Developing an Oral Hygiene Education Song for Children and Teenagers in Nigeria.

BACKGROUND: Oral diseases mainly caused by poor oral hygiene are a major public health problem affecting over half of the world's population. Oral hygiene education targeted at children and teenagers in schools is an important approach in addressing this problem. Folk songs in the language and cultural context children and teenagers are familiar with appears to be a promising tool and alternative to traditional oral hygiene education. OBJECTIVES: This paper aims to report how a local traditional song on oral hygiene education amongst children and teenagers in southwestern Nigeria was developed with a view to providing information on how the song can be developed in other languages as well as how other oral health education songs can be developed. METHOD: Oral health professionals from the University College Hospital, Ibadan, and music experts from the University of Ibadan, in collaboration with traditional/local musicians, parents/guardians, schoolteachers, and community heads, took part in the development of the song over a period of 6 months. Developing the tool involved certain processes which were validated and evaluated. These processes included developing the lyrics, choosing the type of song, creating the melody, and producing and finishing the song as an oral hygiene education tool. Written and audio documentations of the processes were done. RESULTS: A 90-second oral hygiene education song was developed in English and later translated into Yoruba. The numerous steps, collaborations, and meetings required in the development of the song were associated with many learning opportunities including team-building, understanding cultural contexts, effective collaboration, leadership, and communication skills. CONCLUSIONS: Creating new and effective oral hygiene education tool requires various processes and multiple steps and resources. However, it is a necessary and worthy exercise in ensuring sustainable and adequate oral hygiene, especially amongst children and teenagers in underserved populations, as we move into the future.

Lesiones bucales, factores de riesgo de cáncer bucal y autopercepción de irritación mecánica crónica en una campaña de prevención en la Ciudad de Buenos Aires / Oral lesions, oral cancer risk factors and self-perception of chronic mechanical irritation in a prevention campaign in Buenos Aires City

Objetivos: i) Describir las características poblaciona- les, la frecuencia de patologías de mucosa bucal y de factores de riesgo asociados al cáncer bucal en una Campaña de Pre- vención y Diagnóstico Precoz de Cáncer Bucal (CPDPCB) en la Ciudad de Buenos Aires; ii) establecer concordancia entre diagnóstico clínico profesional de irritación mecánica crónica (IMC) y autopercepción de trauma. Materiales y métodos: Se realizó un estudio descrip- tivo retrospectivo, en el que se utilizaron encuestas de 640 pa- cientes que participaron en las CPDPCB del Servicio de Odon- tología del Hospital Alemán entre los años 2016, 2017 y 2018. Se describen las variables demográficas, clínicas y cognitivas, y se analizan empleando chi cuadrado para variables cualitativas y ANOVA para variables cuantitativas comparando los años de campaña. Se realizó un estudio de concordancia entre el diag- nóstico clínico profesional de IMC y el trauma autopercibido mediante test Kappa, sensibilidad y especificidad. Resultados: Los sujetos participantes fueron predomi- nantemente mayores de edad, con bajo consumo de tabaco y alcohol. El porcentaje de pacientes con desórdenes potencial- mente malignos y cáncer bucal fue de 17,2%. La cartelería del hospital y la radio fueron las principales vías de información a los pacientes. El trauma autopercibido no presentó concor- dancia con el diagnóstico clínico profesional de IMC, y mos- tró sensibilidad de 0,41 y especificidad de 0,72. Conclusiones: El nivel de participación de los grupos de mayor riesgo de CBCE en la CPDPCB es bajo, y el perfil epidemiológico de los participantes no coincide generalmente con el perfil de los pacientes con CBCE. La autopercepción de trauma no sería una herramienta confiable para el diagnóstico de IMC (AU)

