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...

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.

Educating parents of children receiving comprehensive dental care under general anesthesia with visual AIDS.

PURPOSE: The purpose of this study was to determine if educating parents with visual aids after their child's treatment under general anesthesia would improve attendance at follow-up appointments, oral health outcomes, and treatment satisfaction. METHODS: Fifty-four parent-child dyads were recruited and randomly assigned to two groups. The control group received verbal education, and the intervention group received verbal and visual education. Oral health was measured using the Gingival Index and the Simplified Oral Hygiene Index (OHI-S) before and after the treatment. Parent surveys were administered before and after treatment. MResults: Seventy-eight percent of the intervention group and 52 percent of the control group returned for follow-up appointments (P=.04). The plaque index decreased (P<.01); the reported brushing frequency increased for all children from baseline to follow-up visit (P=.02). The satisfaction increased only for parents in the intervention group over time (P=.04). CONCLUSIONS: Using visual aids had a positive impact on patient attendance at follow-up and parents' treatment satisfaction. There was an improvement in oral hygiene, as measured by the OHI-S, and an increase in brushing frequency for all children, regardless of whether their parents were educated with or without a visual aid.

Parental views on delivering preventive advice to children referred for treatment of dental caries under general anaesthesia: a qualitative investigation.

OBJECTIVES: To: 1, Explore opinions of parents of children undergoing caries treatment under general anaesthesia (GA) regarding delivery of oral health advice; 2, Discover current oral health practices and beliefs; 3, Inform further research and action. METHODS: Qualitative study using semi-structured interviews and thematic data analysis, sampling parents of children aged 3-10 years undergoing GA tooth extraction due to dental caries. RESULTS: Twenty nine parents were interviewed (mean age 38.9 years, range 28-50, sd 6.4). The mean age of their children was seven years (range 3-10, sd 2.1). All children required deciduous tooth extractions (5.1 teeth on average). Those that also required permanent tooth extractions had on average 2.1 permanent teeth extracted. Many parents knew the importance of oral hygiene and sugar limitation, describing it as 'general knowledge' and 'common sense'. However, few understood that fruit juice is potentially cariogenic. Parenting challenges seemed to restrict their ability to control the child's diet and establish oral hygiene. Many reported not previously receiving oral health advice and reported never having fluoride varnish applied. There were requests for more caries prevention information and advice via the internet, schools or video games. CONCLUSION: Parental oral health knowledge, parenting skills, and previous advice received seem to all be issues related to the oral health of those children. Providing advice, especially in respect to fruit juice cariogenicity and the benefits of fluoride application through a child-friendly website, including a video game, as well as the use of school programmes might be an acceptable approach.

The feasibility, acceptance, and key features of a prevention-focused oral health education program for HIV+ adults.

Poor oral health is common in HIV+ adults. We explored the feasibility, acceptance, and key features of a prevention-focused oral health education program for HIV+ adults. This was a pilot substudy of a parent study in which all subjects (n = 112) received a baseline periodontal disease (PD) examination and provider-delivered oral health messages informed by the Information-Motivation-Behavioral Skills (IMB) Model. Forty-one parent study subjects were then eligible for the substudy; of these subjects, a volunteer sample was contacted and interviewed 3-6 months after the baseline visit. At the recall visit, subjects self-reported behavior changes that they had made since the baseline. PD was reassessed using standard clinical assessment guidelines, and results were shared with each subject. At recall, individualized, hands-on oral hygiene coaching was performed and patients provided feedback on this experience. Statistics included frequency distributions, means, and chi-square testing for bivariate analyses. Twenty-two HIV+ adults completed the study. At recall, subjects had modest, but nonsignificant (p > 0.05) clinician-observed improvement in PD. Each subject reported adopting, on average, 3.8 (± 1.5) specific oral health behavior changes at recall. By self-report, subjects attributed most behavior changes (95%) to baseline health messages. Behavior changes were self-reported for increased frequency of flossing (55%) and toothbrushing (50%), enhanced toothbrushing technique (50%), and improved eating habits (32%). As compared to smokers, nonsmokers reported being more optimistic about their oral health (p = 0.024) at recall and were more likely to have reported changing their oral health behaviors (p = 0.009). All subjects self-reported increased knowledge after receiving hands-on oral hygiene coaching performed at the recall visit. In HIV+ adults, IMB-informed oral health messages promoted self-reported behavior change, subjects preferred more interactive, hands-on coaching. We describe a holistic clinical behavior change approach that may provide a helpful framework when creating more rigorously designed IMB-informed studies on this topic.

