plaque index scores. No statistically significant difference was found for dft and dfs values. CONCLUSION: The educational programme with regular repeated tooth brushing training presented significant improvements in the oral health behaviours. The horizontal scrub technique was deemed more suitable than the Fones technique for preschool children.

[Teaching tooth brushing to children with autistic spectrum disorder : A tablet-based training programme.] / Apprentissage du brossage dentaire chez des enfants présentant un trouble du spectre autistique : effets de l'utilisation de tablettes tactiles.

OBJECTIVE: The primary objective of this exploratory study was to evaluate the short-term (four months) impact of a tooth brushing learning programme based on pictograms generated by the çATED app for iPad designed for patients with autistic spectrum disorder (ASD). METHODS: Fifty-two ASD patients, between the ages of 3 and 19 years, from seven educational centres, were included. A tooth brushing training programme was proposed in collaboration with the educational teams. Observation grids were used to evaluate autonomy during tooth brushing and interaction with the iPad. RESULTS: The results showed improvement of tooth brushing. The children progressively acquired the various brushing skills, although some steps remained difficult to perform. Interactions with the iPad also improved during the programme, encouraging the use of this tool in learning of tooth brushing. CONCLUSIONS: Daily assistance of the children improved the efficacy of tooth brushing, contributing to the preventive care of these patients. The use of an iPad in oral hygiene, especially for learning of tooth brushing, is simple and effective.

PeP-SCOT a health coaching intervention for people in prisons: the development of the intervention protocol.

There is a need for an alternative approach for health promotion prisons since previous work has indicated that health education, while improving health knowledge, does not result in behaviour change. Evidence has suggested that a health coaching assists in this regard. However, the question remained whether this approach would be appropriate and possible in prisons? This paper presents the public health strategies used to work in partnership with prison management to address challenges and accept opportunities as a health coaching intervention protocol was developed for oral health and wellbeing in the prison setting.

YouTube as a source for parents' education on early childhood caries.

BACKGROUND: Patients can and do search the Internet for information on various health-related topics. YouTube™ is one popular website they may consult. AIM: To examine the quality of information offered by YouTube™ for patients seeking information on early childhood caries (ECC). DESIGN: YouTube™ was searched for videos on ECC. The usefulness of selected videos in providing adequate information about ECC was evaluated using a 13-point usefulness score. The guidelines of the American Academy of Pediatric Dentistry were used for benchmarking. RESULTS: Most videos were uploaded by healthcare professionals (60%, n = 18). Videos had generally low usefulness scores (mean: 5.1 ± 2.9; range: 1-11). An average YouTube™ video on ECC was viewed two times/day (range: 0.07-34.4 views/day). Less useful videos ranked early on the viewing list, and viewer's interactions with videos were not affected significantly by their usefulness. CONCLUSION: YouTube™ should not be used as a trusted site for educating patients on ECC.

Can oral health education be delivered to high-caries-risk children and their parents using a computer game? - A randomised controlled trial.

BACKGROUND: Families of children undergoing general anaesthesia (GA) for caries management requested that oral health advice is delivered using audio-visual media. OBJECTIVE: To compare an oral health education computer game to one-to-one education. DESIGN: A blind randomised controlled trial of 4- to 10-year-old children scheduled for GA due to caries. Primary outcome measures were (1) parent and child satisfaction with education method; (2) improvements in child's dietary knowledge; and (3) changes in child's diet and toothbrushing habits. Measures were taken at baseline, post-intervention, and three months later. RESULTS: One hundred and nine families took part. Both methods of education were highly satisfactory to children and parents. Children in both groups showed significant improvement in recognition of unhealthy foods immediately post-education (P < 0.001). Fifty-five per cent of all participants completed telephone follow-up after 3 months and reported improvements in diet, including reducing sweetened drinks (P = 0.019) and non-core foods (P = 0.046) intake, with no significant differences between the groups. Children reported twice-daily toothbrushing but no changes in snack selection. Attendance for a 3-month dental review was poor (11%). CONCLUSION: Oral health education using a computer game can be as satisfactory and as effective in improving high-risk-children's knowledge as one-to-one education. The education received can lead to the positive dietary changes in some families.

Influence of Television Advertising on Behavior of Children across Socioeconomic Backgrounds.