Aims: i) To describe population characteristics, frequency of oral mucosa pathologies, and risk factors for oral squamous cell carcinoma (OSCC) in a Campaign for the Prevention and Early Diagnosis of Oral Cancer (CPEDOC), and ii) to establish concordance between professional clinical diagnosis of chronic mechanical irritation (CMI) and self-perception of trauma. Materials and methods: A retrospective descriptive study was performed using surveys of 640 patients who had participated in the CPEDOC conducted by the Dentistry Ser- vice at the Hospital Alemán during 2016, 2017 and 2018. De- mographic, clinical and cognitive variables were described and analyzed, using chi-square for qualitative variables and ANOVA for quantitative variables, to compare campaign years. Concordance was studied between the professional clinical diagnosis of CMI and self-perceived trauma using the Kappa test, sensitivity and specificity. Results: Participants were predominantly older, with low consumption of tobacco and alcohol. The percentage of patients with potentially malignant disorders and oral cancer was 17.2%. Hospital posters and radio broadcasting were the main channels of information to patients. Self-perceived trauma did not agree with the professional clinical diagnosis of CMI. Self-perceived trauma sensitivity and specificity were 0.41 and 0.72, respectively. Conclusions: The level of participation in the CPEDOC by the groups at higher risk of OSCC was low, and the epide- miological profile of the participants did not generally coincide with the profile of patients with OSCC. Self-perception of trau- ma does not seem to be a reliable tool for the diagnosis of CMI (AU)

O olhar de usuários, residentes e trabalhadores sobre uma intervenção em saúde bucal de abordagem comunitária na ESFdo campo / Perspective of users, residents and workers on a community-based oral health intervention in the rural FHS

Objetivou-se analisar uma intervenção de cuidado integral em saúde bucal de abordagem comunitária protagonizada por residentes de Odontologia em Saúde da Família inseridos em duas unidades de saúde do campo de Caruaru/PE, segundo o olhar de profissionais, residentes e usuários. A intervenção englobou diagnóstico e levantamento das necessidades odontológicas, ações coletivas em saúde bucal e ações assistenciais para cárie com tratamento restaurador atraumático. Os grupos-alvo formam escolares e moradores de áreas mais remotas nas unidades de Lagoa de Pedra e de Xicuru. O estudo qualitativo utilizou técnica do grupo focal para coleta dos dados. Três grupos foram constituídos: nove profissionais, seis residentes e oito usuários. As entrevistas seguiram um roteiro com perguntas abertas sobre o cuidado e as tecnologias em saúde bucal empregadas no contexto das populações campesinas e acesso/acessibilidade às unidades de saúde. Os dados foram submetidos à análise de conteúdo. Emergiram duas categorias temáticas: dificuldades de acesso aos cuidados em saúde bucal e satisfação com as ações implementadas. Os participantes dos três grupos avaliaram positivamente a iniciativa de estabelecer relação educativa/assistencial participativa abrindo-se a espaços comunitários e valorizaram o enfoque adotado pela intervenção de saúde bucal no enfrentamento dos problemas limitadores do acesso aos serviços odontológicos e às ações coletivas que relataram. Contudo, desinteresse na continuidade das ações realizadas e contrários às práticas comunitárias em saúde bucal foram relatadas no grupo focal dos profissionais. Considera-se persistir fatores profissionais e de estrutura limitadores à garantia dos direitos de acesso à saúde aos usuários de áreas mais remotas às unidades de saúde (AU).

The aimof this study was to analyze a comprehensivecommunity-basedoral health care intervention carried out by residents of Dentistry in Family Health inserted in two health units in the rural area of the municipalityof Caruaru/PE, according to the perspective of professionals, residents and users. The intervention included diagnosis and assessment of dental needs, collective actions in oral health and actions for caries treatment with atraumatic restorative treatment. Target groupswere composed of schoolchildren and users frommore remote areas included in the health units of Lagoa de Pedra and Xicuru. The qualitative study used the focus group technique for data collection. Three groups were formed: nine professionals, six residents and eight users. Interviews followed a script with open questions about oral health care and technologies used in the context of ruralpopulations and access/accessibility to health units. Data were submitted to content analysis. Two thematic categories emerged: difficulties in accessing oral health care and satisfaction with implemented actions. Participants in the three groups positively evaluated the initiative ofestablishinga participatory educational/care relationship by opening up to community spaces and valued the approach adopted by the oral health intervention in dealing with problems that limit access to dental services and the reported collective actions. However, lack of interest in the continuity of actions carried out and contrary to community practices in oral health were reported in the focus group of professionals. There ispersistent presence of professional and structural factors that limit the guarantee of access to health ofusers frommore remote areas included inhealth units.

Perceptions of oral health education and practice among nursing students in Malaysia and Australia.