Train the trainer? A randomized controlled trial of a multi-tiered oral health education programme in community-based residential services for adults with intellectual disability.

OBJECTIVES: To assess the impact of a multi-tiered oral health education programme on care staff caring for people with intellectual disability (ID). METHODS: Postal questionnaires were sent to all care staff of a community-based residential care service for adults, randomly assigned to control and intervention groups. A specifically developed training programme was delivered to residential staff nominees, who then trained all staff within the intervention group. The control group received no training. Post-test questionnaires were sent to both groups. Paired-samples t-test was used to compare oral health-related knowledge (K) and behaviour, attitude and self-efficacy (BAS) scores. RESULTS: Of the initial 219 respondents, 154 (response rate between 40% and 35.8%, with attrition rate of 29.7% from baseline to repeat) returned completed questionnaires at post-test (M=8.5 months, range=6.5-11 months). Control and intervention groups were comparable for general training, employment and demographic variables. In the intervention group, mean Knowledge Index score rose from K=7.2 to K=7.9 (P<0.001) and mean BAS scale score rose from BAS=4.7 to BAS=5.4 (P<0.001). There was no statistically significant increase in mean scores from test (K=7.0, BAS=4.7) to post-test (K=7.2, BAS=4.9) for the control group. CONCLUSIONS: Mean scores regarding knowledge, attitude, self-efficacy and reported behaviour increased significantly at 8.5 months in staff where training was provided. The results indicate that a multi-tiered training programme improved knowledge, attitude, self-efficacy and reported behaviour amongst staff caring for people with ID.

Oral and maxillofacial surgery - a case of mistaken identity?

There are international grumbles from those perturbed by an impending identity crisis within oral and maxillofacial surgery (OMFS). This unrest is further compounded by scattered suggestions that a name change may prove beneficial in raising the profile of OMFS. The purpose of this paper is to consider novel methods of increasing awareness of the specialty amongst the public, primary and secondary care colleagues by collecting a consensus of thoughts and opinions regarding the specialty's identity and the appropriate and holistic nomenclature of OMFS. Approximately 300 eight-point questionnaires were distributed internationally with a response rate, via both email and post, of approximately 25% (72). Thirty-two percent of respondents considered there to be an identity crisis within OMFS although just 18% felt that a specialty name change would be beneficial. The results suggest that the problem with identity relates more to incapacity to convey the message of OMFS rather than nomenclature.

Effect of health education on knowledge and oral hygiene practices of persons living with HIV in Nairobi, Kenya.

OBJECTIVE: To assess the effect of oral health education on knowledge and oral health seeking behaviour of persons living with HIV/AIDS (PLWHA). METHODS: Quasi-experimental study design conducted among 195 Persons living with HIV/AIDS attending two Comprehensive Care Centres (CCC) at the Kenyatta National Hospital (intervention group) and Mbagathi district hospital (non-intervention group) in Nairobi Kenya. The participants were selected using systematic random sampling method and data collected using a questionnaire. Data was collected at baseline, at three months (review 1) and at six months (review 2). RESULTS: There was a significant change in oral health knowledge for KNH participants. However, no significant change in oral knowledge was recorded for MDH participants. The proportion of participants who brushed their teeth at least twice a day increased significantly from 52% to 88% for KNH. The proportion of those who had brushed the previous evening increased from 47% to 83.2%. There was no significant change in the proportion brushing at least twice a day among the non-intervention group. There was a significant association between change in knowledge and change to brushing at least twice a day among the intervention group. CONCLUSION: Oral health education led to improved oral health knowledge and oral hygiene practices among PLWHA.