INTRODUCTION: This research analyzed the influence of television on the behavior of children belonging to urban and rural socioeconomic backgrounds of Bhopal city and its vicinity. MATERIALS AND METHODS: About 400 parents with children between 1 and 18 years of age were subjected to a self-designed questionnaire, which sought information regarding the television viewing habits of children. Differences in responses were noted between the subjects of urban and rural areas. Obtained data were subjected to statistical analysis using Pearson's chi-square test to determine the level of significance. RESULTS: The urban class showed a dominating pattern in the positive aspects of television viewing, such as significantly better awareness of oral health, more emphasis shown toward oral care adverts, and a higher knowledge of the cause of dental caries. However, the urban class also possessed a poor attitude; the appearance of a dentist on television did not remind them about oral needs, products with gifts pleased their children to a greater extent, they had more demanding children, parents fulfilled their children's demand more, and they relied on the self for selection of toothpaste. Overall, in all aspects, the rural class lacked significantly. CONCLUSION: Television exerts a positive as well as negative influence on children's behavior among urban and rural communities, with the influence being more obvious in the urban class. CLINICAL SIGNIFICANCE: The results of this study can be utilized in bringing about better and effective advertising oriented toward attaining optimum oral health of children; overall general health through adverts that discourage obesogenic diet and promote a diet rich in protein and fiber can also be focused on.

Perception of Complete Visually Impaired Children to Three Different Oral Health Education Methods: A Preliminary Study.

AIM: To evaluate the perception of visually impaired children to three different methods of oral health education. STUDY DESIGN: Sixty total visually impaired children were divided into three groups of 20 children each. Children in group-I received oral health education through a lecture. Children in group II received Demonstration on a Model by Tell and Touch method (DMTT) and children in group III were self trained on oral hygiene skills. All children received written instructions in Braille. Their knowledge and practice of oral hygiene methods were recorded by a questionnaire and their method of brushing and rinsing was assessed during a personal interview. Data obtained was subjected to statistical analysis. RESULTS: Children in group II were able to brush and rinse significantly better (p <0.05) as compared to the other groups. Demonstration on a Model by Tell and Touch method was found to be the most preferred method of oral health education. CONCLUSION: Oral health education given through DMTT method was perceived well by the visually impaired children.

The role of repetition and reinforcement in school-based oral health education-a cluster randomized controlled trial.

BACKGROUND: Repetition and reinforcement have been shown to play a crucial role in the sustainability of the effect of Oral Health Education (OHE) programs. However, its relevance to school-based OHE imparted by different personnel is not depicted by the existing dental literature. The present study was undertaken to determine the effectiveness of the repeated and reinforced OHE (RR-OHE) compared to one-time OHE intervention and to assess its role in school-based OHE imparted by dentist, teachers and peers. METHODS: The study was a cluster randomized controlled trial that involved 935 adolescents aged 10-11 years. Twenty four boys' and girls' schools selected at random in two towns of Karachi, Pakistan were randomly assigned to three groups to receive OHE by dentist (DL), teachers (TL) and peer-leaders (PL). The groups received a single OHE session and were evaluated post-intervention and 6 months after. The three groups were then exposed to OHE for 6 months followed by 1 year of no OHE activity. Two further evaluations at 6-month and 12-month intervals were conducted. The data were collected by a self-administered questionnaire preceded by a structured interview and followed by oral examination of participants. RESULTS: The adolescents' oral health knowledge (OHK) in the DL and PL groups increased significantly by a single OHE session compared to their baseline knowledge (p < 0.05) and the increase was sustained over 6 months. Although one-time OHE resulted in a significant improvement in adolescents' oral health behavior (OHB) related to the prevention of gingivitis in the two groups (p < 0.05), no significant change was observed in their behavior towards prevention of oral cancer. One-time teacher-led OHE was ineffective in improving adolescents' OHK and OHB. The oral hygiene status (OHS) of the participants in all three groups did not change statistically after one-time OHE. The OHK, OHB and OHS indices increased significantly 6 months after RR-OHE than the initial scores (p < 0.001) irrespective of OHE strategy. Although the OHK scores of the DL and PL groups decreased significantly at 12-month evaluation of RR-OHE (p < 0.05), the said score of the TL group; and OHB and OHS scores of all three groups remained statistically unchanged during this period. CONCLUSIONS: The repetition and reinforcement play a key role in school-based OHE irrespective of educators. The trained teachers and peers can play a complementary role in RR-OHE.

Comparison of Oral Health Education and Fluoride Varnish to Prevent Early Childhood Caries: A Randomized Clinical Trial.

Early childhood caries, a serious health problem among young children, can be prevented with effective intervention. The aim of this study was to evaluate the efficacy of oral health education and a fluoride varnish in the prevention of caries in children under the age of 3 years. For this single-blind randomized parallel group 1-year clinical trial in Shiraz, 300 children aged 12-24 months with sound primary teeth were selected and randomly divided into three groups (n = 100): (1) control: no preventive intervention; (2) oral health counseling, and (3) oral health counseling and fluoride varnish at baseline and 6 months later. At baseline and 4, 8 and 12 months after the intervention, caries risk reduction was recorded as the primary outcome. The mothers' knowledge and performance regarding oral health in children was used as a secondary outcome. A total of 260 children (mean age: 20.49 ± 7.33 months) completed the study. Compared to group 1, caries risk reduction in group 2 was 28% (95% CI: -39.05 to -17.45) and 31% in group 3 (95% CI: -41.88 to -21.73). However, there was no significant difference between groups 2 and 3 (95% CI: -8.58 to 1.47). In all groups, mothers' knowledge and performance at baseline were low; however, they increased significantly in follow-up appointments in groups 2 and 3 (p < 0.001). Oral health education increased mothers' knowledge and performance regarding oral health in children. Oral health counseling alone or associated with the use of fluoride varnish reduced the caries incidence in young children.