OBJECTIVE: Representing the largest proportion of healthcare workers, nurses play a significant role in oral health (OH) maintenance as part of a larger effort to promote holistic patient care. The study aims to determine nursing students' perceptions of OH education and practice in Malaysian and Australian nursing schools. MATERIALS AND METHODS: A self-administered questionnaire (content- and face-validated) survey was undertaken, classroom style, amongst final-year nursing students from selected Malaysian (n = 122, Response rate=97.6%) and Australian (n = 299, Response rate=54.7%) institutions. Quantitative data were analysed via Statistical Package for Social Science software (Chi-square and Fisher's exact tests, p ≤ 0.01). RESULTS: Significantly more Malaysian nursing students, compared to those in Australia, reported having encountered patients with OH issues (98.4% vs. 82.9%), namely halitosis (87.7% vs. 62.2%), oral ulcers (63.1% vs. 41.1%), oral/dental trauma (36.9% vs. 21.1%) and caries in children (28.7% vs. 7.7%). Less than half of Malaysian and Australian nursing students reported that they received adequate OH training (48.4% vs. 36.6%, p ≤ 0.01), especially in detecting oral cancer (18.0.0% vs. 22.6%, p ≤ 0.01) and preventing oral diseases (46.7% vs. 41.7%, p ≤ 0.01). Students in both countries demonstrated positive attitudes and believed in their role in OH care. Most students agreed that they should receive training in OH, especially in smoking cessation and providing OH care for patients with special needs. They also opined that a standardized evidence-based oral hygiene protocol is needed. CONCLUSION: Support for education and practice in this area of patient care suggested positive implications for further development of nurses' roles in OH promotion and management.

Conocimientos y prácticas de salud bucal en embarazadas / Oral health knowledges and practices in pregnant women

La mujer gestante sufre cambios fisiológicos y psicológicos durante los meses de embarazo que pueden derivar en problemas de salud bucal. A través de diversos estudios se observó que múltiples factores actúan como determinantes en lo que a la atención odontológica de la embarazada respecta, entre los cuales se pueden encontrar, la realidad sociocultural de la paciente, su nivel de instrucción educativo, sus conocimientos en cuanto a la atención odontológica, factores de riesgos, entre otros. El profesional odontólogo, tiene en sus manos recursos que pueden ser de gran ayuda por lo que su papel es de suma importancia, desde la educación preventiva, brindando conocimientos técnicos hasta la atención odontológica en sectores vulnerables. El objetivo de este trabajo consistió en reunir la evidencia que se corresponda con el análisis de los conocimientos y prácticas de salud bucal en mujeres embarazadas con el fin de organizar los trabajos hallados en un cuerpo de conocimiento fundamentado (AU)

The pregnant woman suffers physiological and psychological changes during the months of pregnancy that can lead to oral health problems. Through various studies it was observed that multiple factors act as determinants regarding dental care of the pregnant woman, among which can be found the sociocultural reality of the patient, her educational level of instruction, her knowledge regarding dental care, risk factors, among others. The dental professional has resources in her hands that can be of great help, so her role is of the utmost importance, from preventive education, providing technical knowledge to dental care in vulnerable sectors. The objective of this work was to gather the evidence that corresponds to the analysis of oral health knowledge and practices in pregnant women to organize the studies found in a well-founded body of knowledge (AU)

Comparison of oral health behaviour between dental and non-dental undergraduates in a university in southwestern China--exploring the future priority for oral health education.

BACKGROUND: Based on a national survey in 2015, people's oral health behaviour (OHB) has not kept up with the pace of knowledge and attitudes in China after decades of oral health education (OHE). Thus, we need to improve OHE to strengthen people's OHB. Undergraduates are regarded as the best candidates for the improvement of OHE. The objective of this study is to determine undergraduates' oral health status and existing problems in OHB by comparing dental and non-dental students at Sichuan University. We hope to provide some suggestions for future OHE to improve people's OHB. METHODS: A quasi-experimental study designed with a pre-test and post-test group was conducted. A total of 217 dental students and 135 non-dental students were enrolled. They were administered an OHE course focused on OHB. A survey about oral health behaviour and knowledge was conducted before and after the course. RESULTS: According to the pre-course survey, dental students surpassed non-dental students in terms of toothbrushing frequency, method, and time, but unfortunately, flossing was overlooked by all the students. After the course, both dental and non-dental students showed strong willingness to improve their OHB. More non-dental students than dental students were willing to use toothpicks and Chinese herbal toothpaste before and after the course. CONCLUSIONS: OHE focused on behaviour has a positive effect on university students. Future OHE and interventions should focus on flossing, toothbrushing methods, toothpicks, Chinese herbal toothpaste and modifications to adopt new media.