It's magic: a unique practice management strategy.

For thousands of years prior to the advent of modern dentistry, magic has been used to entertain, impress, and motivate individuals. Today's dental professionals are using the concept of The Magic of a Healthy Smile through their use of modern clinical techniques and as a means for practice marketing, patient education, and the reduction of patient stress and fear. This article describes how dentists/magicians have incorporated magic into their practices and the benefits of this useful patient management strategy. A script of the "Happy Tooth Magic Show" and resources for dentists to create their own dental magic show are provided.

Improving children's dental health.

Surveys show that tooth decay in young children is becoming concentrated in more deprived sectors of the population. Only by targeting families with young children in underprivileged areas will dental health be improved further. An analysis of dental health promotion advice has shown that simple, direct advice to "brush teeth twice a day with fluoride toothpaste" is just as effective as complicated health promoting activities. Questions about the development of the teeth and oral structures are common among new parents but they rarely turn to the dental team for answers. Nurses, health visitors and midwives are very much in the front line because of their work with young families. Dental health advice for families with young children, delivered by community health professionals including health visitors and midwives, may be the key to tackling inequalities in oral health in young children.

Programa de salud bucal en escolares / Oral health program in schoolchildren

El objetivo de este trabajo es presentar un programa destinado a niños escolares considerados en riesgo social que se desarrolla en la ciudad de Avellaneda desde 1996. Utiliza medidas educativas, preventivas y restauradoras con el propósito de cambiar el perfil de la patología dominante. El componente educativo consiste en talleres participantes a cargo de un equipo interdisciplinario, y está dirigido a los alumnos de 1 a 7 grado del EGB (Educación General Básica). El componente asistencial incluye tratamientos preventivos, resolución de urgencias e infecciones prioritarias, extracciones y monitoreo. Como recurso físico se utiliza una Unidad Odontológica Móvil que se instala en la puerta de la escuela hasta lograr el 70 por ciento de las altas de los niños bajo programa. La población destinada del componente asistencial son alumnos de 1er grado de escuelas con escasa accesibilidad a los centros de salud. El modelo es incremental, manteniendo en control y atención los pacientes ya tratados e incorporan cada año los niños que ingresan a 1er grado

Programa de salud bucal en escolares / Oral health program in schoolchildren

El objetivo de este trabajo es presentar un programa destinado a niños escolares considerados en riesgo social que se desarrolla en la ciudad de Avellaneda desde 1996. Utiliza medidas educativas, preventivas y restauradoras con el propósito de cambiar el perfil de la patología dominante. El componente educativo consiste en talleres participantes a cargo de un equipo interdisciplinario, y está dirigido a los alumnos de 1 a 7 grado del EGB (Educación General Básica). El componente asistencial incluye tratamientos preventivos, resolución de urgencias e infecciones prioritarias, extracciones y monitoreo. Como recurso físico se utiliza una Unidad Odontológica Móvil que se instala en la puerta de la escuela hasta lograr el 70 por ciento de las altas de los niños bajo programa. La población destinada del componente asistencial son alumnos de 1er grado de escuelas con escasa accesibilidad a los centros de salud. El modelo es incremental, manteniendo en control y atención los pacientes ya tratados e incorporan cada año los niños que ingresan a 1er grado (AU)

Odontología para bebés / Dentistry for babies

El proyecto de la odontología para bebés se constituyó como respuesta a las necesidades de la comunidad en educación y atención en salud oral en el grupo etario de 0 a 5 años de edad. Dicho programa concientiza a las personas para entender que la salud bucal hace parte de la salud general, y al mismo tiempo, genera el trabajo participativo (profesionales-comunidad), posibilita el autocuidado y el mantenimiento de la salud, propicia el trabajo interdisciplinario y multiprofesional, cambia la mentalidad del motivo de consulta curativo al educativo/preventivo y, por ende, disminuye la prevalencia de caries dental en la población menor