A bi-level intervention to improve oral hygiene of older and disabled adults in low-income housing: results of a pilot study.

OBJECTIVE: This paper describes the results of a bi-level intervention, using a cognitive-behavioral theoretical approach, to improve the oral hygiene of older adults and the disabled in community-based low income senior housing. METHODS: The bi-level pilot intervention consisted of an on-site tailored adapted motivational interviewing (AMI) session and two oral health fairs, supported by a resident campaign committee, to change community norms. All materials were available in English and Spanish. Participants completed a survey consisting of 12 domains that provided the basis for tailoring the AMI and shaping the campaigns. The domains were activities of daily living (ADLs), access to oral health information, oral hygiene status, dental knowledge, hygiene behaviors, importance of oral hygiene, self-efficacy/locus of control, diet, intentions, self-management worries/fears, perceived risk and dry mouth. MAIN OUTCOME MEASURES: Each participant received clinical assessments consisting of full-mouth plaque score (PS) and gingival index (GI) before the intervention and at three months. RESULTS: Twenty-seven residents with at least one tooth completed all phases of the study. The mean number of domains requiring attention was 4.5 (SD 1.6) with a range of one to seven. Mean baseline PS was 83% (SD 16%) which improved significantly to 58% (SD 31%); mean baseline GI was 1.15 (SD 0.61) and improved significantly to 0.49 (SD 0.46). CONCLUSIONS: This pilot study supports the feasibility and acceptability of a tailored oral hygiene intervention among older and disabled adults living in low income senior housing. Although a small sample, the study demonstrated significant improvements in both plaque and gingival scores three months after the bi-level intervention.

Awareness of and compliance with healthy oral habits reported by children and their parents in Democratic People's Republic of Korea after a preventive programme.

OBJECTIVE: The study aimed to examine awareness of and compliance with healthy oral habits reported by children and their parents in Pyongyang, Democratic People's Republic of Korea (DPRK), after a preventive programme. MATERIALS AND METHODS: The data were collected in 2013 with self-completed, partly structured questionnaires from 1994 children aged 10 and 13 years and from 200 parents. Association between awareness of and compliance with healthy oral habits reported by the children and their parents was evaluated using Chi square tests and multivariate logistic regression analyses, children's oral health habits according to themselves and their parents were analysed using McNemar's test. RESULTS: Both children and their parents seemed to be familiar with healthy oral habits, although the awareness was not directly related to the reports of the children's oral practices. Most of the children reported brushing their teeth at least twice a day, using fluoride toothpaste and drinking water for thirst but frequent sweet snacking was common. Children's and their parents' reports were consistent with regard to sweet snacking frequency (p = 0.736) and the main thirst quencher (p = 0.349). CONCLUSIONS: Awareness of healthy oral habits appeared to be good among children and their parents. Unhealthy oral habits seemed to coincide with one another.

Effect of an Educational Programme on the Knowledge Level Among an Emergency Service Medical Team Regarding Tooth Avulsion.

PURPOSE: To evaluate the effectiveness of an educational intervention in improving the level of knowledge of tooth avulsion among non-dental healthcare professionals of an emergency medical service in Brazil and the maintenance of this knowledge after a 6-month period. MATERIALS AND METHODS: An intervention study was carried out involving the administration of a questionnaire and presentation of a lecture to 73 healthcare professionals (11 physicians, 41 nurses and 21 paramedics) of an emergency medical service in Brazil. The questionnaire was administered before (T0), immediately after (T1) and 6 months after the lecture (T2). McNemar's test was used to compare the responses, with the significance level set at 5% (p < 0.05). RESULTS: A general improvement was found regarding the concept of tooth avulsion, replantation, conduct in cases of avulsion, ideal time for replantation, ability to perform replantation and storage medium prior to replantation between baseline (T0) and the post-lecture evaluations (p < 0.05). However, an increase in insecurity regarding replantation was found between T1 and T2 (p < 0.001). CONCLUSION: The educational intervention led to a significant increase in the number of correct answers regarding the measures to be taken in cases of tooth avulsion. The professionals' knowledge level remained high 6 months after the lecture. However, a certain degree of insecurity was found regarding the ability to perform replantation.