Progressive muscle relaxation therapy to relieve dental anxiety: a randomized controlled trial.

Dental anxiety causes patients to refuse or delay treatment, which may exacerbate oral diseases. The aim of the current randomized controlled trial was to determine whether progressive muscle relaxation therapy could relieve dental anxiety. The trial included 68 periodontal patients with dental anxiety scores of ≥13 who were randomly assigned to either an intervention group or a control group (n = 34 per group). The intervention group was administered progressive muscle relaxation therapy for 20 min and oral health education for 15 min before periodontal treatment once per week for 4 wk. The control group was provided with oral health education only, for the same duration. Changes in dental anxiety, depression symptoms, blood pressure, heart rate, and salivary cortisol were evaluated 4 wk and 3 months after the intervention. The intervention group exhibited statistically significantly greater reductions in dental anxiety scores than did the control group at the 4-wk (-3.82 vs. -0.89) and 3-month (-4.22 vs. -0.28) assessments. They also exhibited significantly greater reductions in depression symptoms, systolic and diastolic blood pressure, pulse rate, and salivary cortisol levels at both time-points. Progressive muscle relaxation therapy relieves tension and anxiety in dental patients.

Grado de educación, prevención e importancia dental: realidad en padres de familia de León, Guanajuato / Education degree, prevention, and dental importance: reality in parents from Leon, Guanajuato

Objetivo: evaluar el grado de educación, prevención e importanciadental en caries y enfermedad periodontal en padres de familia de niños de primaria de la ciudad de León, Guanajuato. Material y métodos:En este estudio descriptivo, transversal y observacional se hizo una encuesta a 1,249 padres de familia de niños de seis diferentes escuelas primarias que constó de 18 preguntas enfocadas en la educación, prevención e importancia dental. Se estableció una comparación entre padres de familia con niños de escuelas públicas y privadas, así como entre el grado de estudios de los padres de familia con su propio grado de educación y prevención dental. Resultados: Se observó un grado moderado de prevención dental (48.04 por ciento de educación dental (49.48 por ciento), la mayoría da importancia a los dientes deciduos (87.43 por ciento); 65.89 por ciento de los padres consideró sus propios dientes como muy importantes, 8.02 por ciento, moderadamente importantes, 5.12 por ciento, poco importantes y 0.96 por ciento nada importantes. También afi rman que la salud dental tienela misma importancia que la salud sistémica (98.88 por ciento). Hubo máspadres de familia de niños de escuelas privadas en los niveles altos deprevención y educación dental que de escuelas públicas. Asimismo, seobservó que en el nivel alto de educación y prevención dental, cuantomayor era el grado de estudios de los padres de familia, mayor cantidadde ellos se encontraban en estos niveles. Conclusiones: Dado que hayun alto grado de educación dental y uno moderado de prevención, sedetectó que no se lleva a la práctica lo que se sabe, aun cuando se da gran importancia a los dientes, por lo que sería conveniente diseñar un método para asegurar que se apliquen las medidas preventivas e indagar las causas por las que se omiten.

Objective: to evaluate the level of dental education, prevention, andthe importance of caries and periodontal disease in parents of primarylevel children in the city of León, Gto. Material and methods: Inthis descriptive, cross-sectional and observational study, a surveywas applied to 1,249 parents whose children study in six diff erentprimary schools. The survey had 18 questions about dental education,prevention, and importance. A comparison was made between parentswhose children study in private and public schools and between thelevel of studies of parents in the level of dental education and dentalprevention. Results: It was found a moderate level of dental prevention(48.04%) and a high level of dental education (49.48%), almost allparents think that temporal teeth are important (87.43%); 65.89% ofthe parents considered their own teeth as «very important¼, 28.02%as «moderately important¼, 5.12% as «little important¼ and 0.96% as«no important¼. They also affi rm that dental health is as important assystemic health (98.88%). There were more parents with children fromprivate schools with high levels of dental prevention and education thanchildren from public schools. It was also observed that in the high levelof dental education and prevention, the higher the level of studies werein parents, the most of them were found in those levels. Conclusions:Due to the high level of dental education, and a moderate level ofprevention, it was observed that people don’t practice what they know,even though they think teeth are important, so it would be convenientto design a method to assure that preventive measures are done andfi nd out the reasons why they are not taking place.

Intervención educativa sobre factores de riesgos para lesiones premalignas de la cavidad bucal. Bayamo. Enero-marzo. 2016 / Educational intervention on risk factors for premalignant lesions of the oral cavity. Bayamo. January March. 2016

Se realizó un estudio experimental de intervención educativa del tipo antes-después con pacientes de 35-60 años. El universo estuvo constituido por 120 pacientes, con una muestra no probabilística intencional de 80 expuestos a factores de riesgo, con el objetivo de elevar los conocimientos sobre factores de riesgo para lesiones premalignas de la cavidad bucal, consultorio médico de la familia No. 26, Roberto Reyes, Bayamo, Granma, Cuba de enero a marzo 2016. La aplicación de la intervención educativa demostró ser un instrumento práctico para elevar el nivel de conocimiento de la población. Al evaluar el nivel de conocimientos sobre lesiones premalignas antes de la intervención la calificación de bien fue en un bajo por ciento y después se logró aumentar, con diferencias estadísticamente significativas entre ambos momentos(AU)

An experimental study of before-after educational intervention with patients aged 35-60 years was carried out. The universe consisted of 120 patients, with an intentional non-probabilistic sample of 80 exposed to risk factors, aiming to increase knowledge on risk factors for premalignant lesions of the oral cavity, doctor's office No. 26, Roberto Reyes, Bayamo city, Granma province, Cuba; from January to March 2016. The application of the educational intervention proved to be a practical instrument to raise the level of knowledge of the population. When assessing the level of knowledge about premalignant lesions before the intervention, the qualification of good was in a low percentile and then it was possible to increase, with statistically significant differences between both moments(EU)

Comprehensive Oral Health Care to Reduce the Incidence of Severe Early Childhood Caries (s-ECC) in Urban China.

OBJECTIVE: To explore the effectiveness of comprehensive oral health care to reduce the caries incidence for children with severe early childhood caries (s-ECC) in an urban area in China. METHODS: A total of 357 children aged 3 to 4 years old and diagnosed with s-ECC were recruited in this randomised controlled, single-blinded clinical trial for 1 year. Children of two different kindergarten classes were enrolled in this study and randomly divided into a test group (205 children) and a control group (152 children). The test group received comprehensive oral health care, which included: oral health examination, oral health education, topical fluoride application and dental treatment, and the children in the control group only received the oral health examination. The evaluation of the oral health questionnaire for parents was also performed. An evaluation was carried out at the time of recruitment and 1 year later to explore the effectiveness of the comprehensive oral health care model. RESULTS: The differences in decayed teeth (dt), decayed tooth surfaces (ds), filled teeth (ft), filled tooth surfaces (fs) and the ratio of ft /(dt + ft) between the two groups were statistically significant (P < 0.001) at 1 year. The incidence of caries in the control group was higher than that of the test group (P = 0.02). The rate of awareness of oral health knowledge (P = 0.01) and the practice of good diet habits (P = 0.02) by parents in the test group were significantly higher than those in the control group. CONCLUSION: The present study demonstrated that the comprehensive oral health care program reduces and prevents caries amongst children with s-ECC.

La sala lúdica: un complemento de la Clínica Dental Pediátrica Universitaria / The playroom: a complement of the University Pediatric Dental Clinic

El presente artículo muestra las diferentes actividades que realiza la salalúdica SALPEP (Especialidad en Estomatología Pediátrica, Facultad deEstomatología, Universidad Autónoma de San Luis Potosí), tanto educativascomo de preparación conductual antes de ingresar a la consulta dental, en los pacientes pediátricos así como en sus padres que acuden a la Clínica Dental Pediátrica del Posgrado. Además, se resaltan los resultados obtenidos en sus primeros doce meses de labor, los beneficios y experiencias logradas que se han refl ejado en el aumento de la calidad de la atención odontológica, en todos los aspectos...

Evidence From ElderSmile for Diabetes and Hypertension Screening in Oral Health Programs.

The ElderSmile clinical program was initiated in northern Manhattan in 2006. ElderSmile is a comprehensive community-based program offering education, screening and treatment services for seniors in impoverished communities. Originally focused on oral health, ElderSmile was expanded in 2010 to include diabetes and hypertension education and screening. More than 1,000 elders have participated in the expanded program to date. Quantitative and qualitative findings support a role for dental professionals in screening for these primary care sensitive conditions.

Effectiveness, cost-effectiveness and cost-benefit of a single annual professional intervention for the prevention of childhood dental caries in a remote rural Indigenous community.

BACKGROUND: The aim of the study is to reduce the high prevalence of tooth decay in children in a remote, rural Indigenous community in Australia, by application of a single annual dental preventive intervention. The study seeks to (1) assess the effectiveness of an annual oral health preventive intervention in slowing the incidence of dental caries in children in this community, (2) identify the mediating role of known risk factors for dental caries and (3) assess the cost-effectiveness and cost-benefit of the intervention. METHODS/DESIGN: The intervention is novel in that most dental preventive interventions require regular re-application, which is not possible in resource constrained communities. While tooth decay is preventable, self-care and healthy habits are lacking in these communities, placing more emphasis on health services to deliver an effective dental preventive intervention. Importantly, the study will assess cost-benefit and cost-effectiveness for broader implementation across similar communities in Australia and internationally. DISCUSSION: There is an urgent need to reduce the burden of dental decay in these communities, by implementing effective, cost-effective, feasible and sustainable dental prevention programs. Expected outcomes of this study include improved oral and general health of children within the community; an understanding of the costs associated with the intervention provided, and its comparison with the costs of allowing new lesions to develop, with associated treatment costs. Findings should be generalisable to similar communities around the world. The research is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number ACTRN12615000693527; date of registration: 3rd July 2015.

Planning oral health and clinical discharge in primary care: the comprehensive dental care protocol outcome.

INTRODUCTION: The dental care must be driven by preventive and curative measures that can contribute to the population's oral health promotion. OBJECTIVE: To evaluate the impact of the actions proposed by a comprehensive dental care protocol (CDCP) on the oral health condition of primary care users. MATERIALS AND METHODS: The sample consisted of 32 volunteers, assisted throughout the six phases proposed by the CDCP: diagnosis of dental needs; resolution of urgencies; restorative interventions; application of promotional measures; evaluation of the achieved health level; and periodic controls. Data were collected through clinical exams, which measured the simplified oral hygiene index (OHI-S), gingival bleeding index (GBI) and the decayed, missing and filled teeth (DMFT) Index, before and after the CDCP was implemented. Statistical analysis consisted of the Wilcoxon test, at 5% significance level (α = 0.05). RESULTS: The OHI-S and GBI indices showed a significant reduction (p < 0.05) from the initial (1.4 ± 0.6 and 46.3 ± 19.9) to final condition (0.9 ± 0.3 and 21.5 ± 7.5). The decayed, missing and filled teeth and the missing teeth component were not significantly altered (p > 0.05), showing final values equal to 12.7 ± 9.6 and 5.6 ± 7.8, respectively. Decayed elements were fully converted into filled elements, and the final values of the decayed and filled elements were, respectively, 0.0 ± 0.0 and 7.3 ± 5.7 (p < 0.05). CONCLUSIONS: The enactment of the CDCP had a beneficial effect on the oral health of the population assisted by the dental services offered in primary care and this protocol seems to ft the public dental service demands. CLINICAL SIGNIFICANCE: The CDCP can be useful to public dental service planning since it showed an efficient clinical outcome to the patients. We consider that this protocol should be employed in primary care oral health services in order to achieve overall upgrade, access enlargement and public oral health promotion.

Implementing a prenatal oral health program through interprofessional collaboration.

Interprofessional collaboration has become a critical component of accreditation standards in dentistry and medicine. This article reports on implementation in an academic setting of a prenatal oral health program (pOHP) that addresses coordinated care, accreditation standards, and new clinical practice guidelines. The pOHP is an educational intervention for third-year medical students, residents, and faculty members to deliver preventive oral health information and referral to a dental home for pregnant women. At the same time, senior dental students and faculty members are introduced to prenatal oral health principles and delivery of comprehensive oral health care to pregnant women. A systems-based approach was used to guide the pOHP implementation during the 2012-13 academic year. Participants were 96 third-year medical students (50% of the total in an obstetrics and gynecology clerkship) and all 81 fourth-year dental students. During that academic year, 126 dental referrals were made to the School of Dentistry, and 55 women presented for care, resulting in 50% (n=40) of dental students participating in the clinical experience and delivery of simple to complex oral health procedures. The prenatal period is a frequently missed opportunity to address oral health care. The pOHP is an interprofessional collaboration model designed to educate dental and medical providers and provide a system of referral for comprehensive clinical care of pregnant patients, including educating women about their oral health and that of their children. Such programs can help meet interprofessional accreditation standards and encourage implementation of practice guidelines.

Descriptive study of the patients treated at the clinic 'Integrated Dentistry for patients with Special Needs' at Complutense University of Madrid (2003-2012)

OBJECTIVES: To study clinical and epidemiological characteristics of the patients treated at the clinic 'Integrated Dentistry for Patients with Special Needs (Special Care Dentistry)' at Complutense University of Madrid (UCM),as well as to know the dental treatments performed in these patients and the modifications from the usual treatment protocol. The information obtained from the results could also be applied in order to assess the needs of dental students education about this type of patients. Study DESIGN: Medical records review of all the patients referred to the clinic of 'Integrated Dentistry for Patients with Special Needs', performing a retrospective cross-sectional study analyzing their main pathology, ASA risk score (Classification system used by the American Society of Anesthesiologists to estimate the risk posed by the anesthesia for various patient conditions), pharmacological treatment, what kind of dental treatment was necessary, whether the patient was treated or not, and if it was required to change any procedure due to the patient health status (sedation or antibiotic prophylaxis). RESULTS: The number of patients referred to the clinic was 447, of whom 426 were included in this study. Out of them, 52,35 % were men and 47,89 were women, with a mean age of 49,20 years. More frequent pathologies were cardiovascular or cerebrovascular diseases (24,29 %), infectious diseases (12,41%), endocrine diseases (11,66%)and intellectual disability (8,85%). 70'18% of the patients were treated, with sedation being necessary in 9,03% of the cases and antibiotic prophylaxis in 11,70%

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The midwifery initiated oral health-dental service protocol: an intervention to improve oral health outcomes for pregnant women.

BACKGROUND: Evidence is emerging that women's poor oral health and health practices during pregnancy are associated with poor oral health in their children and potentially an increased risk of pre-term or low-birth weight infants. METHODS/DESIGN: The Midwifery Initiated Oral Health-Dental Service (MIOH-DS) trial is a three arm multicentre randomised controlled trial which will recruit women from three metropolitan hospitals aimed at improving women's oral health and service access and indirectly reducing perinatal morbidity. All three arms of the trial will deliver oral health promotion material, although a midwife oral assessment and referral to private/public/health fund dental services pathway (Intervention Group 1) and the midwife oral assessment and referral to local free public dental services pathway (Intervention Group 2) will be compared to the control group of oral health promotional material only. Midwives will undergo specific oral health education and competency testing to undertake this novel intervention. DISCUSSION: This efficacy trial will promote a new partnership between midwives and dentists focused on enhancing the oral health of women and their infants. Should the intervention be found effective, this intervention, with existing on-line educational program for midwives, can be easily transferred into practice for large metropolitan health services within and beyond Australia. Further cost-benefit analysis is proposed to inform national health policy. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12612001271897.

Advances and challenges in oral health after a decade of the "Smiling Brazil" Program.

OBJECTIVE: To analyze oral health work changes in primary health care after Brazil's National Oral Health Policy Guidelines were released. METHODS: A literature review was conducted on Medline, LILACS, Embase, SciELO, Biblioteca Virtual em Saúde, and The Cochrane Library databases, from 2000 to 2013, on elements to analyze work changes. The descriptors used included: primary health care, family health care, work, health care policy, oral health care services, dentistry, oral health, and Brazil. Thirty-two studies were selected and analyzed, with a predominance of qualitative studies from the Northeast region with workers, especially dentists, focusing on completeness and quality of care. RESULTS: Observed advances focused on educational and permanent education actions; on welcoming, bonding, and accountability. The main challenges were related to completeness; extension and improvement of care; integrated teamwork; working conditions; planning, monitoring, and evaluation of actions; stimulating people's participation and social control; and intersectorial actions. CONCLUSIONS: Despite the new regulatory environment, there are very few changes in oral health work. Professionals tend to reproduce the dominant biomedical model. Continuing efforts will be required in work management, training, and permanent education fields. Among the possibilities are the increased engagement of managers and professionals in a process to understand work dynamics and training in the perspective of building significant changes for local realities.